With the introduction of antiretroviral drugs, significant successes have been achieved in the reduction of the risk of HIV transmission from mother to child during pregnancy, delivery and breast feeding in resource-limited settings [
1‐
10]. Despite these successes, significant problems remain that may impact the implementation of HIV mother-to-child transmission (MTCT) interventions in developing countries.
In sub-Saharan Africa, reported proportions of women who disclose their HIV status to sex partners vary widely. Previous studies have found that between 17 % and 86 % of HIV-infected individuals share HIV test results (HIV status) with their sex partners [
11‐
16] with women tested in the context of their antenatal care being less likely to disclose their HIV status to their sex partners than non-pregnant women (16.7 % versus 32 %). In a prevention of mother-to-child transmission (PMTCT) of HIV trial conducted in Tanzania, Kilewo et al. found that only 17 % of the women shared their HIV status with their partner [
17]. Such low proportions of disclosure have implications for PMTCT programs as the optimal uptake and adherence to such programs are difficult for such women whose partners are either unaware of or do not understand the benefits of participation in PMTCT programs [
18‐
21].
Research conducted in a variety of settings has shown that there are a number of barriers that HIV-infected individuals face in sharing their HIV test results with friends, family, and, most importantly, sex partners. These barriers include fears of abandonment and loss of economic support, discrimination, accusations of infidelity, violence, upsetting family members, and blame [
12,
14,
22,
23]. Despite these fears, disclosure of HIV status to sex partners remains an important public health goal as emphasized by the World Health Organization [
24] and the Centers for Disease Control and Prevention [
25] in their HIV testing and counseling protocols. In general HIV disclosure is an essential aspect in the prevention, care, treatment and support for HIV-infected persons [
26]. In the context of PMTCT, disclosure to male partners has been associated with improved adherence to PMTCT regimens [
27], better infant feeding practices [
28], safer sex practices, and increased male partner testing [
29]. Conversely, HIV-infected women who have not disclosed their HIV-1 status to their partner are more likely than other HIV-infected women to have suboptimal adherence to PMTCT regimens [
26,
30,
31], higher drop-out rates from PMTCT programs [
32], and fewer infants tested for HIV-1[
9]. Given the pivotal role of disclosure in PMTCT, understanding the problems faced by HIV infected women concerning HIV status disclosure is critical in informing future MTCT intervention program activities in resource limited settings.
The aim of this study was to describe the proportions, patterns, barriers and outcomes of HIV status disclosure among HIV-infected women participating in a study of mother-to-child HIV-1 transmission rates among NVP-experienced compared to NVP-naïve women, “The Nevirapine Repeat Pregnancy (NVP-RP) Study”.