Uptake and Persistence of Safer Conception Strategies Among South African Women Planning for Pregnancy

IF 2.7 2区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH
Oluwaseyi O. Isehunwa, Manjeetha Jaggernath, Yolandie Kriel, Christina Psaros, Mxolisi Mathenjwa, Kathleen E. Hurwitz, Kara Bennett, Patricia M. Smith, David R. Bangsberg, Jeanne M. Marrazzo, Jessica E. Haberer, Jennifer A. Smit, Lynn T. Matthews
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Abstract

Safer conception strategies can minimize HIV acquisition during periconception periods among women living in HIV-endemic areas. We examined uptake and predictors of persistent use of the same safer conception strategy among a cohort of HIV-uninfected South African women ages 18–35 years planning for pregnancy with a partner living with HIV or of unknown HIV-serostatus. The safer conception strategies we evaluated included oral PrEP, condomless sex limited to peak fertility, and waiting for a better time to have a child (until, for example, the risks of HIV acquisition are reduced and/or the individual is prepared to care for a child); persistence was defined as using the same safer conception strategy from the first visit through 9 months follow-up. Modified Poisson regression models were used to examine predictors of persistent use of the same strategy. The average age of 227 women in our cohort was 24.6 (range: 18.0, 35.7) years. In this cohort, 121 (74.2%) women reported persisting in the same strategy through 9 months. Employment and HIV knowledge were associated with the persistent use of any strategy. Our results highlight the need to provide safer conception services to women exposed to HIV during periconception periods. Findings also offer some insights into factors that might influence persistent use. Further research is needed to better understand how to involve male partners and how their involvement might influence women’s consistent use of safer conception strategies during periconception periods.

Abstract Image

南非计划怀孕妇女对更安全受孕策略的采用和坚持。
对于生活在艾滋病流行地区的女性来说,安全受孕策略可以最大限度地减少围孕期感染艾滋病的几率。我们研究了一群 18-35 岁未感染 HIV 的南非妇女在计划与 HIV 感染者或 HIV 感染者身份不明的伴侣怀孕时对相同的安全受孕策略的接受程度和持续使用的预测因素。我们评估的安全受孕策略包括口服 PrEP、仅限于生育高峰期的无套性行为以及等待更好的生育时机(例如,直到感染 HIV 的风险降低和/或个人做好了照顾孩子的准备);持续性的定义是从首次就诊到 9 个月随访期间使用相同的安全受孕策略。我们使用修正的泊松回归模型来研究持续使用同一策略的预测因素。我们队列中 227 名妇女的平均年龄为 24.6 岁(范围:18.0-35.7)。在这个队列中,121 名妇女(74.2%)表示在 9 个月内坚持使用同一策略。就业和艾滋病知识与持续使用任何策略都有关系。我们的研究结果突出表明,有必要在围孕期为暴露于艾滋病病毒的妇女提供更安全的受孕服务。研究结果还提供了一些可能影响持续使用的因素。为了更好地了解如何让男性伴侣参与进来,以及他们的参与会如何影响妇女在围孕期持续使用安全受孕策略,还需要开展进一步的研究。
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来源期刊
AIDS and Behavior
AIDS and Behavior Multiple-
CiteScore
6.60
自引率
13.60%
发文量
382
期刊介绍: AIDS and Behavior provides an international venue for the scientific exchange of research and scholarly work on the contributing factors, prevention, consequences, social impact, and response to HIV/AIDS. This bimonthly journal publishes original peer-reviewed papers that address all areas of AIDS behavioral research including: individual, contextual, social, economic and geographic factors that facilitate HIV transmission; interventions aimed to reduce HIV transmission risks at all levels and in all contexts; mental health aspects of HIV/AIDS; medical and behavioral consequences of HIV infection - including health-related quality of life, coping, treatment and treatment adherence; and the impact of HIV infection on adults children, families, communities and societies. The journal publishes original research articles, brief research reports, and critical literature reviews. provides an international venue for the scientific exchange of research and scholarly work on the contributing factors, prevention, consequences, social impact, and response to HIV/AIDS. This bimonthly journal publishes original peer-reviewed papers that address all areas of AIDS behavioral research including: individual, contextual, social, economic and geographic factors that facilitate HIV transmission; interventions aimed to reduce HIV transmission risks at all levels and in all contexts; mental health aspects of HIV/AIDS; medical and behavioral consequences of HIV infection - including health-related quality of life, coping, treatment and treatment adherence; and the impact of HIV infection on adults children, families, communities and societies. The journal publishes original research articles, brief research reports, and critical literature reviews.5 Year Impact Factor: 2.965 (2008) Section ''SOCIAL SCIENCES, BIOMEDICAL'': Rank 5 of 29 Section ''PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH'': Rank 9 of 76
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