title: A cross-sectional study of the magnitude, barriers, and outcomes of HIV status disclosure among women participating in a perinatal HIV transmission study, "the Nevirapine Repeat Pregnancy study".
abstract: BACKGROUND
  HIV status disclosure is a difficult emotional task for HIV-infected persons and may create the opportunity for both social support and rejection. In this study, we evaluated the proportions, patterns, barriers and outcomes of HIV- 1 status disclosure among a group of women in Uganda.
  
  
  METHODS
  An exit interview was conducted one year post-partum for 85 HIV-infected women who participated in a study of HIV-1 transmission rates among NVP-experienced compared with NVP-naïve women in "The Nevirapine Repeat Pregnancy (NVP-RP) Study" at the Makerere University-Johns Hopkins University Research Collaboration, Kampala-Uganda, between June 2004 and June 2006.
  
  
  RESULTS
  Of the 85 women interviewed, 99 % had disclosed their HIV status to at least one other person. Disclosure proportions ranged between 1 % to employer(s) and 69 % to a relative other than a parent. Only 38 % of the women had disclosed to their sex partners. Women with an HIV-infected baby were more likely than those with an uninfected baby to disclose to their sex partner, OR 4.9 (95 % CI, 2.0 -11.2), and women were less likely to disclose to a partner if they had previously disclosed to another relative than if they had not, OR 0.19 (95 % CI, 0.14-0.52). The most common reasons for non-disclosure included fear of separation from the partner and subsequent loss of financial support 34 %, and not living with the partner (not having opportunities to disclose) 26 %. While most women (67 %) reported getting social support following disclosure, 22 % reported negative outcomes (neglect, separation from their partners, and loss of financial support). Following disclosure of HIV status, 9 % of women reported that their partner (s) decided to have an HIV test.
  
  
  CONCLUSIONS
  Results from this study show high overall HIV disclosure proportions and how this disclosure of HIV status can foster social support. However, proportions of disclosure specifically to male sex partners were low, which suggests the need for interventions aimed at increasing male involvement in perinatal care, along with supportive counseling.
authors.affiliation: Makerere University-Johns Hopkins University (MU-JHU) Research Collaboration, Kampala, Uganda. fmatovu@musph.ac.ug.|Department of Epidemiology and Biostatistics, Makerere University School of Public Health, Makerere University College of Health Sciences, Kampala, Uganda. fmatovu@musph.ac.ug.|Makerere University - Johns Hopkins University Research Collaboration, MU-JHU Research Building, Old Mulago Hill Road, P.O. Box 23491, Kampala, Uganda. fmatovu@musph.ac.ug.
authors.forename: Flavia M
authors.initials: FM
authors.lastname: Kiweewa
authors.affiliation: Case Western Reserve University, Ohio, USA. pmb18@case.edu.
authors.forename: Paul M
authors.initials: PM
authors.lastname: Bakaki
authors.affiliation: US Department of Health and Human Services, Centers for Disease Control and Prevention, Hanoi, Vietnam. mcconnell@vn.cdc.gov.
authors.forename: Michelle S
authors.initials: MS
authors.lastname: McConnell
authors.affiliation: Makerere University-Johns Hopkins University (MU-JHU) Research Collaboration, Kampala, Uganda. mmusisi@mujhu.org.
authors.forename: Maria
authors.initials: M
authors.lastname: Musisi
authors.affiliation: Makerere University-Johns Hopkins University (MU-JHU) Research Collaboration, Kampala, Uganda. nkcconie@yahoo.co.uk.
authors.forename: Constance
authors.initials: C
authors.lastname: Namirembe
authors.affiliation: Makerere University-Johns Hopkins University (MU-JHU) Research Collaboration, Kampala, Uganda. nakayiwafrances@yahoo.co.uk.
authors.forename: Frances
authors.initials: F
authors.lastname: Nakayiwa
authors.affiliation: Makerere University-Johns Hopkins University (MU-JHU) Research Collaboration, Kampala, Uganda. fkusasira@mujhu.org.
authors.forename: Fiona
authors.initials: F
authors.lastname: Kusasira
authors.affiliation: Makerere University-Johns Hopkins University (MU-JHU) Research Collaboration, Kampala, Uganda. dnakintu@jcrc.org.
authors.forename: Dorothy
authors.initials: D
authors.lastname: Nakintu
authors.affiliation: Makerere University-Johns Hopkins University (MU-JHU) Research Collaboration, Kampala, Uganda. mmubiru@mujhu.org.
authors.forename: Michael C
authors.initials: MC
authors.lastname: Mubiru
authors.affiliation: Makerere University-Johns Hopkins University (MU-JHU) Research Collaboration, Kampala, Uganda. pmusoke@mujhu.org.|Department of Pediatrics and Child Health, Makerere University School of Medicine, University College of Health Sciences, Makerere, Uganda. pmusoke@mujhu.org.
authors.forename: Philippa
authors.initials: P
authors.lastname: Musoke
authors.affiliation: Johns Hopkins University School of Medicine, Baltimore, MD, USA. mgfowler@mujhu.org.
authors.forename: Mary Glenn
authors.initials: MG
authors.lastname: Fowler
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D030881:Disclosure; D005239:Fear; D005260:Female; D015658:HIV Infections / Q000175:diagnosis / Q000523:psychology / Q000635:transmission / Q000821:virology; D015497:HIV-1; D006801:Humans; D008403:Mass Screening; D008875:Middle Aged; D019829:Nevirapine / Q000627:therapeutic use; D049590:Postpartum Period; D011247:Pregnancy; D012747:Sexual Partners; D012944:Social Support; D014454:Uganda; D055815:Young Adult
chemical_list: D019829:Nevirapine