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[感染艾滋病毒妇女的生殖健康与性行为:综述]

[The reproductive health and sexual behavior of HIV-infected women: the review].

作者信息

Leschenko O Ya, Genich E V

机构信息

The Federal State Budget Scientific Institution "The Research Center of Family Health and Human Reproduction", 664003, Irkutsk, Russia,

The Federal State Budget Scientific Institution "The Research Center of Family Health and Human Reproduction", 664003, Irkutsk, Russia.

出版信息

Probl Sotsialnoi Gig Zdravookhranenniiai Istor Med. 2020 Mar;28(2):294-302. doi: 10.32687/0869-866X-2020-28-2-294-302.

Abstract

The increased access to effective anti-retroviral treatment (ART) has made HIV comparable to chronic disease in terms of life expectancy. The advances in scientific knowledge and, in particular, in management of HIV-infected pregnant woman have reduced the risk of mother-to-child transmission of HIV. The analysis of current research demonstrates that HIV has been a problem in terms of sexuality and reproduction. The needs related to sexuality and reproduction are crucial ones to overall health and well-being of HIV-infected population. The future research is to focus not only on how sexual relations and relationships of HIV-positive women are manifested, but also on how health care system is to provide adequate support to women in relation with sexuality and reproduction. The purpose of study was to apply analysis of current research on sexuality, sexual and contraceptive behavior and implementation of reproductive function in HIV-infected women and the conditions affecting this realization. The review of national and international scientific publications concerning such areas as gynecology, reproductive health, sexuality and reproductive behavior of HIV-positive women from indexed on-line journals and relevant websites using such search engines as PubMed and Google in 1997-2019. The sample included 34 peer-reviewed qualitative studies, which covered 9523 HIV-positive surveyed women. The technique of interpretative meta-synthesis was applied to generalize and evaluate how experiences of HIV-positive women in sexuality and reproduction behavior have been described in qualitative studies. The effective anti-retroviral treatment has made HIV comparable to chronic disease in terms of life expectancy. The analysis of current research on this topic established that HIV was a problem in terms of sexuality and reproduction. The conditions that make the burden of HIV more severe are: HIV is an obstacle for starting and continuing relationship, providing sense of fear and loss. At the same time motherhood, spiritual beliefs, and supportive relationships made the burden of HIV easier. The HIV-positive test in women makes their sexual and reproductive health more complicated because of HIV status. Therefore, women face such unique challenges as problems in partnerships, sexual satisfaction and childbearing. The study results are important for developing optimal medical care to alleviate the burden of HIV infection. In addition to medical care, health care workers should consider social and psychological needs to support HIV-positive patients in improving their health and their sexual and reproductive health as well.

摘要

获得有效的抗逆转录病毒治疗(ART)的机会增加,使得在预期寿命方面,艾滋病病毒与慢性病相当。科学知识的进步,尤其是在感染艾滋病病毒的孕妇管理方面的进步,降低了母婴传播艾滋病病毒的风险。对当前研究的分析表明,艾滋病病毒在性与生殖方面一直是个问题。与性和生殖相关的需求对于感染艾滋病病毒人群的整体健康和福祉至关重要。未来的研究不仅要关注感染艾滋病病毒的女性的性关系和人际关系是如何表现的,还要关注医疗保健系统如何在性与生殖方面为女性提供充分支持。该研究的目的是对有关感染艾滋病病毒女性的性、性行为和避孕行为以及生殖功能的实现情况和影响这一实现的条件的当前研究进行分析。通过使用PubMed和谷歌等搜索引擎,对1997年至2019年期间来自索引在线期刊和相关网站的有关妇科、生殖健康、感染艾滋病病毒女性的性与生殖行为等领域的国内外科学出版物进行了综述。样本包括34项经同行评审的定性研究,涵盖了9523名接受调查的感染艾滋病病毒的女性。采用解释性元综合技术来概括和评估定性研究中如何描述感染艾滋病病毒女性在性与生殖行为方面的经历。有效的抗逆转录病毒治疗在预期寿命方面使艾滋病病毒与慢性病相当。对该主题当前研究的分析确定,艾滋病病毒在性与生殖方面是个问题。使艾滋病病毒负担更严重的情况包括:艾滋病病毒是开始和维持关系的障碍,会带来恐惧和失落感。与此同时,为人母、精神信仰和支持性的关系使艾滋病病毒的负担减轻。女性艾滋病病毒检测呈阳性因其感染状况而使她们的性与生殖健康更加复杂。因此,女性面临着诸如伴侣关系问题、性满意度和生育等独特挑战。研究结果对于制定最佳医疗护理以减轻艾滋病病毒感染负担很重要。除了医疗护理外,医护人员还应考虑社会和心理需求,以支持感染艾滋病病毒的患者改善其健康状况以及性与生殖健康。

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