Tavengwa N V, Piwoz E G, Iliff P J, Moulton L H, Zunguza C D, Nathoo K J, Hargrove J W, Humphrey J H
ZVITAMBO Project, Harare, Zimbabwe.
Trop Med Int Health. 2007 Jan;12(1):97-106. doi: 10.1111/j.1365-3156.2006.01758.x.
To examine the relationships between maternal knowledge and concern about HIV status, adoption of preventive practices and risk of acquiring HIV in Zimbabwe.
Knowledge and behavioural data were collected via interview from 2595 mothers enrolled in ZVITAMBO, a randomized trial of postpartum vitamin A supplementation that also offered education on safer infant feeding and sexual practices. Mothers were tested for HIV at delivery; those uninfected at baseline were retested during study follow-up. Logistic regression methods were used to identify variables associated with adoption of preventive behaviours and, for HIV-negative mothers, their relationship to risk of acquiring HIV post-delivery.
A total of 518 mothers (20%) reported practicing safer sex and 289 mothers (11%) reported modifying their feeding behaviour because of HIV. Fear of transmitting HIV (50.4%) and protecting the baby's health (30.9%) were the most frequently cited reasons for behaviour change. Forty-nine HIV-negative mothers acquired HIV during the first postpartum year. After taking into account other significant covariates, mothers who were concerned about their own HIV status were 1.9 times more likely (95% CI: 1.05-3.52; P = 0.03), and those reporting safer sex practices were 58% less likely to become infected (adjusted odds ratio: 0.42; 95% CI: 0.17-1.04; P = 0.06). Married women who reported practicing abstinence to prevent HIV were 3.2 times more likely to become infected than non-abstaining mothers (P = 0.01), while there were no new HIV infections among abstaining single mothers.
Greater emphasis should be given to safer sex practices among women who test negative in mother-to-child HIV prevention programmes.
研究在津巴布韦，母亲对艾滋病毒状况的了解与担忧、预防措施的采用情况以及感染艾滋病毒风险之间的关系。
通过访谈收集了2595名参与ZVITAMBO研究的母亲的知识和行为数据。ZVITAMBO是一项产后维生素A补充剂的随机试验，该试验还提供了关于更安全的婴儿喂养和性行为的教育。母亲们在分娩时接受了艾滋病毒检测；基线时未感染的母亲在研究随访期间再次接受检测。采用逻辑回归方法确定与采取预防行为相关的变量，对于艾滋病毒阴性的母亲，确定这些变量与分娩后感染艾滋病毒风险的关系。
共有518名母亲（20%）报告采取了更安全性行为，289名母亲（11%）报告因艾滋病毒改变了喂养行为。担心传播艾滋病毒（50.4%）和保护婴儿健康（30.9%）是行为改变最常提及的原因。49名艾滋病毒阴性母亲在产后第一年感染了艾滋病毒。在考虑了其他重要的协变量后，担心自身艾滋病毒状况的母亲感染艾滋病毒的可能性高1.9倍（95%置信区间：1.05 - 3.52；P = 0.03），而报告采取更安全性行为的母亲感染艾滋病毒的可能性降低58%（调整后的优势比：0.42；95%置信区间：0.17 - 1.04；P = 0.06）。报告为预防艾滋病毒而禁欲的已婚妇女感染艾滋病毒的可能性是非禁欲母亲的3.2倍（P = 0.01），而禁欲的单身母亲中没有新的艾滋病毒感染病例。
在母婴艾滋病毒预防项目中检测呈阴性的女性中，应更加强调更安全性行为。
