title: Serodiscordance and disclosure among HIV-positive pregnant women in the Southwestern United States.
abstract: The prevalence of HIV-positive pregnant women in relationships with HIV-negative men in the United States is unclear. The purpose of this study was to calculate the prevalence of HIV-positive pregnant women with a serodiscordant (HIV-negative) partner within a single clinic population, assess disclosure of their HIV status, and examine factors associated with disclosure. All HIV-positive pregnant women who received prenatal care at the Harris County Hospital District Women's Program at Northwest Health Center in Houston TX between 1/1/2006 and 4/1/2011 were identified. Data were obtained from electronic medical records. Prevalence of serodiscordance and disclosure was calculated, and predictors of disclosure were evaluated. We identified 212 HIV-positive pregnant women. About 40% had a serodiscordant partner, and 34% had a partner with an unknown HIV status. Disclosure occurred in over 90% of women with a serodiscordant partner and in 68% of women with partners whose HIV status was unknown. Among pregnant women who knew their HIV status prior to the current pregnancy and had a serodiscordant partner, 92% reported disclosing their status prior to conception. Our data indicated that serodiscordant relationships are common in our clinic population. Suboptimal disclosure rates were observed, especially among women who have a partner with an unknown HIV status. Further research is needed to evaluate the prevalence of serodiscordance and disclosure in other United States populations.
authors.affiliation: Physician Assistant Program, Baylor College of Medicine, Houston, Texas, USA.
authors.forename: Lori A
authors.initials: LA
authors.lastname: Nacius
authors.forename: Judy
authors.initials: J
authors.lastname: Levison
authors.forename: Charles G
authors.initials: CG
authors.lastname: Minard
authors.forename: Carl
authors.initials: C
authors.lastname: Fasser
authors.forename: Jessica A
authors.initials: JA
authors.lastname: Davila
mesh_terms: D000328:Adult; D005260:Female; D006678:HIV / Q000276:immunology*; D018023:HIV Seronegativity; D006679:HIV Seropositivity / Q000453:epidemiology / Q000523:psychology*; D006766:Hospitals, County; D006801:Humans; D008297:Male; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000453:epidemiology / Q000523:psychology*; D011295:Prenatal Care; D015995:Prevalence; D012189:Retrospective Studies; D012747:Sexual Partners; D057545:Social Stigma; D012959:Socioeconomic Factors; D015206:Southwestern United States; D013781:Texas / Q000453:epidemiology; D014342:Truth Disclosure; D019562:Viral Load