Barcelona 2013
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| Abstract #459 - E-Posters English | ||||
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Session: 50.39: E-Posters English (Poster) on Sunday in Chaired by Authors: Presenting Author: Dr Blandine Bila - Centre National de recherche scientifique et technologique (CNRST), Burkina Faso |
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| Additional Authors: Dr. Jordi Casabona, Sra Cristina Sanclemente, Dra. Anna Esteve, Dra. Victoria Gonzalez, Grupo HIVITS TS, | ||||
| Aim: Within the EMTCT (Elimination of Mother-to-Child Transmission) policy, pregnant women are proposed HIV testing on a PITC (Provider-Initiated Testing and Counseling) basis. If HIV-positive, PMTCT strategy is applied, which includes ART for prophylaxis and treatment purpose. In any case, during post-test counselling, women are requested to disclose soon their HIV+ status to their partners. In some African countries this pressure for disclosure by health professionals is reinforced by national legislation. The aim of this study is to describe its social effects in the case of women who discover their HIV-positive status during antenatal visits. | ||||
| Method / Issue: Within a study on social aspects of PMTCT in Senegal and Burkina Faso (PREMS/ANRS 12271), HIV-positive women who had discovered their HIV-status during antenatal visit were interviewed about their experiences and relationships with health workers. About 30 women had individual interviews in various contexts (after HIV diagnosis or after infant?s birth), as well as 15 community counsellors for PMTCT and key health workers. | ||||
| Results / Comments: Some women who were interviewed had not disclosed their HIV-status to their partners. Most of them explained that they could not do so within a short time span after diagnosis, but they were expecting for a more socially convenient situation, such as after the infant?s birth or after weaning. Some of them explained that disclosing might bring rejection by their husband, particularly in the case of women engaged in a second union after a divorce or the death of their first husband: in their case the fear of being the one who brought HIV in the couple was a strong psychological burden. Other women engaged in polygamous unions feared that their husband might disclose their status to co-spouses. In all cases women feared that their partners disclose to other people such as their mothers-in-law, who might reject them. The pressure to disclose was a source of psychological distress. Key informants mentioned that this issue is a cause for break in follow-up in PMTCT. | ||||
| Discussion: The pressure to disclose to partners is one of the main concerns of women who discovered their HIV-positive status through PMTCT. The social feasibility of disclosure is not homogenous for all women: in cases such as polygamous unions, second unions, a woman with a vulnerable status in her household, disclosing raises social risks. Women may plan to disclose later, after their infant?s birth or weaning. The psychological experience reported by women leads to consider the pressure to disclose as a form of violence. These data lead to reconsider this component of post-test counseling in the light of its social effects and public health expectations. | ||||
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