Marseille 2007
Marseille 2007
Abstract book
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Abstract #67  -  Does a woman positive HIV-test result lead to enhanced breaking off of the conjugal relationship ? Experience of a PMTCT program in Abidjan, Cote dIvoire, 2001-2005.
Session:
  25.7: Couples (Parallel) on Monday @ 16.30-18.30 in PR Chaired by Jose Catalan, Giovanna Meystre-Agustone
Authors:
  Presenting Author:   Dr Annabel Desgrees du Lou - IRD, France
 
  Additional Authors:  Dr Hermann Brou, Mr Gerard Djohan, Dr Annick Tijou Traore, Dr Didier Ekouevi, Dr Renaud Becquet, Dr Valeriane Leroy,  
Aim:
In resource-limited countries, prevention of mother to child transmission of HIV using antiretrovirals during pregnancy and labour is now available at moderate cost. Such programmes are developped at a large scale. The first step of these programmes consists in the offer of HIV-testing to women attending antenatal care. This HIV-testing allows HIV-infected pregnant women to access to PMTCT interventions, and for HIV-negative women, it is also a mean to encourage them to preserve their negative HIV-status. But this HIV-testing is offered to pregnant women generally engaged in conjugal relationship. After HIV-testing, these women have to take into account their test result in their relation to their male partner. We explore here if these HIV-tested women disclose their test result to their partner and whether a positive HIV-test lead or not to a breaking off of the conjugal relationship.
 
Method / Issue:
In the DITRAME PLUS prevention of mother-to-child HIV transmission project conducted in Abidjan, Cte dIvoire, between 2001 and 2005, HIV-testing was offered to pregnant women. Women HIV-tested and informed of their HIV-status were followed-up 24 months after delivery. At the M18 visit, women were administered a close-ended questionnaire on conjugal issues. We compared, according to the womans HIV status, the proportion of breaking off of the conjugal relationship between the HIV-test and 18 months after delivery, adjusted on socio-demographic factors, on marital status at enrollment and on whether the partner had been informed of the woman HIV test result.
 
Results / Comments:
After HIV testing, 347 HIV-positive women and 393 HIV-negative women were followed up and performed the M18 survey. They all had a male partner at the moment of HIV-testing. Only 42% of HIV-positive women informed their partner of their infection. Negative reactions of the partner were rare (7%). During the 18 months follow-up, 7% of the HIV-positive women and 2% of the HIV-negative women lost their partner by death. When the male partner staid alive, the relationship with this partner was broken off among 15.5% (50/322) of the HIV-positive women versus 2.1% (8/385) of the HIV negative women (p<0.01). Among HIV positive women, the break-up of the union was more frequent among young women (31% for women aged 18-19 versus 13% for women aged 25-29), when the parners did not live together (33% vs 9%) and in polygamous union (32% vs 12% in monogamous union). The frequency of conjugal breaking off did not increase when the male partner was informed of the woman serostatus.
 
Discussion:
Women informed that they are HIV-infected are more likely than others to break-up their conjugal relationship and become single. Nevertheless, it appears that it is not so much due to a negative reaction of the male partner but moreover a decision of the woman : when the conjugal bond is weak (union without coresidence, necessity to cope with co-spouses, ...), it seems that women prefer to break this union rather than to face the difficulties of a conjugal relationship coping with HIV/aids.
 
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