title: Factors associated with non-disclosure of HIV infection status of new mothers in Bangkok.
abstract: The objective of this study was to estimate HIV disclosure rates and identify factors that predict non-disclosure in Thai women who tested HIV positive during pregnancy or at delivery. This was a cohort study evaluating the implementation of prevention of mother-to-child HIV transmission programs at two Bangkok hospitals in 1999-2003. All HIV-infected women who delivered during the study period were enrollment eligible. Thai-language questionnaires were used to collect baseline data before discharge from the hospital. At the 1 and 4 month follow-up visits, women were asked if they had disclosed their HIV status. Of the 799 women who enrolled, 647 (81.0%) completed follow-up at 1 and 4 months. Four hundred fifty-three (70.0%) women disclosed their status by 1 month. Of the 194 women who had not disclosed by 1 month, 48 (24.7%) had disclosed their status by 4 months. An independent increased odds of non-disclosure by 1 month was associated with not having a partner tested for HIV (OR=5.83, 95% CI=3.19-9.08) or not knowing if the partner was ever tested for HIV (OR=1 3.02, 95% Cl=5.26-32.28), first learning of HIV positive status during delivery (OR=6.84, 95% CI=2.36-19.81) or after delivery (OR=3.14, 95% CI=1.57-6.26) and having >2 lifetime sexual partners (OR=1.71, 95% CI=1.04-2.82). Not living with a partner every day was associated with non-disclosure by 4 months in those women who had not disclosed by 1 month (OR=2.28, 95% CI=1.43-3.64). Despite high rates of disclosure by 1 month, 22.6% of women still had not disclosed their HIV status to their partners by 4 months. The benefits of disclosure warrant effective interventions targeted at women at risk for non-disclosure.
authors.affiliation: Thailand MOPH-US CDC Collaboration, Nonthaburi, Thailand.
authors.forename: Natapakwa
authors.initials: N
authors.lastname: Skunodom
authors.forename: Robert W
authors.initials: RW
authors.lastname: Linkins
authors.forename: Mary E
authors.initials: ME
authors.lastname: Culnane
authors.forename: Jerawan
authors.initials: J
authors.lastname: Prymanee
authors.forename: Chantima
authors.initials: C
authors.lastname: Kannasoot
authors.forename: Waraporn
authors.initials: W
authors.lastname: Suwannapha
authors.forename: Suratsavadee
authors.initials: S
authors.lastname: Suwanmaitre
authors.forename: Chariya
authors.initials: C
authors.lastname: Utenpitak
authors.forename: Chanidapa
authors.initials: C
authors.lastname: Yuvasevee
authors.forename: Achara
authors.initials: A
authors.lastname: Teeraratkul
authors.forename: R J
authors.initials: RJ
authors.lastname: Simonds
authors.forename: Jordan W
authors.initials: JW
authors.lastname: Tappero
mesh_terms: D000293:Adolescent; D000328:Adult; D015331:Cohort Studies; D030881:Disclosure / Q000706:statistics & numerical data*; D005260:Female; D015658:HIV Infections / Q000523:psychology*; D006304:Health Status; D006801:Humans; D017533:Marital Status; D009035:Mothers / Q000706:statistics & numerical data*; D015999:Multivariate Analysis; D011247:Pregnancy; D011795:Surveys and Questionnaires