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Pride Mucheto, Addmore Chadambuka, Gerald Shambira, Mufuta Tshimanga, Gombe Notion, Wenceslas Nyamayaro. Determinants of nondisclosure of HIV status among women attending the prevention of mother to child transmission programme, Makonde district, Zimbabwe, 2009. The Pan African Medical Journal. 2011;8:51 Key words: Prevention of mother to child transmission, HIV Status, Determinants, Women Permanent link: http://www.panafrican-med-journal.com/content/article/8/51/full Received: 11/01/2011 - Accepted: 01/04/2011 - Published: 30/04/2011 © Pride Mucheto et al. The Pan African Medical Journal - ISSN 1937-8688. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
Determinants of nondisclosure of HIV status among women attending the prevention of mother to child transmission programme, Makonde district, Zimbabwe, 2009
Pride Mucheto1, Addmore Chadambuka1,&, Gerald Shambira1, Mufuta Tshimanga1, Gombe Notion1, Wenceslas Nyamayaro2
1Department of Community Medicine, University of Zimbabwe, Harare, Zimbabwe, 2Provincial Medical Directorate, Mashonaland West, Zimbabwe
&Corresponding author
Addmore Chadambuka, University of Zimbabwe, School of Medicine, Department of Community Medicine AV 178, Harare, Zimbabwe
The 2007 United Nations General Assembly Report on HIV/AIDS in Zimbabwe reported nondisclosure of HIV status as a challenge in the PMTCT programme. Preliminary investigations on nondisclosure among 21 women tested for HIV at Chinhoyi Hospital showed that only six had disclosed their HIV status. We investigated the determinants of nondisclosure of HIV status.
A cross sectional analytic study was conducted at six health facilities in Makonde district. The Theory of Planned Behaviour was adapted to guide socio-cultural variables assessed. Antenatal and postnatal women tested for HIV in the PMTCT program who consented to participate were interviewed.
We enrolled 334 women. Thirty four percent (114) did not disclose their HIV status. Among HIV positive respondents, 43% (25) did not disclose their status. Women who believed disclosure caused physical abuse (OR=1.81, 95% CI: 1.17-2.90), caused divorce (OR=2.01, 95% CI: 1.25-3.22) and was unimportant (OR= 2.26, 95% CI: 1.33-3.87) were two times less likely to disclose their status. Respondents who received group HIV pre-test counselling were 2.4 times more likely not to disclose. Receiving ANC HIV education at least twice and referral for psychosocial support were significantly protective [OR 0.54 (95% CI 0.24-0.63) and 0.16 (95% CI: 0.06-0.41) respectively. Independent determinants of nondisclosure among HIV positive women were perception that disclosure would cause divorce (AOR=7.82, p=0.03), living with an extended family (AOR=10.3, p=0.01) and needing spousal approval of HIV testing (AOR= 0.11, p<0.001).
Lack of psychosocial support and counselling for women and belief that disclosure causes divorce, abuse or is unimportant contributes to nondisclosure. Identifying women with social challenges and strengthening their referral for psychosocial support can improve disclosure of HIV status and reduce mother to child transmission of HIV.
