Orne-Gliemann Joanna, Font Hélène, Maphosa Talent, Kangwende Abigail, Rusakaniko Simba, Magezi Vhumani, Sengai Tonderai, Shumba Bridget, Zambezi Pemberai, Foster Geoff
*INSERM U1219-Centre Inserm Bordeaux Population Health, Université de Bordeaux, Bordeaux, France; †Université de Bordeaux, ISPED, Centre INSERM U1219-Bordeaux Population Health, Bordeaux, France; ‡Organization for Public Health Interventions and Development, Harare, Zimbabwe; §Clinical Research Centre, Africa University, Mutare, Zimbabwe; ‖University of Zimbabwe, College of Health Sciences, Harare, Zimbabwe; ¶North West University, School of Basic Sciences, Vanderbijlpark, South Africa; #Family AIDS Caring Trust, Mutare, Zimbabwe; and **Mutare Provincial Hospital, Mutare, Zimbabwe.
J Acquir Immune Defic Syndr. 2017 Jun 1;75 Suppl 2:S216-S223. doi: 10.1097/QAI.0000000000001348.
In Southern Africa, groups of mothers living with HIV successfully provide peer psychosocial support during pregnancy and early childhood. We report patterns of attendance at Mother Support Groups (MSGs) sessions among women and mothers living with HIV in rural Zimbabwe.
In the Elimination of Pediatric AIDS cluster-randomized trial, MSGs were established in 14 health facilities in Mutare and Makoni districts. Patterns of attendance at MSG sessions were categorized by calendar attendance from delivery to 6-month postpartum using a Dynamic Time Warping clustering method. Baseline characteristics of women and postpartum MSG attendance patterns were described. Linkages between these patterns and 12-month postpartum retention in care were explored using mixed-effects models.
Most women (88%) attended at least 1 MSG session between enrollment and 6-month postpartum. Two patterns of postpartum MSG attendance, "Regular Attendance" and "Non-Regular Attendance," were readily identified. Being older than 32 (P = 0.01), booking for antenatal care before 22 weeks gestational age (P = 0.02), and being on antiretroviral therapy at first antenatal care booking (P = 0.01) were significantly associated with "Regular Attendance." "Regular Attendance" at MSG sessions during the 6-month postpartum period was significantly associated with better retention in care at 12 months, compared with "Non-Regular Attendance" (P < 0.01).
Women living with HIV attended MSG sessions. However, few attended regularly. Younger and newly diagnosed women were less likely to attend postpartum MSG sessions or remain in care at 12 months postpartum. Peer support models should consider specific needs of these women, especially in rural areas, in order for MSGs to contribute to improve maternal and child health outcomes.
在南部非洲，感染艾滋病毒的母亲群体在孕期和幼儿期成功地提供了同伴心理社会支持。我们报告了津巴布韦农村地区感染艾滋病毒的妇女和母亲参加母亲支持小组（MSG）会议的模式。
在消除儿童艾滋病整群随机试验中，在穆塔雷和马科尼区的14个卫生设施中设立了MSG。使用动态时间规整聚类方法，根据从分娩到产后6个月的日历出勤情况对参加MSG会议的模式进行分类。描述了妇女的基线特征和产后MSG出勤模式。使用混合效应模型探讨了这些模式与产后12个月护理留存率之间的联系。
大多数妇女（88%）在登记入组至产后6个月期间至少参加了1次MSG会议。很容易识别出两种产后MSG出勤模式，即“定期出勤”和“不定期出勤”。年龄大于32岁（P = 0.01）、在孕22周前进行产前检查预约（P = 0.02）以及在首次产前检查预约时接受抗逆转录病毒治疗（P = 0.01）与“定期出勤”显著相关。与“不定期出勤”相比，产后6个月期间“定期出勤”参加MSG会议与12个月时更好的护理留存率显著相关（P < 0.01）。
感染艾滋病毒的妇女参加了MSG会议。然而，很少有人定期参加。年轻和新诊断的妇女在产后参加MSG会议或在产后12个月继续接受护理的可能性较小。同伴支持模式应考虑这些妇女的特殊需求，尤其是在农村地区，以便MSG有助于改善母婴健康结局。
