Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, MI, USA.
Sociological Institute of Russian Academy of Sciences, St. Petersburg, Russia.
Eur J Public Health. 2021 Feb 1;31(1):63-67. doi: 10.1093/eurpub/ckaa133.
There are over 1 million people living with HIV in Russia, and less than half of them are on antiretroviral treatment (ART). Earlier in the epidemic, Russia was successful in implementing prevention of mother-to-child transmission programmes; however, there is a gap in knowledge about postpartum adherence to ART among women living with HIV (WLHIV). The objective of our research study was to identify which factors are associated with postpartum engagement in HIV care and treatment in Russia.
We conducted a community-based participatory research study in five Russian cities. We surveyed 200 WLHIV who had given birth within the previous 24 months about their use of ART. We used multivariable logistic regression to determine which types of social support are associated with adherence to ART in the postpartum period.
Less than half (40%) of mothers reported being adherent to ART. Multivariable analysis showed that having a supportive family environment [aOR = 2.64, 95% CI (1.91-5.83)], and active engagement with other HIV-positive mothers [aOR = 2.20, 95% CI (1.04-4.66)] were positively associated with postpartum adherence to ART. WLHIV who had more than one child were less likely to be adherent then WLHIV with just one child [aOR = 0.44, 95% CI (0.22-0.91)].
The support that new mothers have or do not have can play an important role in WLHIV adherence to ART. The findings from our study provide ideas for improving the likelihood that women will continue to engage in HIV treatment and care after pregnancy.
俄罗斯有超过 100 万人感染艾滋病毒，而接受抗逆转录病毒治疗 (ART) 的人数不到一半。在疫情早期，俄罗斯成功实施了母婴传播预防方案；然而，感染艾滋病毒的妇女（WLHIV）产后坚持接受抗逆转录病毒治疗的知识存在差距。我们的研究目的是确定哪些因素与俄罗斯产后参与艾滋病毒护理和治疗有关。
我们在俄罗斯的五个城市进行了一项基于社区的参与式研究。我们调查了 200 名在过去 24 个月内分娩的 WLHIV，了解她们使用 ART 的情况。我们使用多变量逻辑回归来确定哪些类型的社会支持与产后坚持使用 ART 有关。
不到一半（40%）的母亲报告坚持使用 ART。多变量分析表明，拥有支持性的家庭环境[aOR=2.64，95%CI（1.91-5.83)]，以及积极与其他 HIV 阳性母亲互动[aOR=2.20，95%CI（1.04-4.66)]与产后坚持使用 ART 呈正相关。有多个孩子的 WLHIV 比只有一个孩子的 WLHIV 不太可能坚持使用 ART[aOR=0.44，95%CI（0.22-0.91)]。
新母亲拥有或不拥有的支持可以在 WLHIV 坚持接受 ART 方面发挥重要作用。我们的研究结果为改善女性在怀孕后继续参与 HIV 治疗和护理的可能性提供了思路。
