AIDS and Behavior

, Volume 17, Issue 2, pp 488–497 | Cite as

Non-Disclosure of a Pregnant Woman’s HIV Status to Her Partner is Associated with Non-Optimal Prevention of Mother-to-Child Transmission

  • C. Jasseron
  • L. Mandelbrot
  • C. Dollfus
  • N. Trocmé
  • R. Tubiana
  • J. P. Teglas
  • A. Faye
  • C. Rouzioux
  • S. Blanche
  • J. Warszawski
Original Paper

Abstract

Our objective was to study relations between non-disclosure of HIV to partner, socio demographics and prevention of HIV mother-to-child transmission (PMTCT), among HIV-infected pregnant women enrolled in the French Perinatal Cohort (ANRS-EPF-CO1) from 2005 to 2009 (N = 2,952). Fifteen percent of the women did not disclose their HIV status to their partner. Non-disclosure was more frequent in women diagnosed with HIV infection late in pregnancy, originating from Sub-Saharan Africa or living alone, as well as when the partner was not tested for HIV. Non-disclosure was independently associated with non optimal PMTCT: late initiation of antiretroviral therapy, detectable viral load at delivery and lack of neonatal prophylaxis. Nonetheless, the rate of transmission did not differ according to disclosure status. Factors associated with non-disclosure reflect vulnerability and its association with non optimal PMTCT is a cause for concern although the impact on transmission was limited in this context of universal free access to care.

Keywords

HIV/AIDS Prevention of mother-to-child transmission Non-disclosure during pregnancy Access to care Public health 

Resumen

Nuestro objetivo fue estudiar relaciones entre la no revelación del diagnostico de infección por VIH a la pareja y socio-demográficos factores y prevención de la transmisión madre-niño del VIH (PTMN). Todas las mujeres embarazadas seropositivas que forman parte de la encuesta perinatal francesa (ANRS-EPF-CO1) de 2005 a 2009 fueron incluidas (N = 2,952). Quince por ciento no habían revelado su estatus de VIH a su compañero. La no revelación fue más frecuente en mujeres con un diagnóstico en etapas tardías del embarazo, originarias de África subsahariana o viviendo solas y cuando el compañero no había sido estudiado para el VIH. La no revelación fue asociada independamente a PTMN no óptima: iniciación tardía de la terapia anti-retroviral, carga viral detectable en el parto y ausencia de profilaxis neonatal. Sin embargo, la tasa de transmisión no fue diferente según el estatus de revelación. Factores asociados con la no revelación reflejan vulnerabilidad y su asociación con PTMN no óptima es preocupante aunque con un impacto limitado en un contexto con acceso universal y gratuito al tratamiento.

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Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  • C. Jasseron
    • 1
    • 2
  • L. Mandelbrot
    • 1
    • 3
    • 4
  • C. Dollfus
    • 8
  • N. Trocmé
    • 8
  • R. Tubiana
    • 5
    • 6
  • J. P. Teglas
    • 1
  • A. Faye
    • 3
    • 7
  • C. Rouzioux
    • 9
    • 10
  • S. Blanche
    • 10
    • 11
  • J. Warszawski
    • 1
    • 2
    • 12
  1. 1.INSERM, UMRS 1018, CESP-HIV/IST EpidemiologyLe Kremlin-BicêtreFrance
  2. 2.Department of EpidemiologyAP-HP, Hospital BicêtreLe Kremlin-BicêtreFrance
  3. 3.Université Paris VII DiderotParisFrance
  4. 4.Department of Gynecology and ObstetricsAP-HP, Hospital Louis MourierColombesFrance
  5. 5.Department of Infectious DiseasesAP-HP, Hospital Pitié SalpêtrièreParisFrance
  6. 6.INSERM, U943ParisFrance
  7. 7.Departement of PediatricsAP-HP, Hospital Robert DebréParisFrance
  8. 8.Department of Pediatric Oncology-HematologyAP-HP, Hospital TrousseauParisFrance
  9. 9.Virology LaboratoryAP-HP, Hospital NeckerParisFrance
  10. 10.Université Paris V DescartesParisFrance
  11. 11.Department of Pediatric Immuno-HematologyAP-HP, Hospital NeckerParisFrance
  12. 12.Université Paris-Sud, UMRS 1018Le Kremlin-BicêtreFrance

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