Implications of HIV status disclosure

Exploring the experiences of pregnant and postpartum women in southwestern Uganda

Abstract

Disclosure of HIV status is critical for HIV prevention and control. However, although the benefits of HIV disclosure have received extensive documentation, the same cannot be said for its drawbacks. In the current study, we used a descriptive qualitative study design to highlight the implications of disclosure among 30 pregnant and postpartum women living with HIV in Uganda. We conducted a qualitative content analysis and found that healthcare professionals responded positively and supportively when HIV-positive pregnant and postpartum women disclosed their status, and that individuals who disclosed their status to their husbands but not to wider circles also experienced no mistreatment or discrimination. Contrarily, however, some husbands reacted unfavourably to their wife’s HIV-positive status when a larger audience was involved in the disclosure. In particular, we discovered that co-wives and in-laws promoted stigmatization, including violence, by husbands. The interaction between these HIV-positive women and their mothers also demonstrated both positive and negative implications. This counterintuitive attitude has the consequence of reducing the uptake of antiretroviral drugs. There is therefore a need for policies and initiatives that not only encourage disclosure to health professionals, spouses and a few close relatives or friends but prevent stigmatization, violence and other forms of abuse against HIV-positive women.