Community Cultural Norms, Stigma and Disclosure to Sexual Partners among Women Living with HIV in Thailand, Brazil and Zambia (HPTN 063)

July 2016 - Structural Prevention

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Ojikutu, B.O., Pathak, S., Srithanaviboonchai, K., et al. PLOS ONE (May 2016), 11(5): e0153600, doi: 10.1371/journal.pone.0153600, eCollection 2016.

This study explored the disclosure patterns of HIV-positive women in three settings with concentrated or generalized epidemics: Brazil (n = 99), Thailand (n = 100), and Zambia (n = 100). The authors assessed disclosure to sexual partners, sexual risk behavior, and clinical status were assessed at baseline and at 3, 6, 9 and 12 months via audio computer-assisted survey. At baseline, half of all women (45.3%) reported perceived community HIV stigma at baseline; and 42.9 percent acknowledged perceived community gender norms (marriage and procreation). More Zambian women (66%) endorsed these norms than Thai (38%) or Brazilian women (24%). Two-thirds (67%) of women reported disclosing to their sexual partner at baseline. No significant difference was noted in disclosure to sexual partners over time among the total group or within and across sites. Women who were older (24–44 versus 18–24), had symptoms of severe depression, and those who reported anticipated stigma, were less likely to disclose. Women who were unmarried and those who were not cohabiting with their partner were also less likely to disclose to their sexual partners. The authors concluded that interventions to promote disclosure among women in serodiscordant relationships should incorporate community-level interventions to reduce stigma and promote gender equality.

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