Tanner Amanda E, Chambers Brittany D, Philbin Morgan M, Ware Samuella, Eluka Nneze, Ma Alice, Kinnard Elizabeth N, Fortenberry J Dennis
Department of Public Health Education, University of North Carolina Greensboro, Coleman Building 437, PO Box 27160, Greensboro, NC, 27402, USA.
UCSF Preterm Birth Initiative - California, University of California San Francisco, 550 16th Street, 3rd Floor, San Francisco, CA, 94158, USA.
Matern Child Health J. 2018 Sep;22(9):1233-1239. doi: 10.1007/s10995-018-2603-1.
Background HIV-positive women in the United States can have healthy pregnancies and avoid transmitting HIV to their children. Yet, little is known about the extent to which HIV care providers' reproductive health practices match women's pregnancy desires. Accordingly, we explored young HIV-positive women's pregnancy desires and reproductive health behaviors and examined reproductive health information offered by HIV care clinics. Methods A mixed-method analysis was conducted using data from a 14-site Adolescent Medicine Trials Network (ATN) study. We conducted descriptive statistics on data from 25 HIV-positive women (e.g., demographics, pregnancy desires, and sexual- and health-related behaviors). Qualitative interviews with 58 adolescent and adult clinic providers were analyzed using the constant comparative method. Results About half of the women reported using reproductive health care services (i.e., contraception and pregnancy tests) (n = 12) and wanted a future pregnancy (n = 13). Among women who did not desire a future pregnancy (n = 5), three used dual methods and two used condoms at last sexual encounter. Qualitative themes related to clinics' approaches to reproductive health (e.g., "the emphasis…is to encourage use of contraceptives") and the complexity of merging HIV and reproductive care (e.g., "We [adolescent clinic] transition pregnant moms from our care back and forth to adult care"). Discussion Despite regular HIV-related medical appointments, HIV-positive women may have unaddressed reproductive health needs (e.g., pregnancy desire with providers focused on contraceptive use). Findings from this study suggest that increased support for young HIV-positive women's reproductive health is needed, including supporting pregnancy desires (to choose when, how, and if, to have children).
背景 在美国，感染艾滋病毒的女性能够拥有健康的孕期并避免将艾滋病毒传播给孩子。然而，对于艾滋病毒护理提供者的生殖健康做法与女性怀孕意愿的匹配程度，人们知之甚少。因此，我们探讨了年轻艾滋病毒阳性女性的怀孕意愿和生殖健康行为，并研究了艾滋病毒护理诊所提供的生殖健康信息。方法 使用来自14个地点的青少年医学试验网络（ATN）研究的数据进行混合方法分析。我们对25名艾滋病毒阳性女性的数据（如人口统计学、怀孕意愿以及与性和健康相关的行为）进行了描述性统计。使用持续比较法对58名青少年和成人诊所提供者的定性访谈进行了分析。结果 约一半的女性报告使用了生殖健康护理服务（即避孕和妊娠检测）（n = 12），并希望未来怀孕（n = 13）。在不希望未来怀孕的女性中（n = 5），三人使用了双重避孕方法，两人在最后一次性接触时使用了避孕套。与诊所生殖健康方法相关的定性主题（如“重点……是鼓励使用避孕药具”）以及合并艾滋病毒和生殖护理的复杂性（如“我们[青少年诊所]将怀孕的妈妈们在我们的护理与成人护理之间来回转接”）。讨论 尽管定期进行与艾滋病毒相关的医疗预约，但艾滋病毒阳性女性的生殖健康需求可能未得到满足（如怀孕意愿与专注于避孕使用的提供者之间的矛盾）。本研究结果表明，需要增加对年轻艾滋病毒阳性女性生殖健康的支持，包括支持她们的怀孕意愿（选择何时、如何以及是否生育）。
