Jones Deborah L, Rodriguez Violeta J, Babayigit Suat, Chahine Antonio, Weiss Stephen M, Peltzer Karl
1 Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, FL, USA.
2 Department of Psychology, University of Georgia, Athens, GA, USA.
Int J STD AIDS. 2018 Aug;29(9):908-916. doi: 10.1177/0956462418766932. Epub 2018 Apr 8.
Despite pregnancy spacing recommendations to optimize health outcomes among mothers and neonates, unplanned pregnancy in sub-Saharan Africa is common among women living with human immunodeficiency virus (HIV) (WLHIV). This study examined factors associated with reproductive decision-making among WLHIV to inform pregnancy-planning interventions. WLHIV in rural South Africa (n = 165) were assessed at 12 months postpartum. The relative importance of factors associated with reproductive decision-making was estimated. Women were a mean of 28 years old (SD = 5.71). Risk of mother-to-child transmission (MTCT) of HIV (Mean = 0.43; SD = 0.33) had the greatest impact on decision-making, followed by partners' desires (M = 0.22; SD = 0.18), family preferences (M = 0.18; SD = 0.13), and community opinion (M = 0.17; SD = 0.13). MTCT was most important to women with greater HIV knowledge. However, WLHIV who had been diagnosed with HIV for a longer time placed more emphasis on partner preference and community opinion, and less importance on MTCT risk. Prevention of mother-to-child transmission (PMTCT) was less important to women experiencing intimate partner violence and those with depression. Findings highlight the need for tailored, focused interventions to support the unique circumstances of WLHIV and support the inclusion of families and/or partners in the counseling process. Results underscore the need for perinatal preconception counseling for women during routine HIV care.
尽管有关于优化母亲和新生儿健康结果的妊娠间隔建议，但在撒哈拉以南非洲，感染人类免疫缺陷病毒（HIV）的女性（HIV感染者）意外怀孕的情况很常见。本研究调查了HIV感染者中与生殖决策相关的因素，以为妊娠规划干预措施提供依据。对南非农村地区的165名HIV感染者在产后12个月进行了评估。估计了与生殖决策相关因素的相对重要性。女性的平均年龄为28岁（标准差=5.71）。HIV母婴传播（MTCT）风险（平均值=0.43；标准差=0.33）对决策的影响最大，其次是伴侣的意愿（平均值=0.22；标准差=0.18）、家庭偏好（平均值=0.18；标准差=0.13）和社区意见（平均值=0.17；标准差=0.13）。MTCT对HIV知识较多的女性最为重要。然而，感染HIV时间较长的HIV感染者更强调伴侣偏好和社区意见，而对MTCT风险的重视程度较低。预防母婴传播（PMTCT）对遭受亲密伴侣暴力的女性和患有抑郁症的女性不太重要。研究结果凸显了需要采取针对性、重点突出的干预措施，以支持HIV感染者的特殊情况，并支持在咨询过程中纳入家庭和/或伴侣。结果强调了在常规HIV护理期间为女性提供围产期孕前咨询的必要性。
