Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
Albany Medical Center, Albany, NY, USA.
Womens Health (Lond). 2021 Jan-Dec;17:17455065211061094. doi: 10.1177/17455065211061094.
Adherence to antiretroviral therapy and retention in care significantly drop for women with HIV during the postpartum period. We have a limited understanding of how outcome expectancies influence maternal adherence and retention in care.
Women with HIV from an urban academic clinic completed in-depth interviews in the third trimester and at 3 to 9 months postpartum to evaluate outcome expectancies, facilitators, and barriers to antiretroviral therapy adherence and retention in care. Interviews were audio-recorded and analyzed for content. A codebook was created using deductive (based on the theory of reasoned action approach) and inductive (based on emergent themes) codes.
We conducted 21 interviews with 12 women during pregnancy and 9 women during postpartum period. Participants had a mean age of 31 (standard deviation = 5.7) and most were African American (75%). Outcome expectancies centered mostly around pediatric health to prevent perinatal transmission of HIV and to be healthy to raise their children. Other outcome expectancies included preventing transmission of HIV to their partners. Social support from partners served as a strong facilitator as they helped routinize pill-taking behaviors, provided reminders, and decreased social isolation. Barriers to antiretroviral therapy adherence included depression, the disruption of scheduling routines, and the physical demands associated with the postpartum period. These barriers were accentuated for women with multiple children.
Women's commitment to pediatric health was the primary motive for antiretroviral therapy adherence. Partners also served an important role. These findings suggest that interventions linking pediatric and maternal health, and partner support can improve maternal HIV treatment in the postpartum period.
艾滋病毒感染者在产后期间，其抗逆转录病毒治疗的依从性和护理保留率显著下降。我们对预期结果如何影响产妇的治疗依从性和护理保留率的了解有限。
来自城市学术诊所的艾滋病毒感染者在妊娠晚期和产后 3 至 9 个月完成深入访谈，以评估抗逆转录病毒治疗依从性和护理保留的预期结果、促进因素和障碍。采访进行了录音，并根据内容进行了分析。使用演绎（基于理性行为理论方法）和归纳（基于出现的主题）代码创建了一个代码本。
我们在妊娠期间对 12 名女性和产后期间对 9 名女性进行了 21 次访谈。参与者的平均年龄为 31 岁（标准差=5.7），大多数为非裔美国人（75%）。预期结果主要集中在儿科健康上，以防止母婴传播艾滋病毒，并保持健康以抚养孩子。其他预期结果包括防止将艾滋病毒传播给伴侣。来自伴侣的社会支持是一个强有力的促进因素，因为他们帮助常规化服药行为，提供提醒，并减少社会孤立。抗逆转录病毒治疗依从性的障碍包括抑郁、日程安排规律的打乱以及与产后期间相关的身体需求。这些障碍在有多个孩子的女性中更为突出。
女性对儿科健康的承诺是抗逆转录病毒治疗依从性的主要动机。伴侣也起着重要的作用。这些发现表明，将儿科和孕产妇健康以及伴侣支持联系起来的干预措施可以改善产后期间艾滋病毒感染者的治疗。
