Disclosure of HIV status among HIV-infected pregnant and postpartum women in Cape Town, South Africa
type: CreativeWork
description: Background: With 2.7 million women living with HIV, the burden of HIV remains high in South Africa but adherence to antiretroviral therapy remains a concern among pregnant and postpartum women. Disclosure, or the process of gradually revealing one’s HIV status to individuals in one’s social network, is regarded as an important factor in HIV care, with potential benefits that include improved psychological well-being and adherence to antiretroviral therapy. This thesis sought to provide insights into the patterns, predictors and impact of HIV-status disclosure among pregnant and postpartum women in the context of lifelong antiretroviral therapy in South Africa, including considerations of stigma, social support, depression and unintended pregnancy. Methods: This research included women living with HIV in Gugulethu, Cape Town. A total of 1554 pregnant women were enrolled; those who were initiating antiretroviral therapy were followed up to 18 months postpartum, with one further visit at 36-60 months postpartum. Data were collected using questionnaires and blood specimens for HIV viral load testing. Findings: Across analyses, women’s social and economic circumstances emerged as central to understandings of disclosure, mental health and viral load. At entry into antenatal care, 95% of women who were diagnosed HIV-positive before the pregnancy had disclosed to at least one person but disclosure events formed two separate dimensions: disclosure to (i) a male partner and (ii) family/community members. Among women diagnosed during the pregnancy and initiating antiretroviral therapy, 61% disclosed to a male partner and 71% to a family/community member by 12 months after diagnosis; relationship status modified the impact of each of pregnancy intentions and poverty on disclosure to a male partner. During pregnancy, 1 in 10 women reported elevated depressive symptoms and 60% of women who were subsequently followed during the postpartum period reported that their pregnancy was u…
abstract: Background: With 2.7 million women living with HIV, the burden of HIV remains high in South Africa but adherence to antiretroviral therapy remains a concern among pregnant and postpartum women. Disclosure, or the process of gradually revealing one’s HIV status to individuals in one’s social network, is regarded as an important factor in HIV care, with potential benefits that include improved psychological well-being and adherence to antiretroviral therapy. This thesis sought to provide insights into the patterns, predictors and impact of HIV-status disclosure among pregnant and postpartum women in the context of lifelong antiretroviral therapy in South Africa, including considerations of stigma, social support, depression and unintended pregnancy. Methods: This research included women living with HIV in Gugulethu, Cape Town. A total of 1554 pregnant women were enrolled; those who were initiating antiretroviral therapy were followed up to 18 months postpartum, with one further visit at 36-60 months postpartum. Data were collected using questionnaires and blood specimens for HIV viral load testing. Findings: Across analyses, women’s social and economic circumstances emerged as central to understandings of disclosure, mental health and viral load. At entry into antenatal care, 95% of women who were diagnosed HIV-positive before the pregnancy had disclosed to at least one person but disclosure events formed two separate dimensions: disclosure to (i) a male partner and (ii) family/community members. Among women diagnosed during the pregnancy and initiating antiretroviral therapy, 61% disclosed to a male partner and 71% to a family/community member by 12 months after diagnosis; relationship status modified the impact of each of pregnancy intentions and poverty on disclosure to a male partner. During pregnancy, 1 in 10 women reported elevated depressive symptoms and 60% of women who were subsequently followed during the postpartum period reported that their pregnancy was u…
author: Brittain, Kirsty Jane
keywords: Public Health
date published: 2019
date modified: 2026-07-22T22:23:30Z
provider: University of Cape Town
publisher: Networked Digital Library of Theses and Dissertations
type: WebPage
source organization: Department of Public Health and Family Medicine

PropertyValue
property ID: Handle
value: http://hdl.handle.net/11427/31409