Couple issues in the last pregnancy experience of HIV+ women knowing their status before pregnancy

Background

Even in mothers knowing their HIV status before pregnancy, many women who recently delivered demonstrate a high level of stress regarding medical, social, and psychological questions. We decided to research more deeply into the specificities of vulnerabilities of these women.

Patients and methods

Women attending a MTCT clinic at a teaching hospital within 3 months after delivery were systematically offered the possibility of meeting a psychologist. A number of relevant issues were systematically discussed. Immediately after each guided interview, maternal words were transcribed on the computer. In this study, we selected the subgroup of women who were aware of their HIV status before pregnancy.

Results

37 women have been interviewed; Their median age was 33.5 years (18;44).

32/37 women (86.5%) were of African origin. They have been knowing their HIV status for a median time of 3.5 years (2;20).

Among 26 who had previous pregnancies, 15 had a total of 20 children who did not live with them. Only 3 pregnancies/37 were unintended.

22/37 mothers live with the child's father; 20/22 fathers (90%) are aware of maternal HIV status; they have been immediately informed by the mothers either when they met or when she discovered her HIV status.15/20 of these fathers are HIV negative.

Among the 15 mothers who do not live with the fathers, only 8/15 fathers are informed of the status. All the mothers (4) who disclosed their status during pregnancy were abandoned by the child's father.

25 women got pregnant through unprotected sex (7 fathers being HIV positive, 10 being HIV negative and refusing condom use, 8 unaware of maternal status), 9 used self-insemination after protected intercourse, 1 used AMP, 2 reported condom rupture.

27/37 express frustration of not having been allowed to breast-feed their infant.

Despite information on HIV transmission, only 11/37 do not fear the risk of transmitting HIV to their infant through casual contacts (touching and kissing...).

Conclusion

In women aware of their HIV status for over 3 years before last pregnancy, secret remain strong in a noticeable number of couples. 9/37 had children without their partner being aware of their status, and 18/37 got pregnant through unprotected sex.

27/37 regret not to be able to breast-feed and 26/37 fear to transmit HIV to their infant through casual contact.

Both HIV and secret regarding HIV are detrimental for family life of HIV positive women.