Mupambireyi Zivai, Simms Victoria, Mavhu Webster, Mutasa Concilia, Matsikire Edward, Ricotta April, Pascoe Margaret, Shamu Tinei, Senzanje Beula, Pierotti Chiara, Mushavi Angela, Willis Nicola, Cowan Frances M
Centre for Sexual Health & HIV Research Zimbabwe (CeSHHAR), Harare, Zimbabwe.
MRC International Statistics & Epidemiology Group, London School of Hygiene and Tropical Medicine, London, United Kingdom.
PLoS One. 2025 Jan 10;20(1):e0315299. doi: 10.1371/journal.pone.0315299. eCollection 2025.
The lives of adolescents and young people living with HIV (LHIV) are dominated by complex psychological and social stressors. These may be more pronounced among those perinatally infected. This longitudinal mixed-methods study describes the clinical and psychosocial challenges faced by HIV perinatally infected young mothers in Harare, Zimbabwe to inform tailored support.
HIV perinatally infected young mothers were recruited in 2013 and followed up in 2019. In 2013, they completed a structured interview, clinical examination, psychological screening and had viral load and drug resistance testing. A subset completed in-depth interviews (n = 10). In 2019, they were re-interviewed and had viral load testing. Data were analyzed using STATA 15.0. and thematic analysis.
Nineteen mothers aged 17-24 years were recruited in 2013. Eleven (57.9%) were successfully recontacted in 2019; 3 had died, 2 had relocated and 3 were untraceable. In 2013, all 19 mothers were taking antiretroviral therapy (median duration 8 years, range 2-11 years) and median CD4 count was 524 (IQR 272). In 2013, eight mothers (42.1%) had virological failure (≥1000 copies/ml) (3 of whom subsequently died) and 7 (36.8%) had evidence of drug resistance. In 2019, the proportion with virological failure was 2/11 (18.1%). Six of 11 (54.5%) had switched to second line therapy. In 2013, 64.3% were at risk of common mental disorder and this risk was higher at follow-up (72.7%). Qualitative data highlighted three pertinent themes: HIV status disclosure, adherence experiences and, social and emotional support.
Findings from this study underscore the significant clinical, social and psychological challenges faced by perinatally infected young mothers. The high rates of virological failure, drug resistant mutations, mental health issues and mortality observed in this population indicate the need for tailored and comprehensive health and support services to assist these young mothers.
感染艾滋病毒的青少年和年轻人（LHIV）的生活受到复杂的心理和社会压力因素的支配。在那些围产期感染的人群中，这些压力因素可能更为明显。这项纵向混合方法研究描述了津巴布韦哈拉雷围产期感染艾滋病毒的年轻母亲所面临的临床和心理社会挑战，以为量身定制的支持提供依据。
2013年招募了围产期感染艾滋病毒的年轻母亲，并于2019年进行随访。2013年，她们完成了结构化访谈、临床检查、心理筛查，并进行了病毒载量和耐药性检测。一部分人完成了深入访谈（n = 10）。2019年，对她们进行了再次访谈并进行了病毒载量检测。使用STATA 15.0和主题分析对数据进行分析。
2013年招募了19名年龄在17 - 24岁的母亲。2019年成功重新联系到11人（57.9%）；3人死亡，2人搬迁，3人无法追踪。2013年，所有19名母亲都在接受抗逆转录病毒治疗（中位疗程8年，范围2 - 11年），中位CD4细胞计数为524（四分位间距272）。2013年，8名母亲（42.1%）出现病毒学失败（≥1000拷贝/毫升）（其中3人随后死亡），7名（36.8%）有耐药证据。2019年，病毒学失败的比例为2/11（18.1%）。11名中的6名（54.5%）已改用二线治疗。2013年，64.3%的人有患常见精神障碍的风险，随访时这种风险更高（72.7%）。定性数据突出了三个相关主题：艾滋病毒感染状况的披露、依从性经历以及社会和情感支持。
本研究结果强调了围产期感染艾滋病毒的年轻母亲所面临的重大临床、社会和心理挑战。在这一人群中观察到的高病毒学失败率、耐药突变、心理健康问题和死亡率表明，需要提供量身定制的全面健康和支持服务来帮助这些年轻母亲。
