Double disclosure bind: complexities of communicating an HIV diagnosis in the context of unintended pregnancy in Durban, South Africa.

Journal: AIDS and behavior

Volume: 18 Suppl 1

Issue: 0 1

Year of Publication: 2014

Affiliated Institutions:  Department of Public Health Medicine, University of KwaZulu-Natal, Durban, South Africa, tlcrankshaw@gmail.com.

Abstract summary 

Disclosure of HIV status is widely promoted in the prevention of mother-to-child transmission (PMTCT), but a number of context-specific factors may mediate disclosure outcomes. To better understand HIV-disclosure dynamics, we conducted in-depth interviews among 62 HIV-positive pregnant women accessing PMTCT services in Durban, South Africa. Transcripts were coded for emergent themes and categories. Thirty-nine women (63 %) had been recently diagnosed with HIV; most (n = 37; 95 %) were diagnosed following routine antenatal HIV testing. Forty-two women (68 %) reported unplanned pregnancies. Overall, 37 women (60 %) reported an unintended pregnancy and recent HIV diagnosis. For them, 2 life-changing diagnoses had resulted in a double-disclosure bind. The timing and stigma surrounding these events strongly influenced disclosure of pregnancy and/or HIV. PMTCT-related counseling must be responsive to the complex personal implications of contemporaneous, life-changing events, especially their effect on HIV-disclosure dynamics and, ultimately, on achieving better maternal mental-health outcomes.

Authors & Co-authors:  Crankshaw Tamaryn L TL Voce Anna A King Rachel L RL Giddy Janet J Sheon Nicolas M NM Butler Lisa M LM

Study Outcome 

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Statistics
Citations :  UNAIDS. Opening up the HIV/AIDS epidemic: Guidance on encouraging beneficial disclosure, ethical partner counselling & appropriate use of HIV case-reporting. Geneva: UNAIDS/WHO; 2000.
Authors :  6
Identifiers
Doi : 10.1007/s10461-013-0521-1
SSN : 1573-3254
Study Population
Women
Mesh Terms
Adult
Other Terms
Study Design
Cross Sectional Study
Study Approach
Country of Study
South Africa
Publication Country
United States