Epidemiologic and clinical characteristics of pregnant women living with HIV/AIDS in a region of Southern Brazil where the subtype C of HIV-1 infection predominates

The study analyses the relationship between AIDS-related stigma and the processes of discrimination prior to diagnosis among pregnant women living with HIV/AIDS. The fieldwork involved interviews about the life trajectories of 29 pregnant women living with HIV/AIDS, recruited at two AIDS services in Rio de Janeiro, Brazil. The analysis revealed that before HIV diagnosis, social and gender inequalities experienced by these women reduced their access to material and symbolic goods that could have enhanced educational and career prospects and their ability and autonomy to exercise sexual and reproductive rights. Being diagnosed with HIV triggered fear of moral judgment and of breakdown in social and family support networks. Given these fears, pregnant women living with HIV/AIDS opt for concealment of the diagnosis. It is necessary for health services, NGOs and government agencies to work together to face the factors that fuel stigma, such as socioeconomic and gender inequalities, taboos and prejudices related to sexuality, and also develop actions to enable women to redefine the meaning of the disease.

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Adherence to antiretroviral treatment for hiv positive pregnant women

Revista de Enfermagem UFPE on line ◽

10.5205/reuol.1182-9562-1-le.0404201033 ◽

2010 ◽

Vol 4 (4) ◽

pp. 1823

Author(s):

Paula Saraiva Duailibe Barbosa ◽

Loise Dantas Fonseca Ribeiro ◽

Maria Eliane Liégio Matão ◽

Pedro Humberto Faria Campos ◽

Denismar Borges Miranda

Keyword(s):

Pregnant Women ◽

Hiv Status ◽

Women Living With Hiv ◽

Mother And Child ◽

Las Mujeres ◽

Terapia Antirretroviral ◽

Child Hospital ◽

Socioeconomic Data ◽

Living With Hiv ◽

Hiv Aids

ABSTRACTObjective: to adherence to antiretroviral therapy by pregnant women living with HIV / AIDS and its determinants advantages and constraints. Method: this is about an exploratory descriptive study, from qualitative approach, using socioeconomic data collection questionnaire and open interviews in depth, content analysis to establish the themes. The study was approved by the Ethics in Research of the Mother and Child Hospital (protocol number 023/07). Results: the material was sorted and grouped into two themes: “HIV/AIDS: infection dramatically worldwide” and “Pregnancy and Seropositivity: a challenge that is solvable”, each divided into subcategories for better understanding and analysis of data. Conclusions: the study presents results consistent with the profile of HIV/AIDS in the country with regard to internalization, pauperization and discovery of the diagnosis, confirming the pregnancy period as appropriate to the knowledge of their HIV status. Adherence to treatment in pregnancy is justified by the desire not to transmit the infection to their child. Descriptors: HIV seropositivity; psychology social; pregnancy; medication adherence.RESUMOObjetivo: conhecer a adesão aos anti-retrovirais (ARV) por gestantes vivendo com HIV/aids, bem como os seus determinantes facilitadores e dificultadores. Método: pesquisa exploratória, descritiva com abordagem qualitativa, na qual se utilizou para coleta de dados questionário socioeconômico e entrevista aberta em profundidade; análise de conteúdo para estabelecimento de categorias temáticas. O estudo foi aprovado pelo Comitê de Ética em Pesquisa do Hospital Materno Infantil (protocolo número 023/07). Resultados: o material foi classificado e agrupado em duas categorias temáticas: “HIV/aids: infecção dramática em todo o mundo” e “Gravidez e Soropositividade: desafio que tem solução”, cada uma delas dividida em subcategorias para melhor compreensão e análise dos dados. Conclusões: o estudo apresenta resultado compatível com o perfil da infecção pelo HIV/aids no país no que se refere à interiorização, pauperização e descoberta do diagnóstico. O período da gravidez aparece como oportuno para o conhecimento da soropositividade para o HIV. A adesão ao tratamento no curso da gravidez é justificada pelo desejo de não transmitir a infecção ao filho. Descritores: soropositividade para HIV; psicologia social; gravidez; adesão à medicação. RESUMENObjetivo: la adhesión a la terapia antirretroviral a las mujeres embarazadas que viven con el VIH/SIDA y sus ventajas y limitaciones determinantes. Método: este enfoque cualitativo exploratorio descriptivo, mediante cuestionario de recogida de datos socioeconómicos y entrevistas abiertas en profundidad, análisis de contenido para establecer los temas. El estudio fue aprobado por la Ética en Investigación del Hospital de la Madre y el Niño (número de protocolo 023/07). Resultados: el material fue clasificado y agrupado en dos temas: el “VIH/SIDA: la infección por drásticamente en todo el mundo” y el “Embarazo y la Seropositividad: un reto que tiene solución”, cada una dividida en subcategorías para una mejor comprensión y análisis de datos. Conclusiones: el estudio presenta resultados consistentes con el perfil del VIH/SIDA en el país con respecto a la internalización, la pauperización y el descubrimiento del diagnóstico, lo que confirma el periodo de gestación en su caso al conocimiento de su estado serológico. Adherencia al tratamiento en el embarazo se justifica por el deseo de no transmitir la infección a su hijo. Descriptores: seropositividad para VIH; psicología social; embarazo; cumplimiento de la medicación.

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Lactobacillus-Depleted Vaginal Microbiota in Pregnant Women Living With HIV-1 Infection Are Associated With Increased Local Inflammation and Preterm Birth

Frontiers in Cellular and Infection Microbiology ◽

10.3389/fcimb.2020.596917 ◽

2021 ◽

Vol 10 ◽

Author(s):

Charlotte-Eve S. Short ◽

Richard G. Brown ◽

Rachael Quinlan ◽

Yun S. Lee ◽

Ann Smith ◽

...

Keyword(s):

Preterm Birth ◽

Pregnant Women ◽

Birth Outcomes ◽

Vaginal Microbiota ◽

Second Trimester ◽

Local Inflammation ◽

Women Living With Hiv ◽

Gestational Age At Delivery ◽

Living With Hiv ◽

Hiv 1

BackgroundPregnant women living with HIV-1 infection (PWLWH) have an elevated risk of preterm birth (PTB) of unknown aetiology, which remains after successful suppression of HIV. Women at high risk for HIV have a common bacterial profile which has been associated with poor birth outcomes. We set out to explore factors associated with gestational age at delivery of PWLWH in a UK population.MethodsProspective study of PWLWH (n = 53) in whom the vaginal microbiota and cervicovaginal cytokine milieu were assessed using metataxonomics and multiplexed immunoassays, respectively. Cross-sectional characterisation of vaginal microbiota in PWLWH were compared with 22 HIV uninfected pregnant women (HUPW) at a similar second trimester timepoint. Within PWLWH the relationships between bacterial composition, inflammatory response, and gestational age at delivery were explored.FindingsThere was a high rate of PTB among PWLWH (12%). In the second trimester the vaginal microbiota was more diverse in PWLWH than in HUPW (Inverse Simpson Index, p = 0.0004 and Species Observed, p = 0.009). PWLWH had a lower prevalence of L. crispatus dominant vaginal microbiota group (VMB I, 15 vs 54%) than HUPW and higher prevalence of L. iners dominant (VMB III, 36 vs 9% and VMB IIIB, 15 vs 5%) and mixed anaerobes (VMB IV, 21 vs 0%). Across the second and third trimesters in PWLWH, VMB III/IIIB and IV were associated with PTB and with increased local inflammation [cervicovaginal fluid (CVF) cytokine concentrations in upper quartile]. High bacterial diversity and anaerobic bacterial abundance were also associated with CVF pro-inflammatory cytokines, most notably IL-1β.InterpretationThere is an association between local inflammation, vaginal dysbiosis and PTB in PWLWH. Understanding the potential of antiretroviral therapies to influence this cascade will be important to improve birth outcomes in this population.

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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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Remaking a life: How women living with HIV/AIDS confront inequality.

Journal of Sex & Marital Therapy ◽

10.1080/0092623x.2021.1875171 ◽

2021 ◽

Vol 47 (2) ◽

pp. 205-207

Author(s):

Morag Yule

Keyword(s):

Women Living With Hiv ◽

Living With Hiv ◽

Hiv Aids

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