Disclosure and Quality of Life among HIV Pregnant Women and Nursing Mothers Accessing Care at 37 Military Hospital.

Abstract

Background: There is little research with regards to the psychological well-being and psychosocial impact of disclosure among women living with HIV. Quality of life has been an important factor to consider in the development of the medical outcome measures looking at the success rate of the current prophylactic and therapeutic strategies for PLHIV. Some key predictors that may be used as interventions in promoting QOL of women living with HIV include spiritual well-being, social support systems, physical indications, antiretroviral therapy, psychological well-being, coping strategies and psychiatric co-morbidities. Nevertheless, disclosure of HIV positive status is a major factor that needs to be addressed because it is only after disclosure that one is able to access the full support required to live positively with the infection. Quality of life of PLHIV may be affected both negatively and positively after disclosure and it is for this reason that this study was conducted to determine the factors that play a role in the disclosure of HIV status among pregnant women and mothers living with HIV and how it affects their quality of life. Objective: To determine how disclosure affects the quality of life of pregnant women and nursing mothers living with HIV. Methods: A facility based cross-sectional study of 110 pregnant women and mothers with live births who knew their status before giving birth within the period of 2015 to date and are currently actively receiving care and treatment at the 37 Military Hospital. This study was conducted using a mixed method approach. Quantitative and qualitative research methods were used to assess how disclosure affects quality of life of pregnant women and nursing mothers living with HIV. Two forms of data collection tools were used for the study. These were a structured interviewer administered tool designed by the investigator to gather information on the disclosure of status and other variables which were of importance to the study and an adopted WHOQOL-HIV BREF tool which was used to measure the quality of life of the participant. There were in-depth interviews as well using an interview guide. Result: Of the 110 women that were interviewed, 86.4% had disclosed their status to their sexual partners. Majority (65.3%) disclosed immediately after diagnosis to their sexual partners due to counsel from counselors at the ART clinic. Fears of being rejected, stigmatized and discriminated were the key drivers of non-disclosure of HIV positive status. However, 92.6 % of the women who disclosed their HIV positive status to sexual partners have received some form of support. Those who had disclosed their HIV positive status to their sexual partner had a lower quality of life compared to those who had not disclosed in the physical domain but this difference was not significant. However, those who had disclosed their status had a higher quality of life than those who had not disclosed their HIV positive status in the psychological, social relationships and environment domains. Conclusion: The study showed that the general quality of life of participants was high. In general, status disclosure was not significantly related to QOL. However, participants who had disclosed their HIV positive status to their sexual partners had the added advantage of receiving support. Key Words: HIV/AIDS, Quality of Life, Status Disclosure