Association between maternal HIV disclosure and risk factors for perinatal transmission

OBJECTIVE: To determine whether maternal disclosure of HIV serostatus is associated with uptake of perinatal HIV transmission prevention interventions. STUDY DESIGN: Retrospective cohort study of women living with HIV enrolled in a perinatal HIV clinic. Women who disclosed their HIV serostatus to sexual partner(s) prior to delivery were compared to non-disclosers. Multivariable logistic regression was performed. RESULTS: Of 209 women, 71.3% (N=149) disclosed. Non-disclosers were more likely to attend <10 prenatal visits, demonstrated worse antiretroviral therapy adherence, required more time to achieve virologic suppression, and were less likely to have an undetectable viral load. On multivariable analyses, disclosure status did not remain associated with these factors. However, compared to non-disclosers, disclosers had lower odds of preterm delivery (OR 0.43, 95% CI 0.19–0.94) and greater odds of postpartum visit attendance (aOR 5.10, 95% CI 1.65–15.72). CONCLUSIONS: Non-disclosure of HIV status to sexual partner(s) during pregnancy may be a risk factor for preterm birth and poorer postpartum visit attendance.