Disclosure as a Major Setback in the Management of Mother-to-Child Transmission of Human Immunodeficiency Virus

Mother-to-child transmission (MTCT) of Human Immunodeficiency Virus (HIV) remains a critical global health challenge, particularly in sub-Saharan Africa where the prevalence of paediatric HIV is disproportionately high. Despite significant advances in prevention programmes and the availability of effective antiretroviral therapy (ART), the burden of vertical transmission persists, with Nigeria contributing one of the highest rates worldwide. A major factor undermining the success of prevention of mother-to-child transmission (PMTCT) interventions is the issue of HIV status disclosure. Disclosure is central to adherence and psychosocial support, yet fear of stigma, rejection, domestic violence, and discrimination often deters women from revealing their status to partners, family members, or healthcare providers. Non-disclosure has been consistently linked to poor adherence, limited partner involvement, and increased risk of MTCT. This study employed a narrative review approach, synthesising peer-reviewed literature, policy documents, and global health reports to examine disclosure as a major setback in PMTCT. Findings reveal that while disclosure improves treatment adherence, strengthens support systems, and enhances psychosocial wellbeing, its absence undermines intervention effectiveness and perpetuates paediatric HIV infections. Structural barriers such as weak health systems, inconsistent ART supply, and socio-cultural norms further compound these challenges. Although global strategies such as the WHO “Option B+” approach have shown success in reducing MTCT rates, their outcomes are dependent on consistent ART adherence, supportive disclosure environments, and strong healthcare infrastructure. Addressing stigma, strengthening health systems, and fostering supportive disclosure frameworks remain essential to eliminating MTCT and achieving global paediatric HIV reduction targets. Keywords: HIV disclosure, mother-to-child transmission, antiretroviral therapy, stigma,