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  • Author
    Raeven Grant
  • Discovery PI

    W. Chris Buck

  • Project Co-Author

    Hélio Brande, Winete Joaquim, Camille Rich, Sónia Martins, Quim Adriano, Natália Nipaco, Rito Eleutério, Alice Maieca, Atija Salimo, Merunissa Gafur, Jahit Sacarlal, Olga Cambaco

  • Abstract Title

    Sociocultural barriers to and facilitators of HIV status disclosure by mothers of hospitalized infants to their partners in northern and southern Mozambique

  • Discovery AOC Petal or Dual Degree Program

    Global Health

  • Abstract

    Specialty (if any): n/a

    Keywords: disclosure, HIV, Mozambique

    Background: Mozambique has a 10% vertical HIV transmission (VT) rate with 12,000 new pediatric infections per year. Non-disclosure of HIV status to male partners by pregnant and breastfeeding women is a known barrier to prevention of VT.

    Objectives: To understand the experience of Mozambican women living with HIV (WLHIV) regarding disclosure to male partners with a comparative assessment between the northern and southern regions, and assessment of infant serostatus according to maternal disclosure.

    Methods: A qualitative study was implemented using semi-structured interviews. WLHIV whose infants were hospitalized at Hospital Central de Maputo (HCM, south) and Hospital Central de Nampula (HCN, north) from October 2023-January 2024 were recruited. NVivo 15 was used for thematic analysis using an inductive approach.  

    Results: A total of 30 participants (15-HCM, 15-HCN) were included. Median age was 30 years and 73% were currently living with their partner. Across both sites, 18 (60%) had disclosed, with 2/15 (13%) at HCM and 4/15 (27%) at HCN having done so through couples co-testing during pregnancy. The most common facilitators were relationship transparency and healthcare professional assistance, reported by 9/12 (75%) and 3/12 (25%) of participants who had self-disclosed. After disclosure, 7/12 (58%) reported improved partner support, while 1/12 (8%) was abandoned by her partner. Amongst the participants who had not disclosed, 6/12 (50%), 2/12 (17%), and 1/12 (8%) reported fear of stigma, abandonment, and physical violence, respectively. There was a greater than two-fold higher rate of confirmed HIV in infants of mothers who had not disclosed compared to those who had (50% vs 22%).

    Conclusions: HIV disclosure to male partners can be a positive and protective experience for mothers and their infants. Effective measures are needed to promote male engagement in antenatal care and provide disclosure and psychosocial support to WLHIV for Mozambique to progress towards elimination of VT.

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