Empowerment in pregnancy: ART adherence among women living with HIV in Cape Town, South Africa.
Empowerment in pregnancy: ART adherence among women living with HIV in Cape Town, South Africa.
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DOI：
10.1016/j.socscimed.2022.114738
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发表时间：
2022-03
期刊：
影响因子：
--
通讯作者：
Pellowski JA
中科院分区：
文献类型：
--
作者：
DiClemente-Bosco K;Weber AZ;Harrison A;Tsawe N;Rini Z;Brittain K;Colvin CJ;Myer L;Pellowski JA
坚持抗逆转录病毒治疗（ART）是全球关注的孕妇和产后感染艾滋病毒（WLHIV）的妇女。研究集中在围产期WLHIV以及他们如何平衡坚持，从事艾滋病毒护理和其他形式的自我护理是有限的。妇女赋权理论已被应用于无数的健康行为，以了解模式，建立机制，并制定干预措施，但赋权理论应用于ART的研究不足。为了更深入地了解围产期的健康行为，我们研究这些因素使用奈拉妇女赋权理论，其中表示资源，代理，和成就的三个主要和相互关联的组成部分的授权。数据于2018年3月至7月在南非Gugulethu收集。在怀孕32-35周时与WLHIV进行了30次深入访谈，主题包括与ART坚持和母亲赋权意义相关的经验。分析分为两个阶段：（1）归纳性开放编码的新兴主题;（2）分类主题到Kabeer的授权理论。与会者表示，资源在坚持方面发挥着关键作用，从实际支持到家庭和伴侣提供的激励支持。代理被体验为在通常预期的伴侣撤回支持的情况下成为独立母亲的愿望。与会者将成就描述为注重时间的目标，从出生时没有艾滋病毒的婴儿到长寿和有成效的生活。这些研究结果表明，一个有前途的和创新的方法，以提高整个围产期过渡的ART坚持将集中在理解资源作为一个有利的环境，建立在现有的感觉机构，并强调终身目标实现高水平的坚持。更好地了解妇女赋权如何在怀孕过程中演变，并进入产后期间将支持干预措施的发展，旨在提高抗逆转录病毒疗法的坚持和潜在的额外围产期健康行为。
Adherence to antiretroviral therapy (ART) is a global concern among pregnant and postpartum women living with HIV (WLHIV). Research focusing on peripartum WLHIV and how they balance adherence, engaging in HIV care, and other forms of self-care is limited. Women’s empowerment theories have been applied to myriad health behaviors to understand patterns, establish mechanisms, and develop interventions; yet empowerment theory as applied to ART is under-researched. Seeking deeper insight into peripartum health behaviors, we examine these factors using Naila women’s empowerment theory, which denotes resources, agency, and achievements as three primary and interrelated components of empowerment. Data were collected in Gugulethu, South Africa, between March and July 2018. Thirty in-depth interviews were conducted with WLHIV at 32-35 weeks of pregnancy, with topics including experiences related to ART adherence and meanings of empowerment in motherhood. Analyses had two phases: (1) inductive open-coding for emergent themes; and (2) classifying themes into Kabeer’s empowerment theory. Participants expressed that resources play a critical role in adherence, ranging from practical support to motivational support provided by both family and partners. Agency is experienced as a desire to be an independent mother in the often-expected event that partners withdraw support. Participants described achievements as time-oriented goals, ranging from having a baby born without HIV to living a long and productive life. These findings suggest that a promising and innovative approach to improving ART adherence across the peripartum transition would focus on understanding resources as an enabling environment, build on existing feelings of agency, and highlight the lifelong goals achievable with high levels of adherence. A better understanding of how women’s empowerment evolves over the course of pregnancy and into the postpartum period will support intervention development aimed at improving ART adherence and potentially additional peripartum health behaviors.
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