Matthew Rustici, M Kathryn Mutter, K Meredith Atkins, Eric Holmboe, Helen Kang Morgan, Andrew P J Olson, Andrea Anderson, JoAnn Zell, Genie Roosevelt, Jason Brainard
Consensus-derived Recommended Skills for Transition to Residency Courses
Academic medicine : journal of the Association of American Medical Colleges
hiv partner disclosure rates remain low among pregnant women living hiv many african countries despite potential benefits women families partner disclosure trigger negative responses like blame violence separation women diagnosed hiv late pregnancy limited time prepare partner disclosure sought understand challenges around partner disclosure nondisclosure faced women diagnosed hiv late pregnancy south africa uganda explore pathways safe partner disclosure conducted indepth interviews focus group discussions pregnant women lactating mothers living hiv n 109 disaggregated antenatal care anc initiation 20 weeks gestation male partners n 87 health workers n 53 participants recruited dolphin2 trial sites kampala uganda gugulethu south africa topic guides explored barriers partner disclosure effects nondisclosure strategies safe disclosure using framework analysis approach coded summarised data based socioecological model topic guides emerging issues data data analysed nvivo software findings illustrate pregnant women initiate anc late experience many difficulties compounded late hiv diagnosis various individual interpersonal community health system factors complicate partner disclosure among women postpone decide partner disclosure mainly babys safety women experience stress poor mental health nondisclosure demonstrating agency resilience found many similarities differences around preferred approaches safe partner disclosure among female male participants across countries women male partners preferred healthcare workers assist disclosure identifying right time disclose mentoring women enhance confidence communication skills providing professional mediation partner disclosure couple testing increasing number counsellors training safe partner disclosure deemed necessary strengthening local health services improve safe partner disclosure hiv diagnosis late pregnancy amplifies existing difficulties among pregnant women late anc initiation indicator likelihood pregnant woman highly vulnerable needs safeguarding respective health programmes prepared offer women initiating anc late pregnancy additional support referral complementary programmes achieve safe partner disclosure good health