scholarly journals Feedback-guided Development for Patient Education Animation: HIV Transmission via Breastfeeding

2018 ◽  
Vol 42 (2) ◽  
Author(s):  
Sarah Crawley ◽  
Shelley Wall ◽  
Lena Serghides ◽  
Marc Dryer

This thesis project uses animation to communicate the risk of HIV transmission via breastfeeding to mothers living with HIV in Canada. Current guidelines do not recommend breastfeeding for HIV+ mothers because there is always some level of risk. Knowledge of mother-to-child transmission is poor, and the cultural pressure to breastfeed has complex implications. It was essential that the science of transmission risk be conveyed in a clear and culturally sensitive manner, to allow women to make appropriate, informed decisions about whether or not to breastfeed. To accomplish this, we adopted a user-testing approach. Throughout development, the script, animatic, and character designs were presented for feedback to members of the target audience, healthcare providers, and representatives from Canadian HIV organizations in an iterative design process. At each round of feedback, the script, animatic, and visual assets were revised, and sent for further comment. Ongoing collaboration with the target audience helped us develop an animation with a wide diversity of characters, culturally sensitive metaphors, and nuanced descriptions of risk, in response to feedback that detailed desires about representation and identified how concepts were being misunderstood. User-testing approaches are necessary when creating patient education animations. Population needs, background, and context have a dramatic impact on patient understanding, and cannot be understood properly without user testing and direct feedback. Doing so helps prevent insensitive concepts and easily misinterpreted information, and thus is key to effective patient education animation.

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Gloria Katuta Mayondi ◽  
Aamirah Mussa ◽  
Rebecca Zash ◽  
Sikhulile Moyo ◽  
Arielle Issacson ◽  
...  

Abstract Background Botswana updated its antiretroviral treatment (ART) guidelines in May 2016 to support breastfeeding for women living with HIV (WLHIV) on ART who have documented HIV RNA suppression during pregnancy. Methods From September 2016 to March 2019, we evaluated feeding method at discharge among WLHIV at eight government maternity wards in Botswana within the Tsepamo Study. We validated the recorded feeding method on the obstetric record using the prevention of mother-to-child transmission of HIV (PMTCT) counsellor report, infant formula dispensing log or through direct observation. Available HIV RNA results were recorded from the obstetric record, and from outpatient HIV records (starting February 2018). In a subset of participants, we used electronic laboratory records to verify whether an HIV RNA test had occurred. Univariable and multivariable logistic regression analyses were performed to identify factors associated with infant feeding choice. Results Among 13,354 WLHIV who had a validated feeding method at discharge, 5303 (39.7%) chose to breastfeed and 8051 (60.3%) chose to formula feed. Women who had a documented HIV RNA result in the obstetric record available to healthcare providers at delivery were more likely to breastfeed (50.8%) compared to women who did not have a documented HIV RNA result (35.4%) (aOR 0.59; 95% CI 0.54, 0.65). Among women with documented HIV RNA, 2711 (94.6%) were virally suppressed (< 400 copies/mL). Breastfeeding occurred in a substantial proportion of women who did not meet criteria, including 46 (30.1%) of 153 women with HIV RNA > 400 copies/mL, and 134 (27.4%) of 489 women with no reported ART use. A sub-analysis of electronic laboratory records among 150 women without a recorded result on the obstetric record revealed that 93 (62%) women had an HIV RNA test during pregnancy. Conclusions In a setting of long-standing use of suppressive ART, with majority of WLHIV on ART from the time of conception, requiring documentation of HIV RNA suppression in the obstetric record to inform infant feeding decisions is a barrier to breastfeeding but unlikely to prevent a substantial amount of HIV transmission.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Lashanda Skerritt ◽  
Angela Kaida ◽  
Nadia O’Brien ◽  
Ann N. Burchell ◽  
Gillian Bartlett ◽  
...  

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.


Author(s):  
William R. Short ◽  
Jason J. Schafer

Upon completion of this chapter, the reader should be able to describe the appropriate management of antiretrovirals for pregnant women living with HIV. Over time, research has demonstrated that proper prevention strategies and interventions during pregnancy, labor, and delivery can significantly reduce the rate of mother-to-child transmission (MTCT) of HIV. In 1994, a pivotal study in the field of HIV medicine, the Pediatric AIDS Clinical Trials Group 076, demonstrated that the use of zidovudine (ZDV) monotherapy during pregnancy substantially reduced the risk of HIV transmission to infants by 67% (...


Author(s):  
Henna Budhwani ◽  
Kristine Ria Hearld ◽  
Jodie Dionne-Odom ◽  
Simon Manga ◽  
Kathleen Nulah ◽  
...  

Objective: We examined patterns of contraceptive utilization by HIV status among women in Cameroon, hypothesizing that women living with HIV would utilize contraception at higher rates than their HIV-negative peers. Methods: Deidentified, clinical data from the Cameroon Baptist Convention Health Services (2007-2013) were analyzed (N = 8995). Frequencies compared outcomes between women living with HIV (15.1%) and uninfected women. Multivariate analyses examined associates of contraceptive utilization and desire to become pregnant. Results: Contraceptive utilization was associated with higher education, living with HIV, monogamy, and higher parity ( P < .001). Women living with HIV had 66% higher odds of using contraceptives than their negative peers (odds ratio [OR]: 1.66, confidence interval [CI]: 1.45-1.91, P < .001). Polygamous women had 37% lower odds of using contraceptives compared to monogamous women (OR: 0.63, 95% CI: 0.52-0.75, P < .001). Conclusion: Increasing contraceptive utilization in resource-constrained settings should be a priority for clinicians and researchers. Doing so could improve population health by reducing HIV transmission between partners and from mother to child.


2019 ◽  
Vol 9 (2) ◽  
pp. 228-231 ◽  
Author(s):  
N Nashid ◽  
S Khan ◽  
M Loutfy ◽  
J MacGillivray ◽  
M H Yudin ◽  
...  

Abstract The reduction in human immunodeficiency virus (HIV) transmission through breastmilk with maternal combination antiretroviral therapy (cART) has led many pregnant women living with HIV and healthcare providers to question exclusive formula feeding in resource-rich settings. Here, we describe cART prophylaxis in 3 breastfed infants whose mothers had sustained virologic suppression; all 3 of these infants remained uninfected.


AIDS ◽  
2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Elona Toska ◽  
Siyanai Zhou ◽  
Christina A. Laurenzi ◽  
Roxanna Haghighat ◽  
Wylene Saal ◽  
...  

2009 ◽  
Vol 44 (2) ◽  
pp. S27
Author(s):  
Jacky M. Jennings ◽  
Jonathan M. Ellen ◽  
Bethany Griffin Deeds ◽  
D. Robert Harris ◽  
Larry R. Muenz ◽  
...  

Sign in / Sign up

Export Citation Format

Share Document