scholarly journals Prevention measures for vertical HIV transmission: monitoring infected pregnant women and exposed children

2021 ◽  
Vol 21 (1) ◽  
pp. 207-215
Author(s):  
Cristina Silvana da Silva Vasconcelos ◽  
Renata Junqueira Pereira ◽  
Adiléia Fernandes Barros da Silva Santos ◽  
Lúcia Helena Almeida Gratão
Keyword(s):  
Pregnant Women ◽  
Healthcare Service ◽  
Service Use ◽  
The State ◽  
Public Healthcare ◽  
Prevention Measures ◽  
Cross Sectional ◽  
Women Living With Hiv ◽  
Living With Hiv

Abstract Objectives: to present an analysis of the follow-up of exposed children and pregnant women living with HIV who are assisted in a reference public healthcare service of a Brazilian capital. Methods: this is a cross-sectional study with sociodemographic and clinical data obtainedfrom physical and electronic medical records of women living with HIV and exposed children, treated between 2000 and 2018, in a secondary healthcare service. For associations, the chi-square test at 5% significance was used. Results: the data about 183 pregnancies and 214 children from the capital or other municipalities in the state were analyzed. The women have low schooling, are brown or black, single, multiparous, diagnosed with HIV during prenatal care, with the start of follow-up from the third trimester of pregnancy and the use of prophylaxis during childbirth. As for children, the associations were significant for notification on SINAN, admission to the health service, use of prophylaxis indicating better monitoring for those who live in the state capital. Conclusions: the prevention measures recommended by the Ministry of Health, in general, were followed, but children and pregnant women who live in other cities were worse off than those ones in the capital. Unnotified cases were identified on SINAN. These issues may contribute to new cases of vertical transmission of HIV.

Factors Associated with Postpartum Loss to Follow-Up and Detectable Viremia After Delivery Among Pregnant Women Living with HIV

2019 ◽  
Vol 33 (1) ◽  
pp. 14-20
Author(s):  
Emily H. Adhikari ◽  
Casey S. Yule ◽  
Scott W. Roberts ◽  
Vanessa L. Rogers ◽  
Jeanne S. Sheffield ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Loss To Follow Up ◽  
Factors Associated ◽  
Women Living With Hiv ◽  
Living With Hiv

scholarly journals The relationship between intimate partner violence and HIV outcomes among pregnant women living with HIV in Malawi

2021 ◽  
Vol 33 (4) ◽  
pp. 242-252
Author(s):  
Elizabeth C. Wetzel ◽  
Tapiwa Tembo ◽  
Elaine J. Abrams ◽  
Alick Mazenga ◽  
Mike J. Chitani ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Psychosocial Factors ◽  
Partner Violence ◽  
Health Concern ◽  
Art Adherence ◽  
Global Public Health ◽  
Women Living With Hiv ◽  
Current Partner ◽  
Living With Hiv

BackgroundIntimate partner violence (IPV) is a global public health concern particularly in pregnancy where IPV can have negative health implications for the mother and child. Data suggest IPV disproportionately affects pregnant women living with HIV (PWLWH) compared to those without HIV. HIV-related outcomes are worse among women experiencing IPV. Despite this knowledge, there is paucity of data concerning PWLWH and IPV in Malawi, where there is a high HIV prevalence (10.6%). ObjectivesWe aim to characterize IPV amongst PWLWH in Malawi and describe its relationship to demographic characteristics, psychosocial factors, and HIV-related outcomes. MethodsThis analysis used data from the VITAL Start pilot study, which is a video-based intervention targeting retention and ART adherence amongst PWLWH in Malawi. PWLWH not on ART were recruited at antenatal clinic and given study questionnaires to assess demographics, IPV, and psychosocial factors. Questionnaires were also administered at one-month follow-up to assess outcomes related to HIV. Descriptive statistics and logistic regression models were used to explore the risk factors associated with IPV.ResultsThirty-nine percent of participants reported ever experiencing IPV from their current partner. The majority (53%) reporting IPV experienced more than one type of violence. IPV was associated with being married (p=0.04) and depression (p<0.0001) in the univariable analysis. For women retained at one-month, IPV was associated with reporting a missed ART dose in the past month but not with adherence measured by pill count.ConclusionsA large proportion of PWLWH experienced IPV from their current partner and IPV was associated with worse self-reported ART adherence at one-month follow-up. Further evidence is needed to understand how IPV impacts PWLWH throughout postpartum and beyond. Given the detrimental impact on health outcomes among PWLWH in Malawi, additional focus on IPV is essential to identify mechanisms to prevent, screen, and manage IPV among this population.

scholarly journals Initiation of antiretroviral therapy or antiretroviral prophylaxis in pregnant women living with HIV registered in five townships of Mandalay, Myanmar: A cross sectional study

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Khine Wut Yee Kyaw ◽  
Aye Aye Mon ◽  
Khaing Hnin Phyo ◽  
Nang Thu Thu Kyaw ◽  
Ajay M. V. Kumar ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Pregnant Women ◽  
Prevalence Ratio ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Hiv Diagnosis ◽  
Cross Sectional ◽  
Women Living With Hiv ◽  
Antiretroviral Prophylaxis ◽  
Living With Hiv

Abstract Background A series of interventions are required to prevent mother to child transmission (PMTCT) of Human Immunodeficiency Virus (HIV) starting from HIV testing of pregnant women, initiating antiretroviral therapy (ART) or antiretroviral prophylaxis to HIV-positive pregnant women to providing HIV prophylaxis to newborn babies. Gaps in each step can significantly affect the effectiveness of PMTCT interventions. We aimed to determine the gap in initiation of ART/antiretroviral prophylaxis for pregnant women living with HIV, delay in initiation of ART/antiretroviral prophylaxis and factors associated with the delay. Methods This is a cross sectional study using routinely collected programme data from five health facilities providing PMTCT services located at Township Health Departments (THD) of Mandalay, Myanmar. Results There were 363 pregnant women living with HIV enrolled between January 2012 and December 2017. Sixty (16%) women were excluded from the study due to missing data on dates of HIV diagnosis. Of 303 (84%) women included in the study, 89/303 (29%) and 214/303 (71%) were diagnosed with HIV before and during current pregnancy respectively. Among 214 women, 180 (84%) women were started on ART by the censor date (31st March 2018). Among those who started ART, 109 (61%) women had a delay of starting ART > 2 weeks from diagnosis. Women residing in township 4 had a significantly higher risk of delay in initiation of ART/antiretroviral prophylaxis compared to women residing in township 1 [adjusted prevalence ratio 4.2 (95% confidence interval 1.2–14.8]. Conclusions We found that one in four women living with HIV knew their HIV status before current pregnancy. Although the rate of ART/antiretroviral prophylaxis initiation was high among pregnant women living with HIV, there was a delay. Early initiation of ART/antiretroviral prophylaxis among newly HIV diagnosed pregnant women needs to be strengthened.

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

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.

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

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

scholarly journals Clinical situation of Venezuelan migrants living with HIV in a hospital in Lima, Peru

2021 ◽  
pp. 095646242110240
Author(s):  
Genesis S Huerta-Vera ◽  
Manuel A Amarista ◽  
Fernando A Mejía ◽  
Ana B Graña ◽  
Elsa V Gonzalez-Lagos ◽  
...  
Keyword(s):  
Viral Suppression ◽  
Clinical Situation ◽  
Cross Sectional Study ◽  
People Living With Hiv ◽  
Sectional Study ◽  
Cross Sectional ◽  
Epidemiological Trends ◽  
Clinical Conditions ◽  
Living With Hiv

Due to a huge crisis extensive to health services many Venezuelan people living with HIV (PLWH) had migrated abroad, including Peru where favorable laws were in place until June 2019. We describe the health status and epidemiological trends of PLWH from Venezuela at an HIV program in Lima. We analyzed baseline and follow-up data of all Venezuelan PLWH enrolled in our HIV program from January 2017 to December 2019. A cross-sectional study in a subsample served to describe ARV adherence and context of migration. Between 2017-2019 our HIV Program registered 398 Venezuelan PLWH, representing 20% of the 2018 annual enrollments; numbers decreased since mid-2019. The median age was 30 years (IQR 26;37) and 90.5% were men. Between 2017 and 2019, the proportion with diagnosis in Peru increased from 14.3% to 60.9%; of AIDS stage at entry, from 8.8% to 27.2%. By December 2019, 182/250 (72.8%) were still in care, and 43 (10.8%) had not started ART. Viral suppression evaluated in 195, was achieved in 71.8%. From 2017 to 2019, migrant PLWH arrived in worsened clinical conditions, with increasing diagnosis in Peru; the flow of migrant PLWH entering care diminished with less favorable laws. Viral suppression rates were suboptimal.

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