THE SOCIAL IMPACT OF HIV-INFECTION WOMEN IN KIGALI, RWANDA - A PROSPECTIVE-STUDY

In Rwanda, a central African country, the prevalence of HIV infection now exceeds 30% in urban adults. This study identifies the social serv ices and counseling needs of women who are already infected with the H IV virus, the outcome after disclosure of the women's HIV test result to her partner and estimates the social support available to the women from their partners and relatives. Fifty-five HIV-positive women in K igali were interviewed in 1988 and 47 of this group were interviewed a gain in 1991. The social services most needed by the women in 1988 wer e housing, employment and money. By 1991, the women prioritised food, housing and money as their current needs and food, childcare and money were their future needs in the event they became ill. The preferred s ources of support in 1988 were individual counseling and women's suppo rt groups. By 1991, the preferred sources of support were individual c ounseling and their priest. In 1988, almost 75% of the women did not e xpect a supportive reaction from their partners after disclosure of th e test result. In 1991, acceptance, understanding and sympathy were th e most common reactions of the partners after disclosure. However, 8 ( 21%) had not told their partner their test result. After disclosure, 1 8 of the 37 partners were subsequently tested. Of those tested, 75% we re HIV-positive and 25% were HIV-negative. Condom use was almost twice as high when the partner was informed of the test result, although in couples overall, a third were not using condoms despite knowing the t est result. There were 23 births since 1988 and pregnancy was equally likely whether the test result was known or if the partner tested. The women overall reported good morale in 1991, bolstered by their religi on. Chronic difficulties with sleep, performing daily routine and feel ings of depression were reported by a third of women. Conclusions are that basic survival services are needed for affected families, and a p rogram of testing and counseling for partners is required.