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From prenatal HIV testing of the mother to prevention of sexual HIV transmission within the couple

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  • Desgrées-du-Loû, Annabel
  • Brou, Hermann
  • Traore, Annick Tijou
  • Djohan, Gerard
  • Becquet, Renaud
  • Leroy, Valeriane

Abstract

The first step in preventing mother-to-child HIV transmission (PMTCT) programmes is offering HIV counselling and testing to pregnant women. In developing countries where HIV testing remains rare, it represents a unique opportunity for many women to learn their HIV status. This prenatal HIV testing is not only the entry point to prevention of mother-to-child HIV transmission, but also an occasion for women to sensitize their male partner to sexual risks. Here we explore if these women, HIV-tested as mothers, apply the prevention recommendations they also receive as women. In the Ditrame Plus PMTCT program in Abidjan, Côte d'Ivoire, two cohorts of women (475 HIV-infected women and 400 HIV-negative women) were followed up two years after the pregnancy when they were offered prenatal HIV testing. In each cohort, we compared the proportion of women who communicated with their regular partner on sexual risks, prior to and after prenatal HIV testing. We analysed socio-demographic factors related to this communication. We measured two potential conjugal outcomes of women HIV testing: the level of condom use at sex resumption after delivery and the risk of union break-up. Prenatal HIV testing increased conjugal communication regarding sexual risks, whatever the woman's serostatus. This communication was less frequent for women in a polygamous union or not residing with their partner. Around 30% of women systematically used condoms at sex resumption. Among HIV infected ones, conjugal talk on sexual risks was related to improved condom use. After HIV testing, more HIV-infected women separated from their partners than HIV-uninfected women, despite very few negative reactions from the notified partners. In conclusion, offering prenatal HIV counselling and testing is an efficient tool for sensitizing women and their partners to HIV prevention. But sexual prevention in a conjugal context remains difficult and need to be specifically addressed.

Suggested Citation

  • Desgrées-du-Loû, Annabel & Brou, Hermann & Traore, Annick Tijou & Djohan, Gerard & Becquet, Renaud & Leroy, Valeriane, 2009. "From prenatal HIV testing of the mother to prevention of sexual HIV transmission within the couple," Social Science & Medicine, Elsevier, vol. 69(6), pages 892-899, September.
    • Handle: RePEc:eee:socmed:v:69:y:2009:i:6:p:892-899
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    References listed on IDEAS

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    1. Damien De Walque, 2007. "Sero‐Discordant Couples in Five African Countries: Implications for Prevention Strategies," Population and Development Review, The Population Council, Inc., vol. 33(3), pages 501-523, September.
    2. Chimbiri, Agnes M., 2007. "The condom is an 'intruder' in marriage: Evidence from rural Malawi," Social Science & Medicine, Elsevier, vol. 64(5), pages 1102-1115, March.
    3. Hattori, Megan Klein & Dodoo, F. Nii-Amoo, 2007. "Cohabitation, marriage, and 'sexual monogamy' in Nairobi's slums," Social Science & Medicine, Elsevier, vol. 64(5), pages 1067-1078, March.
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    1. Crankshaw, T.L. & Voce, A. & Butler, L.M. & Darbes, L., 2016. "Expanding the relationship context for couple-based HIV prevention: Elucidating women's perspectives on non-traditional sexual partnerships," Social Science & Medicine, Elsevier, vol. 166(C), pages 169-176.
    2. Tijou Traoré, Annick & Querre, Madina & Brou, Hermann & Leroy, Valériane & Desclaux, Alice & Desgrées-du-Loû, Annabel, 2009. "Couples, PMTCT programs and infant feeding decision-making in Ivory Coast," Social Science & Medicine, Elsevier, vol. 69(6), pages 830-837, September.
    3. Julie Pannetier & Virginie Gigonzac & Nathalie Lydié & Annabel Desgrées du Loû & Rosemary Dray Spira, 2017. "Timing of chronic hepatitis B diagnosis after migration and its determinants among Sub-Saharan African migrants living in France," PLOS ONE, Public Library of Science, vol. 12(12), pages 1-14, December.

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