scholarly journals Improving retention in antenatal and postnatal care: a systematic review of evidence to inform strategies for adolescents and young women living with HIV

2021 ◽  
Vol 24 (8) ◽  
Author(s):  
Kirsty Brittain ◽  
Chloe A Teasdale ◽  
Bernadette Ngeno ◽  
Judith Odondi ◽  
Boniface Ochanda ◽  
...  
2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Ariadna Huertas-Zurriaga ◽  
Patrick A. Palmieri ◽  
Joan E. Edwards ◽  
Sandra K. Cesario ◽  
Sergio Alonso-Fernandez ◽  
...  

Abstract Background Women living with HIV (WLH) lack evidence-based information about reproductive options while managing pressures from family, clinicians, and communities to give up the idea of having children. As the reproduction intentions of WLH are not well understood, stigmatizing behaviors force them to hide their disease to avoid rejection by their family, partner, and social networks. Compliance with social norms, fear of stigma, and discrimination influence their experience. Current research is individual qualitative studies lacking the synthesis perspective necessary to guide intervention development. The purpose of this study was to synthesize the evidence to explain the reproductive decision-making process for WLH in developed countries. Methods A systematic review with qualitative research synthesis was conducted through searches in 10 electronic databases (CINAHL, EMBASE, MEDLINE, Scopus, Social Science Citation Index, Web of Science, Google Scholar, Cuidatge, Cuiden Enfispo, and SciELO). Studies published in journals from 1995 to 2019 with qualitative data about reproductive decision-making among WLH in developed countries were eligible for inclusion. Developed country was operationalized by membership in the OECD for comparative conditions of social wellbeing and economic stability. The CASP and JBI checklists for qualitative research were used to assess study quality and methodological integrity. Thematic analysis and qualitative meta-summary techniques were used for the synthesis. Results Twenty studies from 12 developed countries were included in the synthesis. Findings were organized into 3 meta-themes from 15 themes and 45 subthemes, including: (1) Shattered identity, (2) Barriers, inequities, and misinformation, (3) Coping, resiliency, and support. Reproductive decision-making was perceived as a complex process influenced by facilitators and barriers. The facilitators helped WLH cope with their new situation to become more resilient, while the barriers made their situation more difficult to manage. Conclusion WLH encounter reproductive decision-making with knowledge deficits and limited social support. An integrated approach to holistic care with comprehensive multidisciplinary counseling is needed to support WLH. Clinicians could benefit from professional development to learn how to be authentically present for WLH, including engaging in conversations, demonstrating compassion, and understanding situations. Evidence-based clinical practice guidelines need to be tailored for the family planning and sexual health needs of WLH.


2020 ◽  
pp. 216769682091663 ◽  
Author(s):  
Constance R. S. Mackworth-Young ◽  
Alison Wringe ◽  
Sue Clay ◽  
Mutale Chonta ◽  
Chipo Chiiya ◽  
...  

Art-based research methods can enable young people to generate data that provide insights into their lives. We assessed the feasibility, value, and limitations of collages as a participatory research method to understand the experiences of young women living with HIV. Individual collages were created in participatory workshops, firstly in 2015 and secondly in 2017, by a cohort of young women living with HIV in Lusaka, Zambia. Collages were analyzed visually and thematically and compared to other qualitative methods. Participants engaged readily with making collages and expressed how the collages represented themselves. The collages conveyed aspirations, resilience, optimism, and identities beyond HIV. Other data generation methods focused more on challenges associated with HIV. The second collages demonstrated more complex portrayals of participants’ life and developmental transitions. Collages provided a feasible, effective, and therapeutic method of empowering young women living with HIV to tell their own stories and express their full selves.


2020 ◽  
Author(s):  
Ariadna Huertas-Zurriaga ◽  
Patrick Albert Palmieri ◽  
Joan E. Edwards ◽  
Sandra K. Cesario ◽  
Sergio Alonso-Fernandez ◽  
...  

Abstract Objective: To explain the reproductive decision-making process of women living with HIV according to their experiences.Design: Systematic review with qualitative research synthesis. Studies were assessed with the Critical Appraisal Skills Programme and the JBI Checklist for Qualitative Research. The protocol was registered with PROSPERO, and the results reported in adherence with the PRISMA statement and the ENTREQ recommendations.Setting: Studies with qualitative data from member countries of the Organization for Economic Co-operation and Development were selected to maintain consistency in the conditions of women living with HIV, including socioeconomic, human rights, and access to health services.Participants: Studies published in journals from 1995 to 2019 with qualitative data about reproductive decision-making among women living with HIV were searched in multiple databases, including CINAHL, EMBASE, MEDLINE (through PubMed), Scopus, Social Science Citation Index, Web of Science, Google Scholar, and the Spanish databases Cuidatge, Cuiden Enfispo, and SciELO.Results: From the 4,198 articles identified and assessed, 18 were included for analysis and synthesis with 1,333 participants from 10 countries. Three meta‐categories were constructed from 15 themes that emerged from 45 subthemes to give new meaning to the phenomena of reproductive decision-making for women living with HIV as 1) Shattered identity, 2) Barriers, inequities, and misinformation, and 3) Coping, resiliency, and support.Key Conclusions: Reproductive decision-making is a complex process with multiple challenges that women living with HIV encounter with knowledge deficiencies and limited social support. Decisions need to be taken judiciously by women living with HIV in collaboration with clinicians within the context of a supportive health system. Implications for practice: An integrated approach to care with comprehensive multidisciplinary counseling are needed to support women living with HIV as they engage in reproductive decision-making. Clinicians require professional development as well as evidence-based clinical guidelines and educational resources to support person-centered care for these women, and their families.


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