Jones Deborah L, Rodriguez Violeta J, Mandell Lissa N, Lee Tae Kyoung, Weiss Stephen M, Peltzer Karl
a Department of Psychiatry and Behavioral Sciences , University of Miami Miller School of Medicine , Miami , FL , USA.
b Department of Psychology , University of Georgia , Athens , GA , USA.
AIDS Care. 2019 Sep;31(9):1114-1123. doi: 10.1080/09540121.2019.1620168. Epub 2019 May 23.
The postnatal period is a time of increased susceptibility to HIV infection and superinfection for postpartum women, sexual partners, and infants. This study examined the effect of a prevention to mother-to-child transmission of HIV intervention compared to standard care, and factors associated with unprotected last sex and inconsistent condom use at 12-months postpartum. Participants were = 1399 HIV-infected women 6-30 weeks pregnant ( = 18 weeks (SD = 5.75)) assessed during pregnancy and 12-months postpartum. Women were aged an average of 28 (SD = 5.82); 48% reported 10-11 years of education. Older age (adjusted odds ratio [AOR] = 1.00) and being employed (AOR = 1.51) were associated with greater odds of unprotected sex at 12-month postpartum. Disclosure of HIV status (AOR = 0.64) and greater male involvement during pregnancy (AOR = 0.92) were associated with lower odds of unprotected sex at 12-month postpartum. HIV negative or unknown partner status (AOR = 0.45) and greater depressive symptoms (AOR = 0.97) were associated with lower odds of inconsistent condom use at 12-months postpartum. The intervention was not associated with reduced sexual risk behavior. Future studies should address male involvement and consider measurement of culturally tailored male involvement constructs for men South Africa. Perinatal women may require support for sexual communication and gender equity to reduce sexual risk.
产后时期是产后妇女、性伴侣和婴儿感染艾滋病毒及重复感染的易感性增加的时期。本研究考察了与标准护理相比，预防艾滋病毒母婴传播干预措施的效果，以及产后12个月时与无保护末次性行为和避孕套使用不一致相关的因素。研究对象为1399名怀孕6 - 30周（平均孕周 = 18周（标准差 = 5.75））的艾滋病毒感染女性，在孕期及产后12个月进行评估。这些女性的平均年龄为28岁（标准差 = 5.82）；48%的女性报告接受过10 - 11年教育。年龄较大（调整后的优势比[AOR] = 1.00）和有工作（AOR = 1.51）与产后12个月时无保护性行为的几率较高相关。披露艾滋病毒感染状况（AOR = 0.64）以及孕期男性更多参与（AOR = 0.92）与产后12个月时无保护性行为的几率较低相关。艾滋病毒阴性或伴侣状况未知（AOR = 0.45）以及抑郁症状较重（AOR = 0.97）与产后12个月时避孕套使用不一致的几率较低相关。该干预措施与性风险行为的减少无关。未来的研究应关注男性参与情况，并考虑对南非男性进行针对文化定制的男性参与结构的测量。围产期女性可能需要在性沟通和性别平等方面获得支持，以降低性风险。
