Humphrey John, Wanjama Esther, Carlucci James G, Naanyu Violet, Muli Lindah, Were Edwin, McGuire Alan, Nyandiko Winstone M, Songok Julia, Zimet Gregory, Wools-Kaloustian Kara
Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA.
Department of Pediatrics, Moi Teaching and Referral Hospital, Eldoret, Kenya.
Int J MCH AIDS. 2024 May 17;13:e009. doi: 10.25259/IJMA_6_2024. eCollection 2024.
Understanding the preferences of women living with HIV (WLH) for the prevention of mother-to-child HIV transmission (PMTCT) services is important to ensure such services are person-centered.
From April to December 2022, we surveyed pregnant and postpartum WLH enrolled at five health facilities in western Kenya to understand their preferences for PMTCT services. WLH were stratified based on the timing of HIV diagnosis: known HIV-positive (KHP; before antenatal clinic [ANC] enrollment), newly HIV-positive (NHP; on/after ANC enrollment). Multivariable logistic regression was used to determine associations between various service preferences and NHP (vs. KHP) status, controlling for age, facility, gravidity, retention status, and pregnancy status.
Among 250 participants (median age 31 years, 31% NHP, 69% KHP), 93% preferred integrated versus non-integrated HIV and maternal-child health (MCH) services; 37% preferred male partners attend at least one ANC appointment (vs. no attendance/no preference); 54% preferred support groups (vs. no groups; 96% preferred facility - over community-based groups); and, preferences for groups was lower among NHP (42%) versus KHP (60%). NHP had lower odds of preferring support groups versus KHP (aOR 0.45, 95% CI 0.25-0.82), but not the other services.
Integrated services were highly preferred by WLH, supporting the current PMTCT service model in Kenya. Further research is needed to explore the implementation of facility-based support groups for WLH as well as the reasons underlying women's preferences.
了解感染艾滋病毒的妇女（WLH）对预防艾滋病毒母婴传播（PMTCT）服务的偏好，对于确保此类服务以患者为中心至关重要。
2022年4月至12月，我们对肯尼亚西部五家医疗机构登记的怀孕及产后WLH进行了调查，以了解她们对PMTCT服务的偏好。WLH根据艾滋病毒诊断时间分层：已知艾滋病毒阳性（KHP；产前诊所[ANC]登记前）、新感染艾滋病毒阳性（NHP；ANC登记时及之后）。采用多变量逻辑回归确定各种服务偏好与NHP（相对于KHP）状态之间的关联，并控制年龄、医疗机构、妊娠次数、留存状态和妊娠状态。
在250名参与者中（中位年龄31岁，31%为NHP，69%为KHP），93%的人更喜欢综合的而非非综合的艾滋病毒与母婴健康（MCH）服务；37%的人希望男性伴侣至少参加一次ANC预约（相对于不参加/无偏好）；54%的人更喜欢支持小组（相对于无小组；96%的人更喜欢基于医疗机构的小组而非社区小组）；NHP中对小组的偏好（42%）低于KHP（60%）。与KHP相比，NHP更喜欢支持小组的几率较低（调整后比值比0.45，95%置信区间0.25 - 0.82），但对其他服务的偏好无差异。
WLH高度青睐综合服务，这支持了肯尼亚目前的PMTCT服务模式。需要进一步研究探索为WLH实施基于医疗机构的支持小组以及女性偏好背后的原因。
