Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland 21205, USA.
AIDS Patient Care STDS. 2010 May;24(5):317-23. doi: 10.1089/apc.2009.0293.
The purpose of the study is to assess frequency and determinants of discussions between HIV-infected women and their HIV providers about childbearing plans, and to identify unmet need for reproductive counseling. We conducted a cross-sectional, audio computer-assisted self-interview (ACASI) among 181 predominately African American HIV-infected women of reproductive age receiving HIV clinical care in two urban health clinics. We used descriptive statistics to identify unmet need for reproductive counseling by determining the proportion of women who want to, but have not, discussed future reproductive plans with their primary HIV care provider. Multivariate analysis determined which factors were associated with general and personalized discussions about pregnancy. Of the 181 women interviewed, 67% reported a general discussion about pregnancy and HIV while 31% reported a personalized discussion about future childbearing plans with their provider. Of the personalized discussions, 64% were patient initiated. Unmet reproductive counseling needs were higher for personalized discussions about future pregnancies (56%) than general discussions about HIV and pregnancy (23%). Younger age was the most powerful determinant of provider communication about pregnancy. A significant proportion of HIV-infected women want to talk about reproductive plans with their HIV provider; however, many have not. HIV care providers and gynecologists can address this unmet communication need by discussing reproductive plans with all women of childbearing age so that preconception counseling can be provided when appropriate. Providers will miss opportunities to help women safely plan pregnancy if they only discuss reproductive plans with younger patients.
本研究旨在评估 HIV 感染女性与其 HIV 提供者之间关于生育计划讨论的频率和决定因素，并确定生殖咨询的未满足需求。我们在两家城市健康诊所中对 181 名主要为非裔美国的、处于生育年龄的 HIV 感染女性进行了横断面、音频计算机辅助自我访谈 (ACASI)。我们使用描述性统计来确定生殖咨询的未满足需求，方法是确定希望但尚未与主要 HIV 护理提供者讨论未来生殖计划的女性比例。多变量分析确定了与一般和个性化讨论怀孕相关的因素。在接受采访的 181 名女性中，67%报告了一般的关于怀孕和 HIV 的讨论，而 31%报告了与提供者讨论未来生育计划的个性化讨论。在个性化讨论中，有 64%是由患者发起的。关于未来怀孕的个性化讨论的生殖咨询未满足需求（56%）高于关于 HIV 和怀孕的一般性讨论（23%）。年龄较小是与怀孕相关的提供者沟通的最有力决定因素。相当一部分 HIV 感染女性希望与 HIV 提供者讨论生殖计划；然而，许多人并没有这样做。HIV 护理提供者和妇科医生可以通过与所有有生育能力的女性讨论生殖计划来满足这种未满足的沟通需求，以便在适当的时候提供孕前咨询。如果提供者只与年轻患者讨论生殖计划，他们将错过帮助女性安全计划怀孕的机会。
