Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.
Division of Infectious Diseases, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.
AIDS Res Hum Retroviruses. 2022 Jan;38(1):37-44. doi: 10.1089/aid.2020.0122. Epub 2021 May 7.
Women who experience HIV seroconversion during pregnancy are missed during early routine pregnancy HIV screening and are at high risk of perinatal HIV transmission. Male partner HIV testing during routine prenatal care may be an effective primary prevention strategy by identifying women at risk of seroconversion and mitigating their risk. Our objective was to assess interest in and uptake of male partner HIV testing services offered during prenatal care. This demonstration project included all pregnant, English-speaking, HIV-negative women receiving publicly funded prenatal care in an urban hospital-based practice located in a high HIV prevalence area. Women were offered free HIV screening for their male sexual partners. From April 2017 to June 2018, enrolled women completed surveys on social demographics, medical access characteristics, and HIV testing history. Women were invited to bring their partners to a prenatal visit where HIV testing was offered to their male partners. Factors associated with women's interest in testing and completion of partner testing were assessed using bivariable and multivariable analyses. Of 392 women approached, 70% ( = 274) completed study surveys. Although the majority (76%, = 200 of 264 respondents) of women desired their partner undergo HIV testing, testing was underutilized as only 18 (7%) male partners completed testing. While neither maternal characteristics nor male social or attitudinal factors were associated with interest in or completion of partner HIV testing, sensitivity analyses, performed with multiple imputation, demonstrated some association between interest and completion of partner testing and partner medical care access and utilization. In conclusion, although the majority of low-income women in an urban prenatal clinic expressed interest in having their partners undergo HIV testing, uptake of free partner HIV testing services was uncommon. A focused assessment of implementation and uptake barriers is needed to optimize partner testing and eliminate HIV transmission to mothers and their babies.
在妊娠期间发生 HIV 血清转换的女性会在早期常规妊娠 HIV 筛查期间被漏诊，且处于围产期 HIV 传播的高风险中。在常规产前保健期间对男性伴侣进行 HIV 检测可能是一种有效的初级预防策略，可识别出有血清转换风险的女性，并降低其风险。我们的目的是评估在产前保健中提供男性伴侣 HIV 检测服务的兴趣和接受程度。该示范项目纳入了所有在城市医院基础实践中接受公共资助产前保健的、讲英语的、HIV 阴性的孕妇。为她们的男性性伴侣提供免费的 HIV 筛查。2017 年 4 月至 2018 年 6 月，入组的女性完成了关于社会人口统计学、医疗可及性特征和 HIV 检测史的调查。邀请女性带伴侣来产前就诊，为其男性伴侣提供 HIV 检测。使用双变量和多变量分析评估了与女性检测兴趣和伴侣检测完成相关的因素。在 392 名被接触的女性中，70%（ = 274）完成了研究调查。尽管大多数（76%， = 200 名 264 名受访者中的 200 名）女性希望伴侣接受 HIV 检测，但检测的利用率很低，只有 18 名（7%）男性伴侣完成了检测。虽然母亲的特征以及男性的社会或态度因素均与对伴侣 HIV 检测的兴趣或完成情况无关，但敏感性分析（使用多重插补进行分析）表明，对伴侣检测的兴趣和完成情况与伴侣获得医疗保健和利用情况之间存在一定关联。总之，尽管城市产前诊所的大多数低收入女性对让其伴侣接受 HIV 检测表示感兴趣，但免费伴侣 HIV 检测服务的利用率并不高。需要对实施和利用障碍进行重点评估，以优化伴侣检测并消除 HIV 向母亲及其婴儿的传播。
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