*Maternal Health Task Force, Women and Health Initiative, Department of Global Health and Population, Harvard School of Public Health, Boston, MA; †Division of Reproductive Health, Centers for Disease Control and Prevention, Atlanta, GA; ‡School of Public Health and Family Medicine, Women's Health Research Unit, University of Cape Town, Cape Town, South Africa; §Independent Consultant, Harare, Zimbabwe; ‖Faculty of Health Sciences, Simon Fraser University, Burnaby, Canada; ¶Office of HIV/AIDS, United States Agency for International Development, Washington, DC; #Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, GA; **Office of Health, Infectious Disease and Nutrition, United States Agency for International Development, Washington, DC; ††Department of Obstetrics and Gynecology, Nelson R. Mandela School of Medicine, University of KwaZulu Natal, Durban, South Africa; ‡‡Department of Health Care Organization and Policy, School of Public Health, University of Alabama at Birmingham, Birmingham, AL; and §§Office of the U.S. Global AIDS Coordinator, U.S. Department of State, Washington, DC.
J Acquir Immune Defic Syndr. 2014 Dec 1;67 Suppl 4(Suppl 4):S250-8. doi: 10.1097/QAI.0000000000000377.
INTRODUCTION: HIV makes a significant contribution to maternal mortality, and women living in sub-Saharan Africa are most affected. International commitments to eliminate preventable maternal mortality and reduce HIV-related deaths among pregnant and postpartum women by 50% will not be achieved without a better understanding of the links between HIV and poor maternal health outcomes and improved health services for the care of women living with HIV (WLWH) during pregnancy, childbirth, and postpartum. METHODS: This article summarizes priorities for research and evaluation identified through consultation with 30 international researchers and policymakers with experience in maternal health and HIV in sub-Saharan Africa and a review of the published literature. RESULTS: Priorities for improving the evidence about effective interventions to reduce maternal mortality and improve maternal health among WLWH include better quality data about causes of maternal death among WLWH, enhanced and harmonized program monitoring, and research and evaluation that contributes to improving: (1) clinical management of pregnant and postpartum WLWH, including assessment of the impact of expanded antiretroviral therapy on maternal mortality and morbidity, (2) integrated service delivery models, and (3) interventions to create an enabling social environment for women to begin and remain in care. CONCLUSIONS: As the global community evaluates progress and prepares for new maternal mortality and HIV targets, addressing the needs of WLWH must be a priority now and after 2015. Research and evaluation on maternal health and HIV can increase collaboration on these 2 global priorities, strengthen political constituencies and communities of practice, and accelerate progress toward achievement of goals in both areas.
引言：艾滋病毒对孕产妇死亡率有重大影响，而撒哈拉以南非洲地区的妇女受影响最大。如果不更好地了解艾滋病毒与孕产妇健康不良结局之间的联系，并改善为艾滋病毒感染者（PLHIV）提供的怀孕、分娩和产后护理服务，就无法实现国际承诺，即消除可预防的孕产妇死亡，并将与艾滋病毒相关的孕产妇和产后妇女死亡减少 50%。
方法：本文通过与在撒哈拉以南非洲地区具有孕产妇健康和艾滋病毒经验的 30 名国际研究人员和政策制定者进行磋商，并对已发表的文献进行综述，总结出研究和评估的重点。
结果：为了改进有关减少孕产妇死亡率和改善 PLHIV 孕产妇健康的有效干预措施的证据，需要更好地了解 PLWH 孕产妇死亡的原因，加强和协调方案监测，并开展研究和评估，以改进：（1）PLWH 的怀孕和产后临床管理，包括评估扩大抗逆转录病毒治疗对孕产妇死亡率和发病率的影响，（2）综合服务提供模式，（3）创造有利的社会环境，以鼓励妇女开始并保持护理的干预措施。
结论：随着全球社会评估进展并为新的孕产妇死亡率和艾滋病毒目标做准备，现在和 2015 年后必须将 PLWH 的需求作为优先事项。孕产妇健康和艾滋病毒方面的研究和评估可以增加对这两个全球重点的合作，加强政治选区和实践社区，并加速在这两个领域实现目标的进展。
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