Hampanda Karen M, Nimz Abigail M, Abuogi Lisa L
Department of Community and Behavioral Health, Colorado School of Public Health, 13199 East Montview Boulevard, Suite 310, Mail Stop A090, Aurora, CO, 80045, USA.
University of Colorado School of Medicine, 13001 E 17th Place, Aurora, CO, 80045, USA.
AIDS Res Ther. 2017 Mar 21;14(1):17. doi: 10.1186/s12981-017-0142-2.
Early detection of pediatric HIV through uptake of infant HIV testing is critical for access to treatment and child survival. While structural barriers have been well described, a greater understanding of social and behavioral factors that may relate to maternal uptake of early infant HIV testing services is urgently needed. The aim of this study was to explore how gender power dynamics within couples affect HIV-positive women's uptake of early infant HIV testing at a large health center in Lusaka, Zambia.
In 2014, 320 HIV-positive married postpartum women were recruited at a large public health facility in Lusaka to participate in a cross-sectional survey. Data on uptake of early infant HIV testing by 4-6 weeks of age was collected through medical records. Simple and multiple logistic regression models determined significant predictors of maternal uptake of early infant HIV testing.
In the adjusted model, uptake of early infant HIV testing was associated with female-directed emotional intimate partner violence (aOR 0.41; 95% CI 0.21-0.79; p < 0.01), HIV status disclosure to the male partner (aOR 13.73, 95% CI 3.59-52.49, p < 0.001), and maternal postpartum ART adherence (aOR 2.28, 95% CI 1.15-4.55, p < 0.05).
Domestic relationship dynamics, including emotional violence and HIV status disclosure to the male partner, may play an important role in maternal uptake of early infant HIV testing. These findings provide additional evidence for the link between intimate partner violence against women and poor HIV-related health outcomes. Programs that adequately screen for and address various forms of intimate partner violence within the context of prevention of mother-to-child transmission are recommended.
通过开展婴儿HIV检测实现儿科HIV的早期检测对于获得治疗及儿童生存至关重要。虽然结构性障碍已得到充分描述，但迫切需要更深入了解可能与母亲接受早期婴儿HIV检测服务相关的社会和行为因素。本研究的目的是探讨赞比亚卢萨卡一家大型健康中心内夫妻间的性别权力动态如何影响HIV阳性女性接受早期婴儿HIV检测。
2014年，在卢萨卡一家大型公共卫生机构招募了320名HIV阳性的已婚产后妇女参与一项横断面调查。通过医疗记录收集关于婴儿4至6周龄时接受早期婴儿HIV检测的情况数据。采用简单和多元逻辑回归模型确定母亲接受早期婴儿HIV检测的显著预测因素。
在调整模型中，接受早期婴儿HIV检测与女性主导的情感亲密伴侣暴力相关（调整后比值比为0.41；95%置信区间为0.21 - 0.79；p < 0.01）、向男性伴侣披露HIV感染状况（调整后比值比为13.73，95%置信区间为3.59 - 52.49，p < 0.001）以及母亲产后抗逆转录病毒治疗依从性（调整后比值比为2.28，95%置信区间为1.15 - 4.55，p < 0.05）。
家庭关系动态，包括情感暴力和向男性伴侣披露HIV感染状况，可能在母亲接受早期婴儿HIV检测方面发挥重要作用。这些发现为亲密伴侣对妇女的暴力行为与不良HIV相关健康结果之间的联系提供了更多证据。建议在预防母婴传播的背景下充分筛查并处理各种形式亲密伴侣暴力行为的项目。
