scholarly journals Women of Reproductive Age Living with HIV in Argentina: Unique Challenges for Reengagement in Care

2019 ◽  
Vol 18 ◽  
pp. 232595821988325
Author(s):  
Diego Cecchini ◽  
Maria Luisa Alcaide ◽  
Violeta de Jesus Rodriguez ◽  
Lissa Nicole Mandell ◽  
John Michael Abbamonte ◽  
...  
Keyword(s):  
Self Efficacy ◽  
Latent Class ◽  
Hiv Transmission ◽  
Reproductive Age ◽  
Hiv Care ◽  
Women Of Reproductive Age ◽  
Physician Visits ◽  
Women Living With Hiv ◽  
Living With Hiv ◽  
Disproportionate Burden

This study evaluated the reasons for not taking antiretroviral treatment (ART) among women of reproductive age who are disengaged from HIV care (have missed pharmacy pickups and physician visits), with the goal of identifying strategies for reengagement in HIV care. Participants were cisgender women (n = 162), 18 to 49 years of age, and who completed sociodemographic, medical history, reasons why they were not taking ART, mental health, motivation, and self-efficacy assessments. Latent class analysis was used for analysis. Women who reported avoidance-based coping (avoid thinking about HIV) had higher depression ( U = 608.5, z = −2.7, P = .007), lower motivation ( U = 601, z = −2.8, P = .006), and lower self-efficacy ( U = 644.5, z = −2.4, P = .017) than those not using this maladaptive strategy. As women living with HIV experience a disproportionate burden of poor health outcomes, interventions focused on the management of depression may improve HIV outcomes and prevent HIV transmission.

scholarly journals Patterns of changing pregnancy intentions among women living with HIV in Canada

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Lashanda Skerritt ◽  
Angela Kaida ◽  
Nadia O’Brien ◽  
Ann N. Burchell ◽  
Gillian Bartlett ◽  
...  
Keyword(s):  
Hiv Transmission ◽  
Healthcare Providers ◽  
Undetectable Viral Load ◽  
Subsequent Pregnancy ◽  
Reproductive Age ◽  
Pregnancy Intentions ◽  
Women Living With Hiv ◽  
Living With Hiv ◽  
Health Cohort Study

Abstract Background Women with an undetectable viral load can become pregnant and have children with no risk of HIV transmission to their sexual partners and low risk of transmission to their infants. Contemporary pregnancy intentions of women living with HIV in Canada are poorly understood, evidenced by high rates of unintended pregnancy and low uptake of contraceptives. Methods We used longitudinal survey data from the Canadian HIV Women’s Sexual and Reproductive Health Cohort Study (CHIWOS) to measure and compare pregnancy intentions (Yes vs No vs Unsure) at baseline, 18-months and 36-months follow-up (from 2013 to 2018) among women living with HIV of reproductive age (16–49 years) and potential. We used Sankey diagrams to depict changes in pregnancy intentions over time and multivariable logistic regression to examine the relationship between pregnancy intention within 2 years and subsequent pregnancy. Results At baseline, 41.9% (119/284) of women intended to become pregnant, 43.3% did not, and 14.8% were unsure. Across 36-months of follow-up, 41.9% (119/284) of women changed their pregnancy intentions, with 25% changing from intending to not intending to become pregnant and 13.1% vice versa. Pregnancy intentions were not strongly associated with subsequent pregnancy between baseline and 18-months (aOR 1.44; 95% CI 0.53, 3.72) or between 18 and 36-months (aOR 2.17; 95% CI 0.92, 5.13). Conclusions Our findings underscore the need for healthcare providers to engage in ongoing discussions with women living with HIV to support their dynamic pregnancy intentions.

scholarly journals Improving uptake of cervical cancer screening services for women living with HIV and attending chronic care services in rural Malawi

2020 ◽  
Vol 9 (3) ◽  
pp. e000892
Author(s):  
George C Talama ◽  
Mairead Shaw ◽  
Jordan Maloya ◽  
Tafwirapo Chihana ◽  
Lawrence Nazimera ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Cancer Screening ◽  
Cervical Cancer Screening ◽  
Communicable Disease ◽  
Scale Up ◽  
Cervical Cancer Prevention ◽  
Reproductive Age ◽  
Hiv Care ◽  
Women Living With Hiv ◽  
Living With Hiv

Malawi has the second highest age-standardised incidence rate and the highest mortality rate of cervical cancer in the world. Though the prevalence of HIV is currently 11.7% for Malawian women of reproductive age, cervical cancer screening rates remain low. To address this issue, we integrated cervical cancer screening into a dual HIV and non-communicable disease clinic at a rural district hospital in Neno, Malawi. The project was implemented between January 2017 and March 2018 using the Plan-Do-Study-Act model of quality improvement (QI). At baseline (January to December 2016), only 13 women living with HIV were screened for cervical cancer. One year after implementation of the QI project, 73% (n=547) of women aged 25 to 49 years living with HIV enrolled in HIV care were screened for cervical cancer, with 85.3% of these receiving the screening test for the first time. The number of women living with HIV accessing cervical cancer services increased almost 10 times (from four per month to 39 per month, p<0.001). Key enablers in our QI process included: strong mentorship, regular provision of cervical cancer health talks throughout the hospital, nationally accredited cervical cancer prevention training for all providers, consistent community engagement, continuous monitoring and evaluation, and direct provision of resources to strengthen gaps in the public system. This practical experience integrating cervical cancer screening into routine HIV care may provide valuable lessons for scale-up in rural Malawi.

scholarly journals HIV viral load trajectories of women living with HIV in Metro Vancouver, Canada

2020 ◽  
pp. 095646242096584
Author(s):  
Putu Duff ◽  
Kate Shannon ◽  
Melissa Braschel ◽  
Flo Ranville ◽  
Mary Kestler ◽  
...  
Keyword(s):  
Viral Load ◽  
High Probability ◽  
Latent Class ◽  
Multivariable Analysis ◽  
Hiv Care ◽  
Women Living With Hiv ◽  
Low Probability ◽  
Living With Hiv ◽  
Hiv Aids

This study describes long-term viral load (VL) trajectories and their predictors among women living with HIV (WLWH), using data from Sexual Health and HIV/AIDS: Women’s Longitudinal Needs Assessment (SHAWNA), an open prospective cohort study with linkages to the HIV/AIDS Drug Treatment Program. Using Latent Class Growth Analysis (LCGA) on a sample of 153 WLWH (1088 observations), three distinct trajectories of detectable VL (≥50 copies/ml) were identified: ‘sustained low probability of detectable VL’, characterized by high probability of long-term VL undetectability (51% of participants); ‘ high probability of delayed viral undetectability’, characterized by a high probability VL detectability at baseline that decreases over time (43% of participants); and ‘ high probability of detectable VL’, characterized by a high probability of long-term VL detectability (7% of participants). In multivariable analysis, incarceration (adjusted odds ratio (AOR) = 3.24; 95%CI:1.34–7.82), younger age (AOR = 0.96; 95%CI:0.92–1.00), and lower CD4 count (AOR = 0.82; 95%CI:0.72–0.93) were associated with ‘ high probability of delayed viral undetectability’ compared to ‘sustained low probability of detectable VL.’ This study reveals the dynamic and heterogeneous nature of WLWH’s long-term VL patterns, and highlights the need for early engagement in HIV care among young WLWH and programs to mitigate the destabilizing impact of incarceration on WLWH’s HIV treatment outcomes.

scholarly journals Evaluating the effect of a community score card among pregnant and breastfeeding women living with HIV in two districts in Malawi

PLoS ONE ◽  
2021 ◽  
Vol 16 (8) ◽  
pp. e0255788
Author(s):  
Megan Kays ◽  
Godfrey Woelk ◽  
Tegan Callahan ◽  
Leila Katirayi ◽  
Michele Montandon ◽  
...  
Keyword(s):  
Service Quality ◽  
Collective Efficacy ◽  
Self Efficacy ◽  
Hiv Transmission ◽  
Hiv Care ◽  
Hiv Positive ◽  
Post Intervention ◽  
Women Living With Hiv ◽  
Score Card ◽  
Before And After

Malawi faces challenges with retaining women in prevention of mother-to-child HIV transmission (PMTCT) services. We evaluated Cooperative for Assistance and Relief Everywhere, Inc. (CARE’s) community score card (CSC) in 11 purposively selected health facilities, assessing the effect on: (1) retention in PMTCT services, (2) uptake of early infant diagnosis (EID), (3) collective efficacy among clients, and (4) self-efficacy among health care workers (HCWs) in delivering quality services. The CSC is a participatory community approach. In this study, HCWs and PMTCT clients identified issues impacting PMTCT service quality and uptake and implemented actions for improvement. A mixed-methods, pre- and post-intervention design was used to evaluate the intervention. We abstracted routine clinical data on retention in PMTCT services for HIV-positive clients attending their first antenatal care visit and EID uptake for their infants for 8-month periods before and after implementation. To assess collective efficacy and self-efficacy, we administered questionnaires and conducted focus group discussions (FGDs) pre- and post-intervention with PMTCT clients recruited from CSC participants, and HCWs providing HIV care from facilities. Retention of HIV-positive women in PMTCT services at three and six months and EID uptake was not significantly different pre- and post-implementation. For the clients, the collective efficacy scale average improved significantly post-intervention, (p = 0.003). HCW self-efficacy scale average did not improve. Results from the FGDs highlighted a strengthened relationship between HCWs and PMTCT clients, with clients reporting increased satisfaction with services. However, the data indicated continued challenges with stigma and fear of disclosure. While CSC may foster mutual trust and respect between HCWs and PMTCT clients, we did not find it improved PMTCT retention or EID uptake within the short duration of the study period. More research is needed on ways to improve service quality and decrease stigmatized behaviors, such as HIV testing and treatment services, as well as the longer-term impacts of interventions like the CSC on clinical outcomes.

scholarly journals Integration of Family Planning Services With HIV Treatment for Women of Reproductive Age Living With HIV Attending ART in Special Zone of Oromia Regional State, Ethiopia

2020 ◽  
Author(s):  
Dereje Bayissa Demissie ◽  
Rose Mmusi-Phetoe
Keyword(s):  
Family Planning ◽  
Hiv Treatment ◽  
Reproductive Age ◽  
Age Group ◽  
Women Of Reproductive Age ◽  
Family Planning Services ◽  
Hiv Services ◽  
Women Living With Hiv ◽  
Living With Hiv ◽  
Special Zone

Abstract Background: In settings where HIV prevalence is high, management of sexual and reproductive health is critical to reducing HIV transmission and maternal mortality. Integration of family planning with HIV services is appropriate model for HIV therapy, HIV prevention and care with family planning services in a resource limiting area like Ethiopia. The aims of the study were to determine the status of integration of family planning services with HIV treatment for women of reproductive age in Oromia, Ethiopia Methods: A Health facility based cross-sectional study design was conducted with quantitative data collection approach was used to collect data from women living with HIV attending ART clinics in special zone of surrounding Finfinne, Oromia Region in five health centres. Simple random sampling computer-generated sample was used to select 654 respondents. The returned questionnaires were checked for completeness, cleaned manually, coded and entered into EPI INFO 7.1.6 version. These were then transferred to statistical Package for Social Sciences 23.0 for further analysis. Bivariate and multivariable logistic regressions analysis was used to identify factors associated with integration family planning with HIV services with the significant association at adjusted odds ratio (AOR) with 95% confidence interval (CI) to controlled effects of possible confounders from final model. Result: After discarded16 spoiled questionnaires, the completed response rate of this study was 97.6% (654/670). There were 654 respondents whose ages ranged between 18 and 49 years. The mean age of the respondents was 31.86 years with a SD of ±6.0 years. Most of the respondents in the sample were in the age group 26-35 (n=374, 57%), and only 96 (14.7%) were in the age group 18-25. This study determined the overall integration FP-HIV services were 55.8% among reproductive age women living with HIV in Oromia regional state of special zone health centres. Almost all respondents (n=635, 97.1%) preferred integrated sexual reproductive health and HIV services at the same facility, from the same providers, and 622 (95%) were very or mostly satisfied with the utilisation of integrated family planning/HIV services.Conclusion: The identified factors that affected the integration of family planning with HIV services were educational and occupational status, residence, discussion of family planning with healthcare providers, fertility desire and CD4 counts. Therefore, Ministry of health should engage women in the planning, implementation and evaluation of the integrated family planning/HIV services.

scholarly journals Unmet need for family planning and factors associated among women living with HIV in Oromia regional state, Ethiopia

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Dereje Bayissa Demissie ◽  
Gizachew Abdissa Bulto ◽  
Rose Mmusi-Phetoe
Keyword(s):  
Family Planning ◽  
Healthcare Providers ◽  
Unmet Need ◽  
Reproductive Age ◽  
Women Of Reproductive Age ◽  
Women Living With Hiv ◽  
Regional State ◽  
Future Fertility ◽  
Met Needs ◽  
Living With Hiv

Abstract Objectives The purpose of this study was to determine the prevalence of the unmet need and identifying factors associated with the unmet need among women of reproductive age living with HIV in Oromia regional state, Ethiopia. One critical component of both a full range of contraceptives and satisfying demand for family planning with HIV services all women living with HIV is the appropriate model for HIV therapy, HIV prevention, and care with family planning services in a resource-limiting area like Ethiopia. Methods Health facility-based cross-sectional study design was conducted among women living with HIV attending ART clinics in the special zone of, Oromia regional state, by simple random sampling was used to select 654 respondents. Both bivariate and multivariable logistic regressions analysis was used to identify at adjusted odds ratio (AOR) with 95% CI in the final model. Result The study assessed the magnitude of demand for family planning among HIV-infected women and established that the demand was 630 (96.3%), of which 100 (16%) of women of reproductive age living with HIV had unmet needs for family planning while attending monthly ART clinic drug refilling and follow up. This study identified that factors found to be associated with met needs for family planning among women of reproductive age living with HIV attending ART/PMTC were discussions with healthcare providers (AOR = 4.33, 95% CI 2.56–7.32), previous pregnancy (AOR = 3.07, 95% CI 1.84–5.12); future fertility desire (AOR = 2.15, 95% CI 1.31–3.51); having sexual partners (AOR = 5.26, 95% CI 1.79–15.5) and the number of the sexual partner (one) (AOR = 7.24, 95% CI 1.82–28.74) were identified independent predictors of met needs for family planning. Conclusion The overall demand for family planning was 96% among the women living with HIV, and that 16% of women had an unmet need for family planning. The authors conducted a logistic regression and find various dependent variables that are associated with the met need for family planning services, such as having discussions with healthcare providers, having a partner and previous pregnancy; future fertility desire, the last pregnancy being intended. These results are interpreted to suggest that clear policy implications of family planning must be better integrated into ART clinics.

scholarly journals Preconception and Contraceptive Care for Women Living with HIV

2012 ◽  
Vol 2012 ◽  
pp. 1-14 ◽  
Author(s):  
Mary Jo Hoyt ◽  
Deborah S. Storm ◽  
Erika Aaron ◽  
Jean Anderson
Keyword(s):  
Hiv Transmission ◽  
Unmet Need ◽  
Reproductive Age ◽  
Fertility Desires ◽  
Women Living With Hiv ◽  
Perinatal Hiv ◽  
Specialized Care ◽  
Fertility Data ◽  
Primary Focus ◽  
Living With Hiv

Women living with HIV have fertility desires and intentions that are similar to those of uninfected women, and with advances in treatment most women can realistically plan to have and raise children to adulthood. Although HIV may have adverse effects on fertility, recent studies suggest that antiretroviral therapy may increase or restore fertility. Data indicate the increasing numbers of women living with HIV who are becoming pregnant, and that many pregnancies are unintended and contraception is underutilized, reflecting an unmet need for preconception care (PCC). In addition to the PCC appropriate for all women of reproductive age, women living with HIV require comprehensive, specialized care that addresses their unique needs. The goals of PCC for women living with HIV are to prevent unintended pregnancy, optimize maternal health prior to pregnancy, improve maternal and fetal outcomes in pregnancy, prevent perinatal HIV transmission, and prevent HIV transmission to an HIV-uninfected sexual partner when trying to conceive. This paper discusses the rationale for preconception counseling and care in the setting of HIV and reviews current literature relevant to the content and considerations in providing PCC for women living with HIV, with a primary focus on well-resourced settings.

scholarly journals Integration of family planning services with HIV treatment for women of reproductive age attending ART clinic in Oromia regional state, Ethiopia

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Dereje Bayissa Demissie ◽  
Rose Mmusi-Phetoe
Keyword(s):  
Family Planning ◽  
Hiv Treatment ◽  
Health Centers ◽  
Reproductive Age ◽  
Women Of Reproductive Age ◽  
Family Planning Services ◽  
Hiv Services ◽  
Women Living With Hiv ◽  
Living With Hiv ◽  
Special Zone

Abstract Background In settings where HIV prevalence is high, management of sexual and reproductive health is critical to reducing HIV transmission and maternal mortality. Integration of family planning with HIV services is appropriate for HIV therapy, HIV prevention, and care in a resource-limited country s like Ethiopia. The study aimed at examining the status of integration of family planning services with HIV treatment and factors associated with successful integration of family planning and HIV services for women of reproductive age in Oromia, Ethiopia for better health outcomes. Methods The research design of this study was a quantitative survey, non-experimental, explorative and descriptive. A questionnaire was used to collect data from women living with HIV attending ART clinics in the special zone of surrounding Finfinne, Oromia Region in five health centers. Simple random sampling was used to select 654 respondents. Data was analysed through the use of Statistical Package for Social Sciences version 23.0. Bivariate and multivariate logistic regressions were performed to identify factors associated integration of family planning with HIV services with the significant association at an adjusted odds ratio (AOR) with a 95% confidence interval (CI) to controlled effects of possible confounders from the final model. Result The response rate of this study was 97.6% (654/670). The ages of those who responded to the administered questionnaires ranged between 18 and 49 years. The mean age of the respondents was 31.86 years with an SD of ± 6.0 years. Most of the respondents in the sample were in the age group 26–35 (n = 374, 57%), and only 96 (14.7%) were in the age group 18–25. This overall integration of FP-HIV services among reproductive-age women living with HIV in Oromia regional state of special zone health centers was found to be 55.8%. Almost all respondents (n = 635, 97.1%) preferred integrated family planning and HIV services from the same facility and the same providers. the study found that 622 (95%) were most satisfied with the utilization of integrated family planning/HIV services. Conclusion This study established that in overall, the integration of family planning/HIV services was relatively moderate among women of reproductive age living HIV. The identified factors that affected the integration of family planning with HIV services were the level of education, occupational status, residence, discussion of family planning with healthcare providers, fertility desire and CD4 counts.

scholarly journals Bijou: Engaging Young MSM in HIV Care Using a Mobile Health Strategy

2021 ◽  
Vol 20 ◽  
pp. 232595822110308
Author(s):  
Tiffany Chenneville ◽  
Hunter Drake ◽  
Kemesha Gabbidon ◽  
Carina Rodriguez ◽  
Lisa Hightow-Weidman
Keyword(s):  
Health Literacy ◽  
Self Efficacy ◽  
Retention In Care ◽  
Knowledge Retention ◽  
Hiv Care ◽  
Ehealth Literacy ◽  
Literacy Engagement ◽  
Southeastern Us ◽  
Post Test ◽  
Living With Hiv

Young men who have sex with men (YMSM) living with HIV experience challenges with retention in care, which negatively affects viral suppression. To address this, researchers piloted Bijou, a program designed to provide health education through electronically delivered behavior and risk reduction modules. Participants were 29 YMSM aged 19-24 living with HIV from the southeastern US. Participants completed pre, post, and 3-month follow-up (3MFU) surveys assessing knowledge, intervention acceptability, satisfaction, self-efficacy, ehealth literacy, and usability. Findings revealed significant improvement in knowledge and e-health literacy from pre-test to post-test but lost significance at 3MFU. Self-efficacy scores did not show significant differences from pre-test to post-test or 3MFU. Participants who completed all modules considered Bijou usable and acceptable; however, many did not complete the program. Findings suggest a need for adaptations to promote knowledge retention, e-health literacy, engagement over time, and research with a larger, more representative sample.

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