Anderson Emily A, Momplaisir Florence M, Corson Catherine, Brady Kathleen A
AIDS Activities Coordinating Office, Philadelphia Department of Public Health, 1101 Market Street, 8th Floor, Philadelphia, PA, 19107, USA.
Division of Infectious Diseases and HIV Medicine, Drexel University School of Medicine, Philadelphia, PA, USA.
AIDS Behav. 2017 Sep;21(9):2670-2681. doi: 10.1007/s10461-017-1714-9.
To evaluate the impact of a Perinatal Medical Case Management (PCM) Program for women living with HIV (WLWH). Characteristics of pregnant and postpartum WLWH were compared between those who engaged in PCM and those who did not. Using secondary data collected from routine HIV surveillance, multivariable regression models were used to evaluate the association between PCM and four outcomes adapted from the HIV care continuum. In multivariable models, compared to WLWH not in PCM, participants (n = 448, 52.8%) were almost twice as likely to achieve HIV suppression before delivery (aOR 1.90 [1.33, 2.71], p = 0.0005); were more likely to be retained in HIV care 1 year postpartum (aOR 1.59 [1.17, 2.16], p = 0.0029); and were equally likely to engage in HIV care within 90-days of delivery (aOR 1.21 [0.88, 1.65], p = 0.236) and be virally suppressed 1 year postpartum (aOR 1.26 [0.90, 1.77], p = 0.178). PCM is an important intervention for preventing perinatal HIV transmission and closings gaps in the HIV care continuum for WLWH during pregnancy and postpartum.
评估围产期医疗病例管理（PCM）项目对感染艾滋病毒的女性（WLWH）的影响。比较参与PCM的孕妇和产后WLWH与未参与PCM的孕妇和产后WLWH的特征。利用从常规艾滋病毒监测收集的二手数据，采用多变量回归模型评估PCM与从艾滋病毒治疗连续过程改编的四个结果之间的关联。在多变量模型中，与未参与PCM的WLWH相比，参与者（n = 448，52.8%）在分娩前实现艾滋病毒抑制的可能性几乎高出一倍（调整后比值比[aOR]为1.90[1.33，2.71]，p = 0.0005）；产后1年更有可能继续接受艾滋病毒治疗（aOR为1.59[1.17，2.16]，p = 0.0029）；在分娩后90天内接受艾滋病毒治疗的可能性相同（aOR为1.21[0.88，1.65]，p = 0.236），产后1年病毒得到抑制的可能性相同（aOR为1.26[0.90，1.77]，p = 0.178）。PCM是预防围产期艾滋病毒传播以及缩小WLWH在孕期和产后艾滋病毒治疗连续过程中差距的一项重要干预措施。
