Wits Reproductive Health and HIV Institute, School of Public Health, University of the Witwatersrand, Johannesburg, South Africa.
Makerere University - Johns Hopkins University Research Collaboration, Kampala, Uganda.
PLoS One. 2022 Sep 1;17(9):e0271684. doi: 10.1371/journal.pone.0271684. eCollection 2022.
HIV acquisition among pregnant and breastfeeding women in sub-Saharan Africa and vertical transmission rates remain high despite established strategies for HIV prevention. During the MTN-041/MAMMA study, we explored the influence of grandmothers (mothers and mothers-in-law of pregnant and breastfeeding women) in eastern and southern Africa on the health-related decisions of pregnant and breastfeeding women and their potential to support use of HIV prevention products. To do this we used structured questionnaires and focus group discussions with three stakeholder groups: 1) grandmothers, 2) HIV-uninfected currently or recently pregnant or breastfeeding women and 3) male partners of currently or recently pregnant or breastfeeding women. A total of 23 focus group discussions comprising 68 grandmothers, 65 pregnant or breastfeeding women and 63 male partners were completed across four study sites. Grandmothers were described as important sources of information during pregnancy and breastfeeding playing both supportive and influencer roles due to personal maternal experience and generational knowledge. While pregnant and breastfeeding women were not keen to involve grandmothers in HIV prevention decision making, they were accepting of grandmothers' involvement in a supportive role. Grandmothers expressed willingness to support pre-exposure prophylaxis use and agreed with the other two stakeholder groups that this decision should be made by women themselves or together with partners. These novel data indicate potential for grandmothers' health related supportive roles to be extended to support decision-making and adherence to biomedical HIV prevention options, and possibly contribute to the decline in HIV acquisition among pregnant and breastfeeding women in these communities.
尽管已经有了预防艾滋病的既定策略，但撒哈拉以南非洲地区孕妇和哺乳期妇女的艾滋病感染率和母婴垂直传播率仍然居高不下。在 MTN-041/MAMMA 研究中，我们探讨了东非和南非的祖母（孕妇和哺乳期妇女的母亲和岳母）对孕妇和哺乳期妇女的健康相关决策的影响，以及她们支持使用艾滋病预防产品的潜力。为此，我们使用了结构化问卷和焦点小组讨论，参与者来自三个利益相关者群体：1）祖母，2）未感染艾滋病毒的当前或最近怀孕或哺乳期妇女，以及 3）当前或最近怀孕或哺乳期妇女的男性伴侣。在四个研究地点共完成了 23 次焦点小组讨论，包括 68 名祖母、65 名怀孕或哺乳期妇女和 63 名男性伴侣。祖母被描述为怀孕期间和哺乳期的重要信息来源，由于个人的母性经验和代际知识，她们扮演着支持和影响者的角色。虽然孕妇和哺乳期妇女不希望祖母参与艾滋病预防决策，但她们接受祖母以支持角色参与。祖母表示愿意支持使用暴露前预防措施，并与其他两个利益相关者群体一致认为，这一决定应由妇女自己或与伴侣共同做出。这些新数据表明，祖母在健康相关支持角色方面有潜力扩展到支持决策和坚持使用生物医学艾滋病预防方案，并可能有助于这些社区中孕妇和哺乳期妇女艾滋病感染率的下降。
