Understanding the Effect of a Healthcare Provider-Led Family Planning Support Intervention on Contraception use and Pregnancy Desires among Postpartum Women Living with HIV in Southwestern Uganda.
Understanding the Effect of a Healthcare Provider-Led Family Planning Support Intervention on Contraception use and Pregnancy Desires among Postpartum Women Living with HIV in Southwestern Uganda.
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DOI：
10.1007/s10461-021-03380-z
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发表时间：
2022-01
影响因子：
4.4
通讯作者：
Mugyenyi GR
中科院分区：
文献类型：
--
作者：
Atukunda EC;Matthews LT;Musiimenta A;Agaba A;Najjuma JN;Lukyamuzi EJ;Kaida A;Obua C;Mugyenyi GR
在乌干达，感染艾滋病毒的妇女使用现代避孕方法的比例仍然很低，为45%，多达三分之一的妇女可能在开始使用后的第一年内停止使用这种方法。这增加了意外怀孕、围产期艾滋病毒传播和妊娠并发症的风险。我们的目的是探索和解释计划生育支持干预措施的作用机制，该干预措施是在2016年10月至2018年6月期间在乌干达西南部的一家转诊医院进行的一项随机对照试验中，在320名产后WLWH中进行的，该试验提高了吸收率，减少了避孕中断并降低了妊娠率。有目的地选择了30名WLWH和10名参与本试验的主要性伴侣，并以当地语言进行了访谈;访谈进行了数字记录。生成翻译的转录本并编码。编码的数据进行了反复审查和排序，以获得描述性类别使用归纳内容分析方法。高达83%的女性希望在产后第一年内避免怀孕。定性数据显示，避孕的吸收和使用受到以下因素的影响：1）参与者对不同可用方法的认识和理解; 2）参与者对所提供的卫生服务的看法; 3）医疗保健提供者（HCP）对个人经验的社会文化敏感性和围绕避孕的（错误）概念; 4）有触觉参与，后续提醒和与合作伙伴迅速采取行动或讨论的参考。支持性和文化敏感的HCP和系统促进了信息共享，从而提高了患者对避孕方法的认识和理解，并改善了健康用户体验、护理参与、信心和接受并继续使用现代避孕方法的意愿。
Modern contraceptive prevalence among women living with HIV (WLWH) in Uganda is still low at 45%, and up to a third of women are likely to discontinue the method within the first year of initiation. This increases risks of unplanned pregnancies, perinatal HIV transmission and pregnancy complications. We aim to explore and explain the mechanism of effect of a family planning support intervention investigated in a randomized controlled trial conducted between October 2016 and June 2018 among 320 postpartum WLWH at a referral hospital in Southwestern Uganda that led to improved uptake, decreased contraception discontinuation and lowered pregnancy rates. Thirty WLWH and 10 of their primary sexual partners who participated in this trial were purposively selected and interviewed in the local language; interviews were digitally recorded. Translated transcripts were generated and coded. Coded data were iteratively reviewed and sorted to derive descriptive categories using an inductive content analytic approach. Up to 83% of women wanted to avoid pregnancy within the first year postpartum. Qualitative data showed that contraception uptake and use were influenced by: 1) Participant awareness and understanding of different methods available; 2) Participant perception of offered health services; 3) Healthcare provider (HCP) socio-cultural sensitivity to individual experiences and (mis)conceptions surrounding contraception; 4) Having tactile engagement, follow-up reminders and a reference to prompt action or discussions with partners. Supportive and culturally sensitive HCPs and systems facilitated information sharing leading to increased patient awareness and understanding of the contraceptive methods, and improved health user experience, care engagement, confidence and willingness to take up and continue using modern contraceptive methods.
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影响因子：
8.1
作者：
Cavallaro, Francesca L.;Duclos, Diane;Lynch, Caroline A.
通讯作者：
Lynch, Caroline A.
影响因子：
3.3
作者：
Ahluwalia, Indu B.;Helms, Kristen;Morrow, Brian
通讯作者：
Morrow, Brian
与乌干达西南部艾滋病毒的产后妇女怀孕意图有关的因素。
影响因子：
4.4
作者：
Atukunda EC;Mugyenyi GR;Atuhumuza EB;Kaida A;Boatin A;Agaba AG;Matthews LT
通讯作者：
Matthews LT
影响因子：
4.4
作者：
Atukunda EC;Musiimenta A;Musinguzi N;Wyatt MA;Ashaba J;Ware NC;Haberer JE
通讯作者：
Haberer JE
影响因子：
3.7
作者：
Bebell LM;Ngonzi J;Bazira J;Fajardo Y;Boatin AA;Siedner MJ;Bassett IV;Nyehangane D;Nanjebe D;Jacquemyn Y;van Geertruyden JP;Mwanga-Amumpaire J;Bangsberg DR;Riley LE;Boum Y 2nd
通讯作者：
Boum Y 2nd