HIV status disclosure among postpartum women in rural Tanzania: predictors, experiences and uptake of a nurse-facilitated disclosure intervention

• Type of Material: Article
• Authors: E. Geubbels, Ifakara Health Institute; Anne Williams, Emory University; A. Ramaiya, Ifakara Health Institute; D. Tancredi, University of California Davis; S. Young, Cornell University; C. Chantry, University of California Davis
• Language: English
• Date: 2018-04-03
• Publisher: Taylor & Francis (Routledge): STM, Behavioural Science and Public Health Titles
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: Copyright © 2018 Informa UK Limited
• Final Published Version (URL): http://dx.doi.org/10.1080/09540121.2018.1428724
• Title of Journal or Parent Work: AIDS Care
• ISSN: 0954-0121
• Volume: 30
• Issue: 4
• Start Page: 417
• End Page: 425
• Grant/Funding Information: This work was supported by Campbell Foundation [grant number 5-10]; National Institute of Mental Health [grant number K01 MH098902]; National Institutes of Health [grant number R34 200513446-7].
• Keywords: Tanzania; mothers; HIV; Disclosure
• Research Categories: Health Sciences, Obstetrics and Gynecology; Health Sciences, Public Health; Health Sciences, Immunology

Abstract

HIV status disclosure is a key support strategy to start and maintain HIV care and treatment and to reduce HIV transmission. We explored the patterns and correlates of disclosure and described the effectiveness of nurse-facilitated disclosure among HIV-infected mothers of infants in coastal Tanzania. We enrolled 400 HIV positive women in an observational longitudinal study in 2011,interviewed them about maternal sociodemographic and economic characteristics, maternal and child health and history of HIV disclosure experiences and offered nurse-facilitated HIV disclosure at enrollment or at follow-up 1 month later. Mothers frequently disclosed their status to husbands and/or female relatives and experienced predominantly positive reactions. Economically vulnerable women disclosed more often to elderly female relatives, indicating that Infant and Young Child Feeding counselling given to HIV positive women should garner the support of elderly female relatives for implementing appropriate feeding practices. Nurse-facilitated disclosure was feasible in this low resource setting and was used by patients to help them with both first-time disclosure and disclosure to new persons.