Napravnik S, Royce R, Walter E, Lim W
Department of Epidemiology, University of North Carolina at Chapel Hill, USA.
AIDS Patient Care STDS. 2000 Aug;14(8):411-20. doi: 10.1089/108729100416623.
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.
为了从接受产前护理不足的感染人类免疫缺陷病毒（HIV）的女性角度了解影响产前护理获取和利用的问题，我们进行了三次深入的定性和定量访谈。通过对叙述性访谈的主题分析，出现了四个与这些女性产前护理经历相关的广泛领域。这些是与怀孕、HIV、心理社会状况和医疗保健系统有关的问题。对这些女性来说，产前护理利用的障碍包括怀孕的意外性和计划性以及与HIV感染相关的心理健康问题。贫困、周期性无家可归、对非法物质的成瘾以及缺乏社会支持也是重要障碍。此外，将医疗保健系统视为威胁的看法，包括对披露非法活动后果、歧视和违反保密规定的担忧，成为了突出的障碍。促进因素包括将怀孕视为改变生活的事件、对孩子的关心，特别是预防HIV-1垂直传播、治疗的可获得性以及医疗保健专业人员的支持。访谈中突出的是女性的心理健康问题以及对专业支持的需求。
