Stigma of H.I.V. Is a Barrier to Prenatal Care

http://www.nytimes.com/2012/08/28/health/hiv-stigma-is-a-barrier-to-prenatal-care-study-finds.html

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Fear of being stigmatized as an AIDS patient is still a major barrier to good medical care for pregnant young women in many countries, a new study and a literature review have found.

The study, based on a survey of 1,777 women in rural Nyanza Province in Kenya, was published Wednesday in PLoS Medicine. Only 44 percent of mothers in the province delivered in clinics, and the study found that a major obstacle was that they feared H.I.V. tests.

That echoed the findings of a review of multiple studies in many countries published in July by the same author, Janet M. Turan, a professor of public health at the University of Alabama at Birmingham.

Women may know that treatment saves them and their babies but avoid testing anyway. Many fear being kicked out by their husbands if they are found to be infected. One woman said her neighbors would assume she was a prostitute.

The Kenyan government’s own campaign to get women to visit clinics may have inadvertently backfired by implying that it was especially important for H.I.V.-infected mothers. About 84 percent of the province’s women of childbearing age were not infected, the report said.

The worldwide review described all sorts of stigmatizing behavior. One Mexican woman, for example, described a doctor saying, “How can you even think of getting pregnant knowing you will kill your child because you’re positive?” The doctor threatened not to see her again if she became pregnant, the woman said.