Social support for HIV-infected mothers: relation to HIV care seeking

Predictors of perceived poor social support status of pregnant women attending antiretroviral therapy clinics in south west Ethiopia, 2021

Background

To improve pregnancy outcomes, a pregnant mother living with HIV/AIDS requires a high level of social and emotional support. However, women from low-income countries were subjected to low social support status despite adequate counseling and health messages to increase their social support. Therefore, this study aimed to investigate the predictors of the perceived poor social support status among pregnant women attending ART clinics in Southwest Ethiopia.

Methods

A hospital-based cross-sectional study with consecutive sampling was conducted to enroll 265 pregnant women on antiretroviral therapy (ART) from December 1 to 30, 2021. The data were collected using an interviewer-administered questionnaire. Epidata was used for data entry and analyzed after it was exported to a statistical package for the social sciences. Binary logistic regression was used and the level of significance was declared at P-value <0.05 using Adjusted odds ratio at 95% CI after candidate variables were identified in binary logistic regression at a P-value of <0.25.

Results

Finding from the study figured out that low level of poor social support is found to be 47.2%. Study revealed that income level[AOR = 5.1 95% CI [1.9,13.6]], disclosure status[AOR: 1.9 95% CI [1.1,3.3]], unwanted pregnancy [AOR = 2.3 CI; [ 1.4,3.9]], and low adherence level[AOR: 2.1 95% CI [1.1,3.1]] were strong predictors.

Conclusion

This study identified high levels of poor social support. Increasing access to information education and communications focusing on stigma, disclosure & refresher training that boosts the counseling skills of health care providers to enhance adherence level is strongly recommended.

Resilience and HIV: a review of the definition and study of resilience

We use a socioecological model of health to define resilience, review the definition and study of resilience among persons living with human immunodeficiency virus (PLWH) in the existing peer-reviewed literature, and discuss the strengths and limitations of how resilience is defined and studied in HIV research. We conducted a review of resilience research for HIV-related behaviors/outcomes of antiretroviral therapy (ART) adherence, clinic attendance, CD4 cell count, viral load, viral suppression, and/or immune functioning among PLWH. We performed searches using PubMed, PsycINFO and Google Scholar databases. The initial search generated 14,296 articles across the three databases, but based on our screening of these articles and inclusion criteria, n = 54 articles were included for review. The majority of HIV resilience research defines resilience only at the individual (i.e., psychological) level or studies individual and limited interpersonal resilience (e.g., social support). Furthermore, the preponderance of HIV resilience research uses general measures of resilience; these measures have not been developed with or tailored to the needs of PLWH. Our review suggests that a socioecological model of health approach can more fully represent the construct of resilience. Furthermore, measures specific to PLWH that capture individual, interpersonal, and neighborhood resilience are needed.

Factors associated with the failure to seek HIV care and treatment among HIV-positive women in a northern province of Vietnam

This cross-sectional survey examines the utilization of HIV care and treatment services after HIV diagnosis among women in Vietnam and describes factors that may be associated with failure in seeking services. From May 2007 to November 2007, we conducted structured interviews with 353 HIV-positive women living a Haiphong, a northern province of Vietnam. The women were recruited through a network of people living with HIV/AIDS (HPN+) by means of snowball sampling and through the local, governmental HIV registration system (Provincial AIDS Centre [PAC]). Approximately 26.3% of the study participants had never attended HIV care and treatment services. Failure in seeking the services was associated with not being registered in the PAC (odds ratio [OR]: 3.0; 95% confidence interval [CI]: 1.4-6.4), not having a known HIV-positive family member (OR: 3.2; 95% CI: 1.2-8.3), not having disclosed HIV status (OR: 4.0; 95% CI: 2.0-8.1), and factors associated with the testing situation, whereby women who were tested by chance had a 4.0 times increased OR (95% CI: 1.4-11.7) and women who were tested in relation to antenatal care or delivery had 3.0 times increased OR (95% CI: 1.1-8.5) for failure to seek HIV care compared to women who had been tested because their husbands/partners were sick or had died. We suggest that the posttest counseling and referral system for HIV care and treatment need to be improved. An alternative system for picking up those not wishing to attend the official system might help to approach these needy women.

Linking HIV/AIDS clients' self-care with outcomes

The self-care practice of HIV/AIDS patients has become an important topic to help HIV/AIDS patients maintain their maximum level of well-being in chronic illness management. This article presents a self-care outcomes model that is applicable to HIV/AIDS nursing practice and research, and it identifies attributes and outcomes related to HIV/AIDS patients'self-care. The self-care outcomes model was developed based on the Outcomes Model for Health Care Research and literature review. Key variables related to HIV/AIDS self-care were summarized and discussed based on nine dimensions: client inputs, client processes, client outcomes, provider inputs, provider processes, provider outcomes, setting inputs, setting processes, and setting outcomes. This article reveals that self-care in HIV/AIDS is complex and may be influenced by many factors relating to individual, family, and health care system. More research with advanced multivariate statistical models and randomized controlled trial design will help determine the effectiveness of self-care strategies and interventions.

HIV-1 infected women and prenatal care utilization: barriers and facilitators

In an effort to understand issues affecting prenatal care access and utilization from the perspectives of human immunodeficiency virus (HIV)-infected women who receive inadequate prenatal care, we conducted three in-depth qualitative and quantitative interviews. From a thematic analysis of the narrative interviews, four broad areas emerged as pertinent to these women's prenatal care experiences. These were issues related to pregnancy, HIV, psychosocial conditions, and the health care system. For these women, the barriers to prenatal care utilization included the unexpected and unplanned nature of the pregnancy and mental health issues related to HIV infection. Poverty, periodic homelessness, addiction to illicit substances, and lack of social support were also important barriers. Furthermore, perceptions of the health care system as threatening, including fears related to consequences of disclosing illicit activities, discrimination, and breach of confidentiality emerged as salient barriers. Facilitating factors included the pregnancy being experienced as a life-transforming event, concern for their children, especially preventing HIV-1 vertical transmission, availability of treatment, and support from health care professionals. Prominent throughout the interviews were the women's mental health concerns and need for professional support.

Caring for the child and family with HIV disease

Caring for children with HIV infection is a much more optimistic process than in the beginning of the epidemic. Antiretroviral therapies are available, and additional drugs are receiving approval from the US Food and Drug Administration. Cautious optimism must be tempered with an understanding that living with the disease is a complicated and daunting process for these children and their families. Although scientific knowledge and medical treatments are moving forward, the social and environmental uncertainties remain for families. Comprehensive care is a balance of health care services and supportive, community-based services offered in a compassionate manner.

Poor women living with HIV: self-identified needs

Women with HIV are a growing at-risk population in our communities. They are often poor members of minority groups who have responsibilities for dependent children and other family members. They may experience physiological, psychological, and social symptoms and have needs that are unique to them as women. The purpose of this study was to give women with HIV the opportunity to identify their needs. Using the Objects Content Test, 48 women attending HIV clinics in a midsouth city listed 349 needs: 32% psychosocial, 14% physical, 13% service and maintenance, and 11% financial and legal. It is important for nurses working with these women in the community to know how they perceive their own needs and issues to plan and provide effective health care programs for this growing group of clients.