Kumar Alok, Bent Valmay
The Queen Elizabeth Hospital, Department of Pediatrics & Obstetrics, St. Michael, Barbados.
Rev Panam Salud Publica. 2003 Jan;13(1):1-9. doi: 10.1590/s1020-49892003000100001.
To describe the demographic profile, social and family characteristics, and lifestyle traits of HIV-infected childbearing women in the Caribbean nation of Barbados in comparison to a control group of HIV-negative women.
Data for this report were drawn from the Pediatrics HIV Surveillance Program of the Queen Elizabeth Hospital in Barbados. The data covered all HIV-infected women in the country who delivered between 1986-2000, with similar data coming from a control group of HIV-negative childbearing women. Routine information recorded during antenatal care was obtained from the women's case records. Additional data were collected from interviews with the women.
There were 182 HIV-infected women who delivered during the study period, and a group of 202 childbearing women served as controls. In comparison to the control group, the HIV-infected women were younger, more often multiparous, and more likely to have been unemployed at the time of their pregnancy. The HIV-infected women also had had an earlier onset of sexual activity, had had more sexual partners during their lifetime, and were more likely to be involved with an older sexual partner. At the time of giving birth most of the HIV-infected women were asymptomatic for AIDS and were living with either their parents (mother or father or both) or the baby's father. In addition, at the time of their six-weeks-postnatal visit, the large majority of the HIV-infected women were involved in caring for their children. The proportion of HIV-infected women who were diagnosed prior to childbirth increased significantly over the study period, rising from 25% during 1986-1990 to 82% during 1996-2000. Slightly over one-fifth of the HIV-infected women had had one or more subsequent pregnancies after they had learned that they were infected.
The early age of sexual activity as well as repeated pregnancies, especially from different and older partners, may have contributed significantly to both vertical and horizontal HIV transmission in Barbados. Future studies of HIV incidence and its trend among childbearing women could be important for monitoring the HIV epidemic in this country. Many of the HIV-infected childbearing women in our study were unemployed, sick, and had multiple children. Therefore, to help them to plan for and cope with the disease and also the care of their children beyond the perinatal period, there is a need to provide the women with repeated counseling with continued follow-up and, where necessary, additional economic, social, and medical support.
描述加勒比国家巴巴多斯感染艾滋病毒的育龄妇女的人口统计学特征、社会和家庭特征以及生活方式特点，并与未感染艾滋病毒的女性对照组进行比较。
本报告的数据取自巴巴多斯伊丽莎白女王医院的儿科艾滋病毒监测项目。数据涵盖了该国1986年至2000年间分娩的所有感染艾滋病毒的妇女，未感染艾滋病毒的育龄妇女对照组也提供了类似数据。产前护理期间记录的常规信息来自这些妇女的病例记录。另外还通过与这些妇女的访谈收集了更多数据。
在研究期间有182名感染艾滋病毒的妇女分娩，202名育龄妇女作为对照组。与对照组相比，感染艾滋病毒的妇女更年轻，多产的情况更常见，怀孕时更有可能处于失业状态。感染艾滋病毒的妇女开始性活动的年龄更早，一生中拥有的性伴侣更多，而且更有可能与年龄较大的性伴侣交往。分娩时，大多数感染艾滋病毒的妇女没有艾滋病症状，与父母（母亲或父亲一方或双方）或孩子的父亲住在一起。此外，在产后六周访视时，绝大多数感染艾滋病毒的妇女都在照顾自己的孩子。在研究期间，分娩前被诊断出感染艾滋病毒的妇女比例显著增加，从1986年至1990年期间的25%升至1996年至2000年期间的82%。略超过五分之一的感染艾滋病毒的妇女在得知自己感染后有过一次或多次后续怀孕。
性活动开始年龄早以及多次怀孕，尤其是与不同且年龄较大的伴侣怀孕，可能在很大程度上导致了巴巴多斯艾滋病毒的垂直和水平传播。未来对育龄妇女中艾滋病毒发病率及其趋势的研究对于监测该国的艾滋病毒疫情可能很重要。我们研究中的许多感染艾滋病毒的育龄妇女失业、患病且子女众多。因此，为帮助她们规划并应对疾病以及围产期之后对孩子的照料，有必要为这些妇女提供反复的咨询并持续随访，必要时提供额外的经济、社会和医疗支持。
