Fertility Intentions and Clinical Care Attendance Among Women Living with HIV in South Africa

Understanding the fertility intentions of people living with HIV can guide safer conception planning and prevention of mother-to-child transmission (PMTCT). Most research has addressed fertility intentions among women, rather than couples, at a single time point. This clinical trial of a PMTCT intervention in rural Mpumalanga province, South Africa, examined longitudinal fertility intentions among perinatal women living with HIV and their male partners. Study assessments and intervention and control sessions were conducted prenatally and postpartum. Longitudinal predictors of participants’ ( n = 360 men, n = 917 women) fertility intentions were similar between sexes. Younger age and male involvement in perinatal care were associated with reporting fertility intentions at both baseline and 12 months postpartum. Having an HIV-positive infant and discussing pregnancy plans with a healthcare provider by 12 months postpartum were associated with incident fertility intentions after reporting no plans for further children at baseline. Results highlight the important role of healthcare providers to educate men and women on issues surrounding conception, as well as the potential for incorporating PMTCT and safer conception education into HIV clinical services.

Download Full-text

Trajectories of fertility intentions among women living with HIV in South Africa

AIDS Care ◽

10.1080/09540121.2020.1719969 ◽

2020 ◽

pp. 1-7

Author(s):

Katherine B. Rucinski ◽

Kimberly A. Powers ◽

Audrey E. Pettifor ◽

Vivian Black ◽

Brian W. Pence ◽

...

Keyword(s):

South Africa ◽

Fertility Intentions ◽

Women Living With Hiv ◽

Living With Hiv

Download Full-text

Prevalence and Correlates of Snuff Use, and its Association With Tuberculosis, Among Women Living With HIV in South Africa

Nicotine & Tobacco Research ◽

10.1093/ntr/nty137 ◽

2018 ◽

Vol 21 (8) ◽

pp. 1087-1092 ◽

Cited By ~ 1

Author(s):

Jessica L Elf ◽

Ebrahim Variava ◽

Sandy Chon ◽

Limakatso Lebina ◽

Katlego Motlhaoleng ◽

...

Keyword(s):

South Africa ◽

Tobacco Use ◽

Smokeless Tobacco ◽

People Living With Hiv ◽

Potential Health ◽

Adjusted Analysis ◽

Women Living With Hiv ◽

Urine Cotinine ◽

Smokeless Tobacco Use ◽

Living With Hiv

Abstract Introduction A higher proportion of people living with HIV (PLWH) smoke compared to the general population, but little information exists about the prevalence and correlates of smokeless tobacco use among PLWH. In South Africa, dry powdered tobacco is inhaled nasally as snuff. Methods A cross-sectional survey among PLWH attending three HIV clinics was conducted. Snuff use was assessed via self-report and urine cotinine. Results Given the low (3%) prevalence of snuff use among men, analysis was restricted to n = 606 nonsmoking women living with HIV. Half (n = 298, 49%) were snuff users, the majority of whom (n = 244, 84%) had a positive urine cotinine test. In adjusted analysis, snuff use was negatively associated with higher education (relative risk [RR] 0.55; 95% confidence interval [CI]: 0.39, 0.77) and mobile phone ownership (RR 0.83; 95% CI: 0.71, 0.98), and positively associated with ever having tuberculosis (TB) (RR 1.22; 95% CI: 1.03, 1.45). In adjusted analysis, with current TB as the outcome, snuff use was marginally statistically significantly associated with a twofold increase in odds of a current TB diagnosis (odds ratio [OR] 1.99; 95% CI: 0.98, 4.15). Discussion A high proportion of nonsmoking South African women living with HIV use snuff, which was a risk factor for TB. Additional research is needed to understand the relationship between snuff, TB, and other potential health risks. Implications PLWH have a higher prevalence of smoking than their seronegative peers, but there is a paucity of research on smokeless tobacco use in this population, especially in low-resource settings. TB is the leading cause of death among PLWH, and with improvements to HIV treatment and care, PLWH are at greater risk of tobacco-related diseases. We report an extremely high prevalence of snuff use among women living with HIV in South Africa. Further, in this population snuff use is positively associated with ever having a TB diagnosis, as well as currently having TB.

Download Full-text

Utility and acceptability of text messages for PMTCT: a qualitative assessment of user experiences (Preprint)

10.2196/preprints.32272 ◽

2021 ◽

Author(s):

Melinda Brown ◽

May Maloba ◽

Catherine Wexler ◽

Natabhona Mabachi ◽

Sharon Koech ◽

...

Keyword(s):

Medication Adherence ◽

Pilot Study ◽

Clinical Care ◽

Text Messages ◽

Hiv Care ◽

Qualitative Assessment ◽

Women Living With Hiv ◽

Pregnancy And Postpartum ◽

Living With Hiv ◽

The Impact

BACKGROUND Evidence that text messages can support patient adherence to HIV care is growing. We conducted a pilot study of the HIV Infant Tracking System (HITSystem 2.0), an intervention that includes SMS to patients to support maternal medication adherence, appointment attendance, and hospital-based deliveries during the antenatal period. OBJECTIVE The objective of this study was to qualitatively assess women’s experiences receiving SMS to understand message utility and acceptability with the goal of refining and strengthening the intervention. METHODS As part of an intervention development pilot study, we conducted semi-structured interviews with 33 women living with HIV who received SMS through the HITSystem 2.0 throughout their pregnancy and postpartum period. Interview questions assessed women’s feedback of the SMS, the impact of the SMS on their PMTCT care, and suggestions for improvement. RESULTS Participants described how SMS reinforced existing strategies for medication adherence and served as cues to action for antenatal appointments and hospital-based deliveries. SMS also provided encouragement and enhanced their sense of engagement with their clinical care team. Given the neutral content of the messages, most women reported no concerns about message confidentiality. Recommendations to enhance utility included greater customizability (timing and frequency of messages) and a few women suggested more comprehensive counseling regarding the SMS content to anticipate at the time of enrollment. CONCLUSIONS SMS content was deemed useful and acceptable by pregnant and postpartum women living with HIV and engaged in PMTCT services. Participant recommendations to increase message customization options have been adopted to enhance the intervention. CLINICALTRIAL Trial registration: clinicaltrials.gov, NCT02726607. Registered 01 April 2016. Retrospectively registered. https://clinicaltrials.gov/ct2/show/NCT02726607

Download Full-text