Brown University School of Public Health, Rhode Island, USA.
Department of Prevention and Community Health, The George Washington University, Washington, DC, USA.
AIDS Behav. 2024 Dec;28(12):4199-4208. doi: 10.1007/s10461-024-04478-w. Epub 2024 Sep 6.
In recent years, significant progress has been made in treatment access for women living with HIV (WLHIV). For example, option B+, which requires that all pregnant persons who test positive for HIV start on antiretroviral treatment, has been instrumental in reducing the risk of vertical transmission. For birthing individuals who have a low HIV viral load, there is a minimized risk of vertical transmission during breastfeeding. However, an alarming rate of WLHIV in South Africa disengage from care during postpartum. Given that work is intricately linked to individuals' socioeconomic status, and thus health outcomes, and their health-seeking ability, it is important to explore the role of work in decisions that impact HIV-related care for the dyad postpartum. Semi-structured interviews were conducted with 26 women living with HIV at 6-8 weeks postpartum in Cape Town, South Africa. A secondary qualitative data analysis was conducted following thematic content analysis. Three themes were identified, spanning participants' financial considerations, navigating childcare needs, and considerations for exclusive breastfeeding. For many participants, there was often a conflict between returning to work, childcare, and the decision whether or not to breastfeed-in addition to their HIV care. This conflict between participants' commitments suggests an increased pressure that WLHIV may face postpartum, which could impact their ability to remain engaged in their healthcare and adherent to medication. Although exclusive breastfeeding is an important recommendation for the baby's health outcomes; there is a need for structural support for WLHIV as they navigate work re-entry during postpartum.
近年来，艾滋病毒感染者（WLHIV）的治疗可及性取得了显著进展。例如，B+方案要求所有艾滋病毒检测呈阳性的孕妇开始接受抗逆转录病毒治疗，这对于降低垂直传播风险起到了重要作用。对于艾滋病毒载量低的分娩个体，母乳喂养期间垂直传播的风险较低。然而，南非令人震惊的 WLHIV 比例在产后阶段脱离了护理。鉴于工作与个人的社会经济地位密切相关，从而与健康结果及其寻求健康的能力相关，因此，探讨工作在影响产后 HIV 相关护理的决策中所起的作用非常重要。在南非开普敦，对 26 名产后 6-8 周的艾滋病毒感染者进行了半结构式访谈。在主题内容分析之后，对二次定性数据分析进行了研究。确定了三个主题，涵盖了参与者的财务考虑、照顾儿童的需求以及对纯母乳喂养的考虑。对许多参与者来说，重返工作、照顾孩子和是否母乳喂养之间常常存在冲突——除此之外，他们还需要考虑自己的 HIV 护理。参与者之间的承诺存在冲突，这表明产后 WLHIV 可能面临更大的压力，这可能会影响他们参与医疗保健和坚持药物治疗的能力。尽管纯母乳喂养对婴儿的健康结果非常重要；但 WLHIV 在产后重返工作时需要得到结构性支持。
