Factors Affecting Disclosure in South African HIV-Positive Pregnant Women
Factors Affecting Disclosure in South African HIV-Positive Pregnant Women
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DOI：
10.1089/apc.2007.0194
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发表时间：
2008-11-01
影响因子：
4.9
通讯作者：
Jeffery, Bridget
中科院分区：
文献类型：
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作者：
Makin, Jennifer D.;Forsyth, Brian W. C.;Jeffery, Bridget
为了了解影响妊娠期 HIV 阳性妇女披露 HIV 状况的社会和心理因素，南非比勒陀利亚产前诊所的 438 名 HIV 阳性妇女被邀请参加一项纵向研究。 2003 年 6 月至 2004 年 12 月期间，共有 293 名妇女（62%）入组。在怀孕期间和产后 3 个月时进行了评估社会人口统计学和心理测量的调查问卷。在注册时，59% 的人已向其伴侣透露，42% 的人已向其他人透露。后续这一比例分别上升至 67% 和 59%。逻辑回归分析确定已婚（调整后优势比 [AOR] 2.32；95% 置信区间 [CI] 1.20-4.47）、事先讨论过测试（AOR 4.19；CI 2.34-7.49）、有受过高等教育的伴侣（AOR 2.76；CI 1.29-5.88）和较少的暴力经历（AOR 0.48；CI） 0.24-0.97）作为与在注册前向合作伙伴披露相关的因素。更好的住房（AOR 1.26；CI 1.06-1.49）、对伴侣较少的经济依赖（AOR 0.46；CI 0.25-0.85）以及认识艾滋病毒感染者（AOR 2.13；CI 1.20-3.76）与事先向他人披露有关。基线时耻辱程度的增加降低了注册后向伴侣披露信息的可能性（AOR 0.91；CI 0.84-0.98），而回避应对水平的增加则减少了随后向他人披露的可能性（AOR 0.84；CI 0.72-0.97）。这些结果让我们了解了怀孕期间被诊断为艾滋病毒阳性的女性的信息披露情况，并确定了可用于筛查需要帮助的女性的变量。
To provide understanding of social and psychological factors that affect disclosure of HIV status among women diagnosed HIV-positive in pregnancy, 438 HIV positive women attending antenatal clinics in Pretoria, South Africa were invited to participate in a longitudinal study. A total of 293 (62%) women were enrolled from June 2003 to December 2004. Questionnaires assessing sociodemographics and psychological measures were administered during pregnancy and at 3 months postdelivery. At enrollment, 59% had disclosed to their partners and 42% to others. This rose to 67% and 59%, respectively, by follow-up. Logistic regression analysis identified being married (adjusted odds Ratio [AOR] 2.32; 95% confidence interval [CI] 1.20-4.47), prior discussion about testing (AOR 4.19; CI 2.34-7.49), having a partner with tertiary education (AOR 2.76; CI 1.29-5.88) and less experience of violence (AOR 0.48; CI 0.24-0.97) as factors associated with having disclosed to partners prior to enrollment. Better housing (AOR 1.26; CI 1.06-1.49), less financial dependence on partners (AOR 0.46; CI 0.25-0.85), and knowing someone with HIV (AOR 2.13; CI 1.20-3.76) were associated with prior disclosure to others. Increased levels of stigma at baseline decreased the likelihood of disclosure to partners postenrollment (AOR 0.91; CI 0.84-0.98) and increased levels of avoidant coping decreased subsequent disclosure to others (AOR 0.84; CI 0.72-0.97). These results provide understanding of disclosure for women diagnosed as HIV positive in pregnancy, and identify variables that could be used to screen for women who require help.