Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
Division of Infectious Diseases, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
J Perinatol. 2018 Jun;38(6):639-644. doi: 10.1038/s41372-018-0066-2. Epub 2018 Feb 12.
To determine whether maternal disclosure of HIV serostatus is associated with uptake of perinatal HIV transmission prevention interventions.
Retrospective cohort study of women living with HIV enrolled in a perinatal HIV clinic. Women who disclosed their HIV serostatus to sexual partner(s) prior to delivery were compared to non-disclosers. Multivariable logistic regression was performed.
Of 209 women, 71.3% (N = 149) disclosed. Non-disclosers were more likely to attend <10 prenatal visits, demonstrated worse antiretroviral therapy adherence, required more time to achieve virologic suppression, and were less likely to have an undetectable viral load. On multivariable analyses, disclosure status did not remain associated with these factors. However, compared to non-disclosers, disclosers had lower odds of preterm delivery (OR: 0.43, 95% CI: 0.19-0.94) and greater odds of postpartum visit attendance (aOR: 5.10, 95% CI: 1.65-15.72).
Non-disclosure of HIV status to sexual partner(s) during pregnancy may be a risk factor for preterm birth and poorer postpartum visit attendance.
确定孕产妇 HIV 感染状况披露是否与围产期 HIV 传播预防干预措施的采用有关。
对在围产期 HIV 诊所登记的 HIV 阳性孕妇进行回顾性队列研究。在分娩前向性伴侣披露 HIV 感染状况的女性与未披露者进行比较。采用多变量逻辑回归进行分析。
在 209 名女性中，71.3%（N=149）披露了 HIV 感染状况。未披露者更有可能就诊次数<10 次，表现出较差的抗逆转录病毒治疗依从性，需要更长时间达到病毒学抑制，并且病毒载量不可检测的可能性较低。在多变量分析中，披露状况与这些因素不再相关。然而，与未披露者相比，披露者早产的可能性较低（OR：0.43，95%CI：0.19-0.94），产后就诊的可能性更高（aOR：5.10，95%CI：1.65-15.72）。
在妊娠期间未向性伴侣披露 HIV 感染状况可能是早产和产后就诊不佳的危险因素。
