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Huertas-Zurriaga A, Alonso-Fernández S, Leyva-Moral JM. Reproductive Decision Making of Spanish Women Living With HIV: A Constructivist Grounded Theory Study. J Assoc Nurses AIDS Care 2024; 35:201-209. [PMID: 38417079 DOI: 10.1097/jnc.0000000000000455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/01/2024]
Abstract
ABSTRACT The process of reproductive decision making among women living with HIV is intricate and multifaceted, influenced by health considerations, societal factors, and personal values. In this study, we employed Charmaz's Constructivist Grounded Theory to understand how Spanish women living with HIV make decisions regarding reproduction. We conducted 26 face-to-face interviews until data saturation was achieved. Findings suggested that social constructs such as femininity and motherhood play a significant role in the reproductive decision-making process for women living with HIV. The women's beliefs about HIV, doubts, marginalizing situations, and health barriers create challenges to making reproductive decisions. These findings provide valuable implications for designing care plans that meet the unique sexual and reproductive health needs of women with HIV. An integrated and comprehensive multidisciplinary counseling approach is necessary to improve the quality of care.
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Affiliation(s)
- Ariadna Huertas-Zurriaga
- Ariadna Huertas-Zurriaga, PhD, MSc, RN, is an adjunct professor, Nursing Department-Faculty of Medicine, Universitat Autonoma de Barcelona, Spain and is a registered nurse at Hospital Germans Trias i Pujol, Badalona, Spain
- Sergio Alonso-Fernandez, PhD, MSc, RN, is a registered nurse at the Hospital Germans Trias i Pujol, Badalona, Spain and is a researcher at the GRIN Research Group, IDIBELL, Bellvitge Biomedical Research Institute, L'Hospitalet, Spain
- Juan M. Leyva-Moral, PhD, MSc, BSN, CHNS, BSN, is an Associate Professor and Coordinator of the Nursing Research Group in Vulnerability and Health-GRIVIS, Nursing Department-Faculty of Medicine, Universitat Autònoma de Barcelona, Spain
| | - Sergio Alonso-Fernández
- Ariadna Huertas-Zurriaga, PhD, MSc, RN, is an adjunct professor, Nursing Department-Faculty of Medicine, Universitat Autonoma de Barcelona, Spain and is a registered nurse at Hospital Germans Trias i Pujol, Badalona, Spain
- Sergio Alonso-Fernandez, PhD, MSc, RN, is a registered nurse at the Hospital Germans Trias i Pujol, Badalona, Spain and is a researcher at the GRIN Research Group, IDIBELL, Bellvitge Biomedical Research Institute, L'Hospitalet, Spain
- Juan M. Leyva-Moral, PhD, MSc, BSN, CHNS, BSN, is an Associate Professor and Coordinator of the Nursing Research Group in Vulnerability and Health-GRIVIS, Nursing Department-Faculty of Medicine, Universitat Autònoma de Barcelona, Spain
| | - Juan M Leyva-Moral
- Ariadna Huertas-Zurriaga, PhD, MSc, RN, is an adjunct professor, Nursing Department-Faculty of Medicine, Universitat Autonoma de Barcelona, Spain and is a registered nurse at Hospital Germans Trias i Pujol, Badalona, Spain
- Sergio Alonso-Fernandez, PhD, MSc, RN, is a registered nurse at the Hospital Germans Trias i Pujol, Badalona, Spain and is a researcher at the GRIN Research Group, IDIBELL, Bellvitge Biomedical Research Institute, L'Hospitalet, Spain
- Juan M. Leyva-Moral, PhD, MSc, BSN, CHNS, BSN, is an Associate Professor and Coordinator of the Nursing Research Group in Vulnerability and Health-GRIVIS, Nursing Department-Faculty of Medicine, Universitat Autònoma de Barcelona, Spain
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Benitez X, Aragon K, Jakeman B, Bachyrycz A, Iandiorio M, Meliniotis A, Shah M, Stever E, Herman A. Patient perspectives and needs regarding contraception in female patients with HIV: A qualitative study. J Am Pharm Assoc (2003) 2024; 64:307-313. [PMID: 37952846 DOI: 10.1016/j.japh.2023.11.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2023] [Revised: 11/06/2023] [Accepted: 11/06/2023] [Indexed: 11/14/2023]
Abstract
BACKGROUND Women with human immunodeficiency virus (HIV) are at risk of unintended pregnancy and may experience barriers to accessing contraception such as social stigma, concern for drug-drug interactions with HIV regimens, cost, and access to care. As pharmacist prescriptive authority for contraception becomes more prevalent, pharmacists may play a role in expanding access to contraception for women with HIV. Little is known about perspectives in this population regarding pharmacists prescribing contraception. OBJECTIVES The objective of our study was to explore participants' experiences with contraception and childbearing, identify barriers to receiving contraception and unmet needs for contraceptive services, and explore perspectives on pharmacists prescribing contraception among women with HIV receiving care at a specialty HIV clinic. METHODS This qualitative study used semistructured phone interviews with female patients receiving care at the University of New Mexico Truman Health Services in Albuquerque, New Mexico (NM). Interviews were transcribed verbatim and analyzed by 2 independent coders using Dedoose software. RESULTS Contraception use was high in our population, with 75% of participants reporting a current contraceptive method. Among our population, participants were supportive of pharmacists prescribing contraception. Participants appreciated that pharmacies were accessible and convenient and that pharmacists are well trained and able to manage drug-drug interactions. Participants expressed a preference for pharmacists to explain all available contraceptive options and to have a thorough understanding of their medical history and medications. Participants expressed concern about privacy and disclosure of their HIV status when receiving contraception from a pharmacist. CONCLUSION Among our population of women with HIV receiving care at a specialty clinic in NM, participants were supportive of pharmacists prescribing contraception. Pharmacists should consider the preferences of this population when prescribing contraception. Further research is warranted in additional populations of women with HIV to further explore unique perspectives among non-English speaking patients and those who do not receive care at specialty clinics.
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Graham M, McKenzie H, Lamaro Haintz G, Dennis C. Who do Australian women seek social support from during the reproductive decision-making process? HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:e4028-e4040. [PMID: 35302266 PMCID: PMC10078729 DOI: 10.1111/hsc.13785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 12/03/2021] [Accepted: 03/02/2022] [Indexed: 06/14/2023]
Abstract
Limited evidence exists about women's experiences of social support for reproductive decision-making, particularly who women seek social support from during decision-making. Using a concurrent mixed methods approach, this research explored who women aged 25-35 years living in Victoria, Australia, seek social support from during reproductive decision-making. Women seek social support for reproductive decision-making from multiple sources. However, through exploring women's support seeking for reproductive decision-making, rather than once a reproductive decision had been made, the study highlights the nuanced and contextual nature of support seeking for reproductive decision-making demonstrating support seeking is influenced by: type of reproductive decision; women's relationships with members of their social network; previous experiences of support seeking for reproductive decisions; expectations of the support they would receive; homophily; and temporality. This research provides important insight into who women seek support from for reproductive decision-making. Understanding this will help inform future social and public health interventions.
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Affiliation(s)
- Melissa Graham
- School of Psychology and Public HealthDepartment of Public HealthLa Trobe UniversityBundooraVictoriaAustralia
| | - Hayley McKenzie
- School of Health and Social DevelopmentDeakin UniversityBurwoodVictoriaAustralia
| | | | - Carly Dennis
- School of Health and Social DevelopmentDeakin UniversityBurwoodVictoriaAustralia
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Plagens-Rotman K, Merks P, Pisarska-Krawczyk M, Kędzia W, Justyna J, Czarnecka-Operacz M, Jarząbek-Bielecka G. Possible Interdisciplinar Standard for the Care of Pregnant Women Living with HIV-Polish Experience. Healthcare (Basel) 2022; 10:healthcare10101949. [PMID: 36292396 PMCID: PMC9602101 DOI: 10.3390/healthcare10101949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2022] [Revised: 09/25/2022] [Accepted: 09/27/2022] [Indexed: 11/04/2022] Open
Abstract
HIV data for 2020 show a decline in the number and rate of new HIV cases diagnosed in the EU during the last decade. The COVID-19 pandemic has paralyzed the functioning of healthcare facilities in Poland and worldwide, also impacting the detection of HIV infection. Early diagnosis of HIV and implementation of antiretroviral treatment limit HIV transmission. A woman with HIV diagnosed during pregnancy should be under the care of a specialist in infectious diseases experienced in antiretroviral treatment. In this way, she will be properly protected during the delivery, and relevant medications can be implemented for the newborn baby. Taking these aspects into account, the medical team should consist of: A specialist in infectious diseases, an obstetrician, a neonatologist and pediatrician, a midwife, and a dermato-venereologist. Every effort should be made to increase the scope and quality of monitoring of the spread of the epidemic in Poland, with special emphasis on diagnostics based on specific tests among populations particularly exposed to HIV infections cooperating with non-governmental organizations.
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Affiliation(s)
- Katarzyna Plagens-Rotman
- Center for Pediatric, Adolescent Gynecology and Sexology Division of Gynecology, Department of Perinatology and Gynecology, Poznan University of Medical Sciences, 61-758 Poznan, Poland
- Correspondence:
| | - Piotr Merks
- Department of Pharmacology and Clinical Pharmacology, Faculty of Medicine, Collegium Medicum, Cardinal Stefan Wyszynski University in Warsaw, 01-938 Warszawa, Poland
| | | | - Witold Kędzia
- Division of Gynecology, Department of Perinatology and Gynecology, Poznan University of Medical Sciences, 61-758 Poznan, Poland
| | - Jaskulska Justyna
- Higher School of Strategic Planning in Dąbrowa Górnicza, Kościelna 4, 41-303 Dąbrowa Górnicza, Poland
| | - Magdalena Czarnecka-Operacz
- Allergic and Occupational Skin Diseases Unit, Department of Dermatology, Medical University of Poznań, 60-355 Poznan, Poland
| | - Grażyna Jarząbek-Bielecka
- Center for Pediatric, Adolescent Gynecology and Sexology Division of Gynecology, Department of Perinatology and Gynecology, Poznan University of Medical Sciences, 61-758 Poznan, Poland
- Division of Gynecology, Department of Perinatology and Gynecology, Poznan University of Medical Sciences, 61-758 Poznan, Poland
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Turner S, Nader M, Lurie E. A contingency management approach for treatment of methamphetamine use disorder and human immunodeficiency virus antiretroviral treatment adherence in pregnancy to prevent mother-to-child transmission: a case report. J Med Case Rep 2022; 16:165. [PMID: 35473945 PMCID: PMC9044665 DOI: 10.1186/s13256-022-03391-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Accepted: 03/28/2022] [Indexed: 11/10/2022] Open
Abstract
Introduction This review highlights the rising prevalence of methamphetamine use in pregnancy in North American and the difficulty of managing active human immunodeficiency virus infection in a pregnant woman while actively using methamphetamines. Multidisciplinary medical teams with knowledge of addiction medicine, infectious disease management, and pregnancy are needed to provide combined expert care to reduce the harms associated with substance use and improve adherence to antiretroviral treatment. We report the case of a treatment-naïve pregnant patient with human immunodeficiency virus who was actively using methamphetamines. The patient was able to initiate and adhere to antiretroviral treatment while taking a prescription stimulant in a contingency management paradigm. To the best of our knowledge, this is the first documented case of prescription stimulants being used in pregnancy to improve adherence to antiretroviral medications. Case presentation A 32-year-old white woman with untreated human immunodeficiency virus, a newly diagnosed pregnancy, and actively using methamphetamines presented to a drop-in combined prenatal care and addiction medicine clinic. After initiating a prescription amphetamine in a contingency management paradigm, she was adherent to human immunodeficiency antiretroviral treatment and had a fully suppressed viral load throughout the remainder of her pregnancy. Conclusion Active treatment of methamphetamine use disorders with prescription stimulants, coupled with contingency management, may represent a mechanism to engage patients in care and improve adherence to antiretroviral treatment (and prevent mother-to-child-transmission of human immunodeficiency virus).
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Affiliation(s)
- Suzanne Turner
- Department of Family Medicine, McMaster University, 100 Main St W 5th Floor, Hamilton, ON, L8P 1H6, Canada.
| | - Maya Nader
- St. Michael's Hospital, Unity Health, 36 Queen St E, Toronto, ON, M5B 1W8, Canada.,Department Family and Community Medicine, University of Toronto, 500 University Ave, Toronto, ON, M5G 1V7, Canada
| | - Erin Lurie
- St. Michael's Hospital, Unity Health, 36 Queen St E, Toronto, ON, M5B 1W8, Canada.,Department Family and Community Medicine, University of Toronto, 500 University Ave, Toronto, ON, M5G 1V7, Canada
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Huertas-Zurriaga A, Palmieri PA, Aguayo-Gonzalez MP, Dominguez-Cancino KA, Casanovas-Cuellar C, Linden KLV, Cesario SK, Edwards JE, Leyva-Moral JM. Reproductive decision-making of Black women living with HIV: A systematic review. WOMEN'S HEALTH 2022; 18:17455057221090827. [PMID: 35404192 PMCID: PMC9006353 DOI: 10.1177/17455057221090827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Background: Black women living with HIV account for a higher proportion of new HIV diagnoses than other groups. These women experience restricted access to reproductive services and inadequate support from healthcare providers because their position in society is based on their sexual health and social identity in the context of this stigmatizing chronic disease. By recognizing the analytical relevance of intersectionality, the reproductive decision-making of Black women can be explored as a social phenomenon of society with varied positionality. Objective: The purpose of this review was to synthesize the evidence about the reproductive decision-making of Black women living with HIV in high-income countries from the beginning of the HIV epidemic to the present. Methods: This systematic review was guided by the JBI evidence synthesis recommendations. Searches were completed in seven databases from 1985 to 2021, and the review protocol was registered with PROSPERO (CRD420180919). Results: Of 3503 records, 22 studies were chosen for synthesis, including 19 observational and three qualitative designs. Nearly, all studies originated from the United States; the earliest was reported in 1995. Few studies provided detailed sociodemographic data or subgroup analysis focused on race or ethnicity. Influencing factors for reproductive decision-making were organized into the following seven categories: ethnicity, race, and pregnancy; religion and spirituality; attitudes and beliefs about antiretroviral therapy; supportive people; motherhood and fulfillment; reproductive planning; and health and wellness. Conclusion: No major differences were identified in the reproductive decision-making of Black women living with HIV. Even though Black women were the largest group of women living with HIV, no studies reported a subgroup analysis, and few studies detailed sociodemographic information specific to Black women. In the future, institutional review boards should require a subgroup analysis for Black women when they are included as participants in larger studies of women living with HIV.
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Affiliation(s)
- Ariadna Huertas-Zurriaga
- Àrea de Suport a la Recerca en Cures, Hospital Universitari Germans Trias i Pujol, Barcelona, Spain
- Evidence-Based Health Care South America: A JBI Affiliated Group, Lima, Peru
| | - Patrick A Palmieri
- Evidence-Based Health Care South America: A JBI Affiliated Group, Lima, Peru
- South American Center for Qualitative Research, Universidad Norbert Wiener, Lima, Perú
- College of Graduate Health Studies, A.T. Still University, Kirksville, MO, USA
- Center for Global Nursing, Texas Woman’s University, Houston, TX, USA
| | - Mariela P Aguayo-Gonzalez
- Evidence-Based Health Care South America: A JBI Affiliated Group, Lima, Peru
- Department d’Infermeria, Facultat de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain
- Grupo de Investigación Enfermera en Vulnerabilidad y Salud (GRIVIS), Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Karen A Dominguez-Cancino
- Evidence-Based Health Care South America: A JBI Affiliated Group, Lima, Peru
- Escuela de Enfermería, Universidad Científica del Sur, Lima, Perú
- Escuela de Salud Pública, Universidad de Chile, Santiago de Chile, Chile
| | - Cristina Casanovas-Cuellar
- Àrea de Suport a la Recerca en Cures, Hospital Universitari Germans Trias i Pujol, Barcelona, Spain
- Department d’Infermeria, Facultat de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Kara L Vander Linden
- Department of Research, Saybrook University, Pasadena, CA, USA
- Glaser Center for Grounded Theory, Institute for Research and Theory Methodologies, Poway, CA, USA
| | - Sandra K Cesario
- Center for Global Nursing, Texas Woman’s University, Houston, TX, USA
- Nelda C. Stark College of Nursing, Texas Woman’s University, Houston, TX, USA
| | - Joan E Edwards
- Center for Global Nursing, Texas Woman’s University, Houston, TX, USA
- Nelda C. Stark College of Nursing, Texas Woman’s University, Houston, TX, USA
| | - Juan M Leyva-Moral
- Evidence-Based Health Care South America: A JBI Affiliated Group, Lima, Peru
- Center for Global Nursing, Texas Woman’s University, Houston, TX, USA
- Department d’Infermeria, Facultat de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain
- Grupo de Investigación Enfermera en Vulnerabilidad y Salud (GRIVIS), Universitat Autònoma de Barcelona, Barcelona, Spain
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Skerritt L, Kaida A, O'Brien N, Burchell AN, Bartlett G, Savoie É, Boucoiran I, Gormley R, Kestler M, Money D, Loutfy M, de Pokomandy A. Patterns of changing pregnancy intentions among women living with HIV in Canada. BMC WOMENS HEALTH 2021; 21:350. [PMID: 34615492 PMCID: PMC8496032 DOI: 10.1186/s12905-021-01492-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Accepted: 09/23/2021] [Indexed: 12/01/2022]
Abstract
Background Women with an undetectable viral load can become pregnant and have children with no risk of HIV transmission to their sexual partners and low risk of transmission to their infants. Contemporary pregnancy intentions of women living with HIV in Canada are poorly understood, evidenced by high rates of unintended pregnancy and low uptake of contraceptives. Methods We used longitudinal survey data from the Canadian HIV Women’s Sexual and Reproductive Health Cohort Study (CHIWOS) to measure and compare pregnancy intentions (Yes vs No vs Unsure) at baseline, 18-months and 36-months follow-up (from 2013 to 2018) among women living with HIV of reproductive age (16–49 years) and potential. We used Sankey diagrams to depict changes in pregnancy intentions over time and multivariable logistic regression to examine the relationship between pregnancy intention within 2 years and subsequent pregnancy. Results At baseline, 41.9% (119/284) of women intended to become pregnant, 43.3% did not, and 14.8% were unsure. Across 36-months of follow-up, 41.9% (119/284) of women changed their pregnancy intentions, with 25% changing from intending to not intending to become pregnant and 13.1% vice versa. Pregnancy intentions were not strongly associated with subsequent pregnancy between baseline and 18-months (aOR 1.44; 95% CI 0.53, 3.72) or between 18 and 36-months (aOR 2.17; 95% CI 0.92, 5.13). Conclusions Our findings underscore the need for healthcare providers to engage in ongoing discussions with women living with HIV to support their dynamic pregnancy intentions.
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Affiliation(s)
| | - Angela Kaida
- Faculty of Health Sciences, Simon Fraser University, Burnaby, Canada
| | - Nadia O'Brien
- Centre de Recherche du Centre Hospitalier de l'Université de Montreal (CRCHUM), Montreal, Canada
| | - Ann N Burchell
- Department of Family and Community Medicine, Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, Canada
| | - Gillian Bartlett
- Department of Family and Community Medicine, University of Missouri, Columbia, USA
| | - Édénia Savoie
- Chronic Viral Illness Service, McGill University Health Centre, Glen Site 1001 Decarie Blvd., Rm D02.4110, Montreal, QC, H4A 3J1, Canada
| | - Isabelle Boucoiran
- Women and Children's Infectious Diseases Center, Centre Hospitalier Universitaire Sainte-Justine, Montreal, Canada
| | - Rebecca Gormley
- Faculty of Health Sciences, Simon Fraser University, Burnaby, Canada.,British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada
| | - Mary Kestler
- Oak Tree Clinic, BC Women's Hospital and Health Centre, Vancouver, Canada.,Faculty of Medicine, University of British Colombia, Vancouver, Canada
| | - Deborah Money
- Oak Tree Clinic, BC Women's Hospital and Health Centre, Vancouver, Canada.,Faculty of Medicine, University of British Colombia, Vancouver, Canada
| | - Mona Loutfy
- Women's College Research Institute, Women's College Hospital, Toronto, Canada
| | - Alexandra de Pokomandy
- Department of Family Medicine, McGill University, Montreal, Canada. .,Chronic Viral Illness Service, McGill University Health Centre, Glen Site 1001 Decarie Blvd., Rm D02.4110, Montreal, QC, H4A 3J1, Canada.
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Huertas-Zurriaga A, Palmieri PA, Edwards JE, Cesario SK, Alonso-Fernandez S, Pardell-Dominguez L, Dominguez-Cancino KA, Leyva-Moral JM. Motherhood and decision-making among women living with HIV in developed countries: a systematic review with qualitative research synthesis. Reprod Health 2021; 18:148. [PMID: 34246286 PMCID: PMC8272303 DOI: 10.1186/s12978-021-01197-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Accepted: 06/24/2021] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Women living with HIV (WLH) lack evidence-based information about reproductive options while managing pressures from family, clinicians, and communities to give up the idea of having children. As the reproduction intentions of WLH are not well understood, stigmatizing behaviors force them to hide their disease to avoid rejection by their family, partner, and social networks. Compliance with social norms, fear of stigma, and discrimination influence their experience. Current research is individual qualitative studies lacking the synthesis perspective necessary to guide intervention development. The purpose of this study was to synthesize the evidence to explain the reproductive decision-making process for WLH in developed countries. METHODS A systematic review with qualitative research synthesis was conducted through searches in 10 electronic databases (CINAHL, EMBASE, MEDLINE, Scopus, Social Science Citation Index, Web of Science, Google Scholar, Cuidatge, Cuiden Enfispo, and SciELO). Studies published in journals from 1995 to 2019 with qualitative data about reproductive decision-making among WLH in developed countries were eligible for inclusion. Developed country was operationalized by membership in the OECD for comparative conditions of social wellbeing and economic stability. The CASP and JBI checklists for qualitative research were used to assess study quality and methodological integrity. Thematic analysis and qualitative meta-summary techniques were used for the synthesis. RESULTS Twenty studies from 12 developed countries were included in the synthesis. Findings were organized into 3 meta-themes from 15 themes and 45 subthemes, including: (1) Shattered identity, (2) Barriers, inequities, and misinformation, (3) Coping, resiliency, and support. Reproductive decision-making was perceived as a complex process influenced by facilitators and barriers. The facilitators helped WLH cope with their new situation to become more resilient, while the barriers made their situation more difficult to manage. CONCLUSION WLH encounter reproductive decision-making with knowledge deficits and limited social support. An integrated approach to holistic care with comprehensive multidisciplinary counseling is needed to support WLH. Clinicians could benefit from professional development to learn how to be authentically present for WLH, including engaging in conversations, demonstrating compassion, and understanding situations. Evidence-based clinical practice guidelines need to be tailored for the family planning and sexual health needs of WLH.
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Affiliation(s)
- Ariadna Huertas-Zurriaga
- Hospital Universitari Germans Trias I Pujol, Badalona, 08916 Barcelona, Spain
- Grupo de Investigación Enfermera en Vulnerabilidad Y Salud (GRIVIS), Universitat Autònoma de Barcelona, Avda. Can Domènech, Edifici M. Despatx M3/213, Bellaterra (Cerdanyola del Vallès), 08193 Barcelona, Spain
| | - Patrick A. Palmieri
- South American Center for Qualitative Research, Universidad Norbert Wiener, Av. Arequipa 444, Torre 2, Piso 4, Lima, 15046 Perú
- College of Graduate Health Studies, A. T. Still University, 800 W. Jefferson Street, Kirksville, MO 63501 USA
- Center for Global Nursing, Texas Woman’s University, 6700 Fannin St, Houston, TX 77030 USA
- EBHC South America: A JBI Affiliated Group, Calle Cartavio 406, Suite 402, Lima, 15023 Peru
| | - Joan E. Edwards
- Center for Global Nursing, Texas Woman’s University, 6700 Fannin St, Houston, TX 77030 USA
- Nelda C. Stark College of Nursing, Texas Woman’s University, 6700 Fannin St, Houston, TX 77030 USA
| | - Sandra K. Cesario
- Center for Global Nursing, Texas Woman’s University, 6700 Fannin St, Houston, TX 77030 USA
- Nelda C. Stark College of Nursing, Texas Woman’s University, 6700 Fannin St, Houston, TX 77030 USA
| | - Sergio Alonso-Fernandez
- Recerca i Innovació en Cures Infermeres, Hospital Universitari Germans Trias I Pujol, Badalona, 08916 Barcelona, Spain
| | - Lidia Pardell-Dominguez
- Grupo de Investigación Enfermera en Vulnerabilidad Y Salud (GRIVIS), Universitat Autònoma de Barcelona, Avda. Can Domènech, Edifici M. Despatx M3/213, Bellaterra (Cerdanyola del Vallès), 08193 Barcelona, Spain
- EBHC South America: A JBI Affiliated Group, Calle Cartavio 406, Suite 402, Lima, 15023 Peru
- Department D’Infermeria, Facultat de Medicina, Universitat Autònoma de Barcelona, Avda. Can Domènech, Edifici M. Despatx M3/213, Bellaterra (Cerdanyola del Vallès), 08193 Barcelona, Spain
| | - Karen A. Dominguez-Cancino
- EBHC South America: A JBI Affiliated Group, Calle Cartavio 406, Suite 402, Lima, 15023 Peru
- Escuela de Enfermería, Universidad Científica del Sur, Carr. Panamericana Sur 19, Villa EL Salvador, Lima, 15067 Perú
- Escuela de Salud Pública, Universidad de Chile, Independencia 939, Independencia, 8380453 Santiago de Chile, Chile
| | - Juan M. Leyva-Moral
- Grupo de Investigación Enfermera en Vulnerabilidad Y Salud (GRIVIS), Universitat Autònoma de Barcelona, Avda. Can Domènech, Edifici M. Despatx M3/213, Bellaterra (Cerdanyola del Vallès), 08193 Barcelona, Spain
- EBHC South America: A JBI Affiliated Group, Calle Cartavio 406, Suite 402, Lima, 15023 Peru
- Department D’Infermeria, Facultat de Medicina, Universitat Autònoma de Barcelona, Avda. Can Domènech, Edifici M. Despatx M3/213, Bellaterra (Cerdanyola del Vallès), 08193 Barcelona, Spain
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Yang F, Li Z, Subramianian SV, Lu C. Assessment of Knowledge of HIV/AIDS and Association With Socioeconomic Disparities Among Young Women in Low- and Middle-Income Countries, 2003 to 2018. JAMA Netw Open 2021; 4:e2035000. [PMID: 33481034 PMCID: PMC7823222 DOI: 10.1001/jamanetworkopen.2020.35000] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
IMPORTANCE Knowledge of HIV/AIDS among the younger population is crucial for long-term control. Little research has been done on which groups of young women (aged 15-24 years) in low- and middle-income countries (LMICs) have been left behind with respect to obtaining this knowledge. OBJECTIVE To provide an up-to-date assessment of the levels of and changes in knowledge of HIV/AIDS and its associations with socioeconomic disparity among young women in LMICs. DESIGN, SETTING, AND PARTICIPANTS This cross-sectional study used nationally representative Demographic and Health Surveys with available data on HIV/AIDS knowledge in 51 LMICs between 2003 and 2018. The final data set contained 282 757 young women. For 40 LMICs with multiple surveys available, we examined changes in knowledge and socioeconomic disparities. Analyses of the survey data were conducted between December 1, 2019, and July 31, 2020. MAIN OUTCOMES AND MEASURES The percentage of young women who were able to (1) correctly identify the 2 major ways of preventing the sexual transmission of HIV, (2) reject the 2 most common local misconceptions about HIV transmission and (3) know that a healthy-looking person can transmit HIV. The level of and changes in young women's knowledge of HIV/AIDS as well as knowledge disparities by residential area, wealth status, and level of education on the aggregate and country levels were assessed. RESULTS Of a total of 282 757 young women from 51 LMICs, 29.3% (95% CI, 24.1% to 34.5%) reported having knowledge of HIV/AIDS in the latest years, ranging from 1.0% (95% CI, 0.7% to 1.3%) in Afghanistan in 2015 to 64.9% (95% CI, 63.3% to 66.5%) in Rwanda in 2014 to 2015. Those living in rural areas, living in households in the lowest income quintile, or with low levels of education reported less knowledge about HIV/AIDS than their counterparts (-12.8 [95% CI, -10.6 to -14.9] percentage points; -21.8 [95% CI, -18.3 to -25.3] percentage points; and -19.4 [95% CI, -16.6 to -22.2] percentage points, respectively). Among the 40 countries that had undertaken at least 2 surveys during the period, the surveys indicated that there was a significant increase in knowledge of HIV/AIDS among young women in 24 countries (60.0%), but a significant decrease in 10 countries (25.0%). Less than half of countries experienced significant reductions in disparities associated with residential area (8 countries [20.0%]), wealth (5 countries [12.5%]), or education (17 countries [42.5%]). CONCLUSIONS AND RELEVANCE This cross-sectional study of women in 51 LMICs found low levels and large gaps in knowledge of HIV/AIDS between groups, suggesting that future HIV-prevention campaigns should emphasize providing easily accessible information to socioeconomically disadvantaged groups.
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Affiliation(s)
- Fan Yang
- Nanjing Medical University School of Health Policy and Management, Nanjing, Jiangsu Province, People’s Republic of China
| | - Zhihui Li
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - S. V. Subramianian
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Chunling Lu
- Division of Global Health Equity, Brigham and Women’s Hospital, Boston, Massachusetts
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts
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10
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Chilaka VN, Konje JC. HIV in pregnancy - An update. Eur J Obstet Gynecol Reprod Biol 2020; 256:484-491. [PMID: 33246666 PMCID: PMC7659513 DOI: 10.1016/j.ejogrb.2020.11.034] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2020] [Revised: 11/09/2020] [Accepted: 11/11/2020] [Indexed: 11/16/2022]
Abstract
Human immunodeficiency virus (HIV) is an infection with a global prevalence and currently no cure or vaccine. Women living with HIV who become pregnant or who acquire the virus during pregnancy are at risk of both maternal and perinatal morbidity and mortality mainly if the virus is poorly controlled. Furthermore, there is a risk of vertical transmission to the fetus during pregnancy labour and postpartum through breastfeeding. Appropriate management must be instituted to reduce the consequences of HIV in pregnancy, ideally starting with preconception counselling and planning pregnancies when the viral load is minimum. During pregnancy, an appropriate combined anti-retroviral (cART) medication is mandatory with very close monitoring of the viral load, cluster of differentiation 4 (CD4) cell counts, blood counts, liver and kidney function tests. Planning delivery should not be different in women on cART and suppressed viral loads. However, special care must be taken to limit vertical transmission in those who present late and in whom viral load is unknown or not controlled at the time of delivery. Breastfeeding remains a potential source of infection for the baby and is being discouraged in high-income countries for women living with HIV; however, in low-income countries, the recommendation is exclusive breastfeeding. If breastfeeding must happen, it is best when viral load is suppressed, and cART continued until weaning. Serodiscordant couples present unique problems, and their management should begin with the planning of pregnancy. Emphasis should be on taking steps to prevent HIV transmission to the negative partner and vertical transmission to the new-born.
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Affiliation(s)
- Victor N Chilaka
- Women's Wellness Research Center, Hamad Medical Corporation, Doha, Qatar; Weill Cornell Medicine, Doha, Qatar.
| | - Justin C Konje
- Weill Cornell Medicine, Doha, Qatar; Sidra Medicine, Doha, Qatar; University of Leicester, UK
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Asamoah CK, Asamoah BO, Agardh A. A generation at risk: a cross-sectional study on HIV/AIDS knowledge, exposure to mass media, and stigmatizing behaviors among young women aged 15-24 years in Ghana. Glob Health Action 2018. [PMID: 28621223 PMCID: PMC5496072 DOI: 10.1080/16549716.2017.1331538] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Abstract
HIV/AIDS stigmatizing behaviors are a huge barrier to early detection and treatment of individuals with the AIDS virus. HIV/AIDS stigma and related consequences are debilitating, especially for vulnerable populations. This study sought to assess whether young women's HIV/AIDS knowledge levels and exposure to mass media (television and radio) have an influence on their stigmatizing behaviors and role as agents of stigma towards individuals living with HIV and AIDS. The data used for this study originated from the Ghana Multiple Indicator Cluster Survey 2011. Binary and multiple (stepwise) logistic regression analyses were used to examine the associations between HIV/AIDS knowledge, frequency of exposure to mass media, and HIV/AIDS stigmatizing behaviors among young women aged 15-24 years in Ghana. Of the 3573 young women, 80% of 15-19-year-olds and 76% of 20-24-year-olds had at least one stigmatizing behavior towards persons living with HIV/AIDS (PLHA). Young women with increased knowledge regarding HIV/AIDS and frequent exposure to mass media (television and radio) had lesser tendency to stigmatize or act as agents of stigma towards PLHA (proportion with at least one stigmatizing behavior per subgroup - HIV/AIDS knowledge: those with highest knowledge score 579 [70.1%], those with lowest knowledge score 28 [90.3%]; mass media: those with daily exposure 562 [73.4%], those not exposed at all 249 [89.2%]). There was a graded negative 'exposure-response' association between the ranked variables: HIV/AIDS knowledge, mass media, and HIV/AIDS stigmatizing behaviors. The significant inverse association between HIV/AIDS knowledge, frequency of exposure to mass media, and HIV/AIDS stigmatizing behaviors persisted even after adjusting for all other covariates in the multiple logistic regression models. It is extremely important to increase HIV/AIDS-related knowledge and reduce stigma among young women in Ghana through targeted HIV/AIDS factual knowledge transfer. The use of mass media for communication of issues regarding HIV/AIDS, its mode of transmission, and associated stigma should be emphasized among women in Ghana.
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Affiliation(s)
- Charity Konadu Asamoah
- a International Master Programme in Public Health, Faculty of Medicine , Lund University , Malmö , Sweden
| | - Benedict Oppong Asamoah
- b Social Medicine and Global Health, Department of Clinical Sciences , Lund University , Malmö , Sweden
| | - Anette Agardh
- b Social Medicine and Global Health, Department of Clinical Sciences , Lund University , Malmö , Sweden
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Jones DL, Echenique M, Potter J, Rodriguez VJ, Weiss SM, Fischl MA. Adolescent girls and young women living with HIV: preconception counseling strategies. Int J Womens Health 2017; 9:657-663. [PMID: 29066934 PMCID: PMC5605185 DOI: 10.2147/ijwh.s136668] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Background Rates of pregnancy among women living with HIV are similar to those in the general population. Unintended pregnancies are also common, and among adolescents and young women perinatally infected (PHIV+) or behaviorally infected (BHIV+) with HIV, planning for both conception and contraception is an important element of HIV care that may be neglected. This pilot study examined the influence of intervention strategies targeting fertility planning, safer conception practices and patient-provider communication. It was hypothesized that preconception counseling interventions would enhance reproductive knowledge, planning and practices, as well as stimulate discussion with providers regarding conception. Methods Adolescent girls and young women (N=34) perinatally (n=21) or behaviorally (n=13) infected with HIV, aged 16–29 years, were recruited from urban South Florida, and completed measures of reproductive knowledge, sexual practices and fertility intentions. Participants were randomized to condition, ie, video presentation plus Motivational Interviewing (MI), MI only, control. Results The average age of women was 22 years (SD =3.27), and the majority of them were African American. Levels of depression were higher among BHIV+ compared to PHIV+ at baseline and 6 months. Pregnancy knowledge (pregnancy, safe conception and pregnancy planning) and the proportion of those engaging in birth control planning (condom use, long-term birth control, patient-provider discussions on preventing pregnancy and fertility desires) were similar between conditions at post-intervention and 6 months. Bayes factors indicated that the data were insensitive with regard to differences between conditions, limiting support for both the null and alternative hypotheses. Conclusion The impact of interventions used in this study to stimulate pregnancy planning was inconclusive. Results suggest that pregnancy planning interventions may require greater intensity to influence sexual behavior in this population. Despite adequate reproductive knowledge, HIV-infected adolescent girls and young women may fail to engage in planning behavior.
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Affiliation(s)
| | | | | | | | | | - Margaret A Fischl
- Department of Medicine, Division of Infectious Diseases, University of Miami Miller School of Medicine, Miami, FL, USA
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14
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Rodriguez VJ, Cook RR, Weiss SM, Peltzer K, Jones DL. Psychosocial correlates of patient-provider family planning discussions among HIV-infected pregnant women in South Africa. Open Access J Contracept 2017. [PMID: 28626358 PMCID: PMC5473338 DOI: 10.2147/oajc.s134124] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Patient–provider family planning discussions and preconception counseling can reduce maternal and neonatal risks by increasing adherence to provider recommendations and antiretroviral medication. However, HIV-infected women may not discuss reproductive intentions with providers due to anticipation of negative reactions and stigma. This study aimed to identify correlates of patient–provider family planning discussions among HIV-infected women in rural South Africa, an area with high rates of antenatal HIV and suboptimal rates of prevention of mother-to-child transmission (PMTCT) of HIV. Participants were N=673 pregnant HIV-infected women who completed measures of family planning discussions and knowledge, depression, stigma, intimate partner violence, and male involvement. Participants were, on average, 28 ± 6 years old, and half of them had completed at least 10–11 years of education. Most women were unemployed and had a monthly income of less than ~US$76. Fewer than half of the women reported having family planning discussions with providers. Correlates of patient–provider family planning discussions included younger age, discussions about PMTCT of HIV, male involvement, and decreased stigma (p < 0.05). Depression was indirectly associated with patient–provider family planning discussions through male involvement (b = −0.010, bias-corrected 95% confidence interval [bCI] [−0.019, −0.005]). That is, depression decreased male involvement, and in turn, male involvement increased patient–provider family planning discussions. Therefore, by decreasing male involvement, depression indirectly decreased family planning discussions. Study findings point to the importance of family planning strategies that address depression and facilitate male involvement to enhance communication between patients and providers and optimize maternal and neonatal health outcomes. This study underscores the need for longitudinal assessment of men’s impact on family planning discussions both pre- and postpartum. Increasing support for provision of mental health services during pregnancy is merited to ensure the health of pregnant women living with HIV and their infants.
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Affiliation(s)
- Violeta J Rodriguez
- Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Ryan R Cook
- Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Stephen M Weiss
- Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Karl Peltzer
- HIV/AIDS/STIs and TB (HAST) Research Programme, Human Sciences Research Council, Pretoria, South Africa.,ASEAN Institute for Health Development, Mahidol University, Salaya, Thailand.,Department of Psychology, University of Limpopo, Turfloop, South Africa
| | - Deborah L Jones
- Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, FL, USA
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Jones DL, Cook R, Potter JE, Miron-Shatz T, Chakhtoura N, Spence A, Byrne MM. Fertility Desires among Women Living with HIV. PLoS One 2016; 11:e0160190. [PMID: 27610626 PMCID: PMC5017599 DOI: 10.1371/journal.pone.0160190] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2016] [Accepted: 07/14/2016] [Indexed: 12/03/2022] Open
Abstract
OBJECTIVE Rates of pregnancy among women living with HIV (WLHIV) have increased with the availability of effective HIV treatment. Planning for pregnancy and childbirth is an increasingly important element of HIV care. Though rates of unintended pregnancies are high among women in general, among couples affected by HIV, significant planning and reproductive decisions must be considered to prevent negative health consequences for WLHIV and their neonates. To gain insight into this reproductive decision-making process among WLHIV, this study explored women's knowledge, attitudes and practices regarding fertility planning, reproductive desires, and safer conception practices. It was hypothesized that pregnancy desires would be influenced by partners, families, the potential risk of HIV transmission to infants, and physicians' recommendations. METHODS WLHIV of childbearing age were recruited from urban South Florida, and completed an assessment of demographics (N = 49), fertility desires and a conjoint survey of factors associated with reproductive decision-making. RESULTS Using conjoint analysis, we found that different decision paths exist for different types of women: Younger women and those with less education desired children if their partners wanted children; reproductive desires among those with less education, and with less HIV pregnancy-related knowledge, displayed a trend toward additional emphasis on their family's desires. Conversely, older women and those with more education appeared to place more importance on physician endorsement in their plans for childbearing. CONCLUSIONS Results of this study highlight the importance of ongoing preconception counselling for all women of reproductive age during routine HIV care. Counselling should be tailored to patient characteristics, and physicians should consider inclusion of families and/or partners in the process.
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Affiliation(s)
- Deborah Lynne Jones
- Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, Florida, United States of America
| | - Ryan Cook
- Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, Florida, United States of America
| | - JoNell Efantis Potter
- Obstetrics and Gynecology, University of Miami Miller School of Medicine, Miami, Florida, United States of America
| | - Talya Miron-Shatz
- Ono Academic College, Kiryat Ono, Israel
- Center for Medicine in the Public Interest, New York, New York, United States of America
| | - Nahida Chakhtoura
- Obstetrics and Gynecology, University of Miami Miller School of Medicine, Miami, Florida, United States of America
| | - Andrew Spence
- Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, Florida, United States of America
| | - Margaret M. Byrne
- Epidemiology and Public Health, University of Miami Miller School of Medicine, Miami, Florida, United States of America
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Echenique M, Rodriguez VJ, LaCabe RP, Privette CK, Jones DL, Potter JE, Fischl MA. Behaviorally and perinatally HIV-infected young women: targets for preconception counseling. AIDS Care 2016; 29:372-377. [PMID: 27535165 DOI: 10.1080/09540121.2016.1220483] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
This study aimed to describe demographic and psychological characteristics among HIV-infected young women, and to identify knowledge, attitudes, and behaviors associated with conception, with the goal of informing interventions or programmatic decisions regarding preconception counseling methods for young women living with HIV. Behaviorally and perinatally HIV-infected young women (n = 34) were conveniently sampled in Miami, Florida. Participants were asked to complete measures of reproductive knowledge, attitudes toward conception, and risk behaviors, as well as measures of depression and cognitive functioning. Perinatally and behaviorally HIV-infected young women were very similar in important areas of health preconception practices such as conception-related health literacy and conception-related communication with providers. Behaviorally infected women, however, were somewhat more likely to have been pregnant in the past, and had greater knowledge of healthy contraception practices and family planning. Despite the difference among groups, both the perinatally and behaviorally acquired women demonstrated having adequate overall knowledge. Depression was higher and consistent with moderate depression among the behaviorally HIV-infected women in comparison to perinatally infected women. This study found that that despite adequate reproductive knowledge, most young HIV-infected women were not using contraception. Given the consequences of presentation of advanced HIV during pregnancy, the need for both treatment adherence and preconception counseling is essential. Results suggest that interventions or programmatic decisions regarding preconception counseling methods for young women living with HIV are necessary and potentially transferrable between populations.
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Affiliation(s)
- Marisa Echenique
- a Department of Psychiatry and Behavioral Sciences , University of Miami Miller School of Medicine , Miami , FL , USA
| | - Violeta J Rodriguez
- a Department of Psychiatry and Behavioral Sciences , University of Miami Miller School of Medicine , Miami , FL , USA
| | - Richard P LaCabe
- a Department of Psychiatry and Behavioral Sciences , University of Miami Miller School of Medicine , Miami , FL , USA
| | - C Kyle Privette
- a Department of Psychiatry and Behavioral Sciences , University of Miami Miller School of Medicine , Miami , FL , USA
| | - Deborah L Jones
- a Department of Psychiatry and Behavioral Sciences , University of Miami Miller School of Medicine , Miami , FL , USA
| | - JoNell Efantis Potter
- b Department of Obstetrics and Gynecology , University of Miami Miller School of Medicine , Miami , FL , USA
| | - Margaret A Fischl
- c Department of Infectious Diseases , University of Miami Miller School of Medicine , Miami , FL , USA
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Management of HIV Infection during Pregnancy in the United States: Updated Evidence-Based Recommendations and Future Potential Practices. Infect Dis Obstet Gynecol 2016; 2016:7594306. [PMID: 27504071 PMCID: PMC4967680 DOI: 10.1155/2016/7594306] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2016] [Revised: 06/08/2016] [Accepted: 06/16/2016] [Indexed: 12/02/2022] Open
Abstract
All HIV-infected women contemplating pregnancy should initiate combination antiretroviral therapy (cART), with a goal to achieve a maternal serum HIV RNA viral load beneath the laboratory level of detection prior to conceiving, as well as throughout their pregnancy. Successfully identifying HIV infection during pregnancy through screening tests is essential in order to prevent in utero and intrapartum transmission of HIV. Perinatal HIV transmission can be less than 1% when effective cART, associated with virologic suppression of HIV, is given during the ante-, intra-, and postpartum periods. Perinatal HIV guidelines, developed by organizations such as the World Health Organization, American College of Obstetricians and Gynecologists, and the US Department of Health and Human Services, are constantly evolving, and hence the aim of our review is to provide a useful concise review for medical providers caring for HIV-infected pregnant women, summarizing the latest and current recommendations in the United States.
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