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肯尼亚男伴参与度与预防母婴传播连续护理服务的成功完成情况。

Male partner involvement and successful completion of the prevention of mother-to-child transmission continuum of care in Kenya.

机构信息

Department of Obstetrics and Gynecology, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.

Center for Global Health, University of Colorado School of Public Health, Aurora, CO, USA.

出版信息

Int J Gynaecol Obstet. 2021 Mar;152(3):409-415. doi: 10.1002/ijgo.13442. Epub 2020 Dec 10.

Abstract

OBJECTIVE

To examine the relationship between male partner involvement (MPI) in prevention of mother-to-child transmission (PMTCT) activities and successful completion of the PMTCT continuum of care, which remains sub-optimal in settings with high prevalence of HIV.

METHODS

A cross-sectional survey was administered in June-August 2017 to a sample of 200 postpartum Kenyan women with HIV enrolled in a parent trial. Composite PMTCT and MPI variables were created. Descriptive, simple and multivariable regression, and mediation analyses were performed.

RESULTS

Of the women, 54% reported successful completion of PMTCT. Depression and internalized HIV stigma were independently associated with lower likelihood of successful completion of PMTCT (adjusted risk ratio [aRR] 0.97; 95% confidence interval [CI] 0.94-0.99; aRR 0.92; 95% CI 0.88-0.98, respectively). Each MPI activity was associated with 10% greater likelihood of successful completion of PMTCT (P < 0.05). The relationship between MPI and the successful completion of PMTCT was partially mediated through women's reduced internalized HIV stigma (β -0.03; 95%CI -0.06 to -0.00).

CONCLUSION

Greater MPI in PMTCT activities has direct and indirect effects on women's successful completion of all necessary steps across the PMTCT continuum. Reduced internalized HIV stigma is likely a key mechanism in the relationship.

摘要

目的

探讨男性在预防母婴传播(PMTCT)活动中的参与度(MPI)与 PMTCT 照护连续体的完成情况之间的关系,在 HIV 流行率较高的环境中,后者仍不尽人意。

方法

2017 年 6 月至 8 月,对参加一项父母试验的 200 名肯尼亚产后 HIV 感染妇女进行了横断面调查。创建了复合 PMTCT 和 MPI 变量。进行了描述性、简单和多变量回归以及中介分析。

结果

在这些女性中,54%报告成功完成了 PMTCT。抑郁和内化的 HIV 耻辱感与成功完成 PMTCT 的可能性较低独立相关(调整后的风险比 [aRR] 0.97;95%置信区间 [CI] 0.94-0.99;aRR 0.92;95%CI 0.88-0.98)。每一项 MPI 活动都与成功完成 PMTCT 的可能性增加 10%相关(P<0.05)。MPI 与成功完成 PMTCT 之间的关系部分通过女性内化的 HIV 耻辱感降低而产生中介作用(β -0.03;95%CI -0.06 至 -0.00)。

结论

MPI 在 PMTCT 活动中的增加对妇女成功完成 PMTCT 连续体上的所有必要步骤具有直接和间接的影响。内化的 HIV 耻辱感降低可能是两者关系的关键机制。

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