Background: Non-disclosure of HIV positive status to a partner threatens to reverse
gains made in prevention of mother-to-child transmission (PMTCT) in resource
limited settings. Determining the association between non-disclosure and infant HIV
acquisition is important to justify focussing on disclosure as a strategy in PMTCT
programmes.
Objective: To determine the association between non-disclosure of HIV positive
status to a partner and mother-to-child transmission (MTCT).
Methods: Using a matched case-control design, we compared 34 HIV positive
infants to 146 HIV negative infants and evaluated whether the mothers had disclosed
their HIV status to their partner.
Results: Non-disclosure was more frequent among cases (overall, 16.7%; cases,
52.8%; controls 7.6%), p<0.001 and significantly associated with MTCT (aOR 8.9
(3.0-26.3); p<0.0001), with male partner involvement partially mediating the effect of
non-disclosure on MTCT.
Conclusions: There is a need for PMTCT programmes to focus on strategies to
improve male partner involvement and partner disclosure without compromising the
woman’s safety.