Dynamics of leukocyte telomere length in pregnant women living with HIV, and HIV-negative pregnant women: A longitudinal observational study

Background: Secondary distribution of HIV self-testing kits (HIVST) to pregnant women attending antenatal care (ANC) clinics to give to their male partners is a promising strategy to increase testing coverage among men, but its costs are unknown. Methods: We conducted micro-costing of a trial evaluating secondary distribution of HIVST on pregnant women living with HIV (PWLHIV) in an ANC in Kampala, Uganda. Costs (2019 USD) were collected from program budgets, expenditure records, time and motion observations, and staff interviews and estimated for three scenarios: as-studied, reflecting full costs of the research intervention, Ministry of Health (MOH) implementation, reflecting the research intervention if implemented by the MOH, and MOH roll-out, the current strategy being used to roll out HIVST distribution. Results: In the as-studied scenario, cost of HIVST provision was $13.96/PWLHIV reached, and $11.89 and $10.55 per HIV-positive and HIV-negative male partner, respectively, who linked to a clinic for facility-based testing. In the MOH implementation scenario, costs were $9.45/PWLHIV, and $7.87 and $6.99, respectively, per HIV-positive and HIV-negative male partner linking to the clinic. In the MOH roll-out scenario, the cost of HIVST provision to pregnant women regardless of HIV status was $3.70/woman, and $6.65/HIV-positive male partner. Conclusion: Secondary distribution of HIVST from pregnant women can be implemented at reasonable cost to increase testing among men in Uganda and similar settings in Africa.

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Contraceptive use and preference of HIV infected pregnant women living with HIV-negative partners in the central region of Cameroon: a cross sectional survey

10.21203/rs.2.13501/v1 ◽

2019 ◽

Author(s):

Martin Kuete ◽

Hilary Christiane Sipeuwou Ngueye ◽

Sean Zhe Wang ◽

HongFang Yuan ◽

XiuLan Ma ◽

...

Keyword(s):

Family Planning ◽

Pregnant Women ◽

Central Region ◽

Hiv Positive ◽

Family Planning Services ◽

Cross Sectional ◽

Women Living With Hiv ◽

Discordant Couples ◽

Living With Hiv ◽

Hiv Negative

Abstract Background Evidences in sub-Saharan Africa including Cameroon indicate that most of HIV discordant couples want more children despite their HIV status. Investigate and establish contraception preferences among HIV infected individuals are fundamental and crucial to provide effective reproductive healthcare.Methods We performed a cross-sectional study using structured questionnaire to explore HIV-positive pregnant women patterns including their family planning services, their preferences and its use, and their knowledge related to HIV/AIDS. Bivariate and multivariate analyses were conducted to explore associations and predictors of contraception preference and use; all tests were two sided significant at P < 0.05.Results Overall, 94 HIV-positive pregnant women aged 30.70±5.50 years living with HIV-negative partners were from the different areas of the central region of Cameroon. Three-fourths were aware of the effectiveness of modern contraceptives and condoms, and only 28% had experienced modern contraption. 98% preferred to use traditional methods associated with infrequent condoms use. Multiple sociodemographic factors (marital status, group age, educational level, religion, occupation) affected contraceptive method preferences and its use ( P <0.05). These factors are the landmarks to predict discordant couples’ behavior in HIV disclosure, discussion and decision making for contraception, preventing mother to-child transmission and HIV-negative partner infection ( P <0.05).Conclusion Despite the awareness of participants related both on contraception methods and HIV/AIDS matters, participants faced societal, cultural and demographic barriers to make own decision for contraception use. Promoting effective family planning services and given the entire range of contraception options may help women living with HIV to choose for effective ones and consequently reduce newly HIV infections.

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Experiences and predictors of psychological distress in pregnant women living with HIV

British Journal of Health Psychology ◽

10.1111/bjhp.12510 ◽

2021 ◽

Author(s):

Ifeanyichukwu Anthony Ogueji

Keyword(s):

Psychological Distress ◽

Pregnant Women ◽

Women Living With Hiv ◽

Living With Hiv

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Social Vulnerability among Foreign-Born Pregnant Women and Maternal Virologic Control of HIV

American Journal of Perinatology ◽

10.1055/s-0040-1721714 ◽

2020 ◽

Author(s):

Ashish Premkumar ◽

Lynn M. Yee ◽

Lia Benes ◽

Emily S. Miller

Keyword(s):

Antiretroviral Therapy ◽

Pregnant Women ◽

Median Time ◽

Social Vulnerability ◽

Viral Suppression ◽

Foreign Born ◽

Women Living With Hiv ◽

Virologic Control ◽

Clinical Records ◽

Living With Hiv

Objective The aim of this study was to assess whether social vulnerability among foreign-born pregnant women living with HIV is associated with maternal viremia during pregnancy. Study Design This retrospective cohort study included all foreign-born pregnant women living with HIV who received prenatal care in a multidisciplinary prenatal clinic between 2009 and 2018. A licensed clinical social worker evaluated all women and kept detailed clinical records on immigration status and social support. Social vulnerability was defined as both living in the United States for less than 5 years and reporting no family or friends for support. The primary outcome was evidence of viral non-suppression after achievement of initial suppression. Secondary outcomes were the proportion of women who required > 12 weeks after starting antiretroviral therapy to achieve viral suppression, median time to first viral suppression (in weeks) after initiation of antiretroviral therapy, and the proportion who missed ≥ 5 doses of antiretroviral therapy. Bivariable analyses were performed. Results A total of 111 foreign-born women were eligible for analysis, of whom 25 (23%) were classified as socially vulnerable. Social and clinical characteristics of women diverged by social vulnerability categorization but no differences reached statistical significance. On bivariable analysis, socially-vulnerable women were at increased risk for needing > 12 weeks to achieve viral suppression (relative risk: 1.78, 95% confidence interval: 1.18–2.67), though there was no association with missing ≥ 5 doses of antiretroviral therapy or median time to viral suppression after initiation of antiretroviral therapy. Conclusion Among foreign-born, pregnant women living with HIV, markers of virologic control during pregnancy were noted to be worse among socially-vulnerable women. Insofar as maternal viremia is the predominant driver of perinatal transmission, closer clinical surveillance and support may be indicated in this population. Key Points

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