Factors influencing sexually transmissible infection disclosure to male partners by HIV-positive pregnant women in Pretoria townships, South Africa: a qualitative study
Factors influencing sexually transmissible infection disclosure to male partners by HIV-positive pregnant women in Pretoria townships, South Africa: a qualitative study
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DOI：
10.1071/sh18177
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发表时间：
2019-01-01
期刊：
影响因子：
1.6
通讯作者：
Medina-Marino, Andrew
中科院分区：
文献类型：
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作者：
Daniels, Joseph;De Vos, Lindsey;Medina-Marino, Andrew
性传播感染（STI）可能会增加母婴传播（MTCT）的风险。然而，在南非，怀孕期间对性传播感染（STI-TT）进行诊断检测和有针对性的治疗并不是标准的护理。研究方法：一项定性研究嵌套在STI-TT干预调查的动机和使能因素与STI检测结果披露性伴侣。半结构化访谈程序包括伙伴沟通、艾滋病毒和性传播感染披露、财务安全和关系动态。访谈以参与者首选的语言进行，录音，转录成英文，并使用不断比较的方法进行分析。这项研究在南非比勒陀利亚的两个乡镇进行。结果：28例HIV阳性孕妇接受了访谈。根据访谈，两个披露经验的妇女被确定-那些与脆弱的经验和那些与自我扶持的经验，在他们的伙伴关系。易受伤害的妇女讨论了亲密伴侣暴力（IPV）和关系的解体的恐惧，影响他们的测试结果披露的因素。自力更生的妇女讨论了她们与伴侣谈论性传播感染和艾滋病毒感染的能力，以及多个同时存在的伴侣关系对感染艾滋病毒/性传播感染的影响。这两组妇女都对男子的健康行为感到关切，她们都认为未出生的孩子的健康和发育是披露检测结果的一个关键动机。结论：加强对孕妇的咨询和支持，使其向伴侣披露其性传播感染检测结果，可以改善伴侣接受治疗的情况，从而减少再次感染的风险，从而提高怀孕期间性传播感染诊断检测的影响。
Background Sexually transmissible infections (STI) may increase the risk of mother-to-child transmission (MTCT) of HIV. However, diagnostic testing and targeted treatment of STI (STI-TT) during pregnancy is not standard care in South Africa. Methods: A qualitative study was nested in a STI-TT intervention to investigate motivating and enabling factors associated with STI test results disclosure to sexual partners. A semi-structured interview protocol covered partner communication, HIV and STI disclosure, financial security and relationships dynamics. Interviews were conducted in participants' preferred language, audio-recorded, transcribed into English and analysed using a constant comparison approach. The study was conducted in two townships in Pretoria, South Africa. Results: Twenty-eight HIV-positive pregnant women were interviewed. Based on the interviews, two disclosure experiences for women were identified - those with vulnerable experiences and those with self-enabling experiences within their partnerships. Vulnerable women discussed intimate partner violence (IPV) and fear of relationship dissolution as factors influencing their test result disclosure. Self-enabled women discussed their ability to talk with their partners about STI and HIV infections and the influence of multiple concurrent partnerships in the acquisition of HIV/STIs. Both groups of women were concerned about men's health behaviours, and all cited the health and development of their unborn child as a key motivator for test result disclosure. Conclusions: Improved counselling and support for pregnant women to disclose their STI test results to their partners may improve the impact of STI diagnostic testing during pregnancy by improving partner treatment uptake and thus reducing the risk of re-infection.