A randomized group antenatal care pilot showed increased partner communication and partner HIV testing during pregnancy in Malawi and Tanzania.
A randomized group antenatal care pilot showed increased partner communication and partner HIV testing during pregnancy in Malawi and Tanzania.
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DOI：
10.1186/s12884-021-04267-6
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发表时间：
2021-11-24
影响因子：
3.1
通讯作者：
Patil CL
中科院分区：
文献类型：
--
作者：
Jeremiah RD;Patel DR;Chirwa E;Kapito E;Mei X;McCreary LL;Norr KF;Liu L;Patil CL
产前保健中的艾滋病毒检测对于在撒哈拉以南非洲实现零新发感染至关重要。虽然大多数妇女在产前接受了检测，但如果她们的伴侣没有接受检测，她们仍然有感染艾滋病毒并将其传染给婴儿的风险。本研究评估了艾滋病毒增强和以中心为基础的小组ANC模式-使用互动式学习练习伴侣沟通的小组ANC+如何与怀孕期间伴侣艾滋病毒检测的改善相关。在马拉维和坦桑尼亚进行的一项随机试点研究发现，分配到ANC+组和单独ANC组的孕妇（n = 218）有多个阳性结果。该分析增加了先前未发表的两项晚期妊娠结果：与伴侣就三个生殖健康主题（安全性行为、艾滋病毒检测和计划生育）进行沟通，以及自第一次产前检查以来进行伴侣艾滋病毒检测。采用多变量logistic回归模型评估ANC类型对伴侣沟通和伴侣测试的影响。我们还进行了中介分析，以评估伴侣沟通是否介导护理类型对伴侣HIV检测的影响。在ANC+组中，近70%的妇女报告与其伴侣就生殖健康问题进行了沟通，而在单独ANC组中，这一比例为45%。在控制了显著协变量后，ANC组的女性报告其伴侣接受艾滋病毒检测的可能性是单独ANC组的两倍（OR 1.99; 95% CI: 1.08, 3.66）。ANC +组模式对伴侣HIV检测的积极作用完全由增加的伴侣沟通介导。艾滋病毒预防被纳入非洲人国民健康促进小组，但不影响非洲人国民健康促进标准主题的服务和覆盖范围，这表明可以利用非洲人国民健康促进小组将当地高度优先的健康促进需求纳入非洲人国民健康促进小组。这些发现提供证据表明，更多的伴侣沟通可以促进健康的生殖行为，包括预防艾滋病毒。需要进行更多的研究，以了解ANC小组允许妇女与合作伙伴讨论敏感话题的过程，以及这些交流如何导致合作伙伴进行艾滋病毒检测。
HIV testing at antenatal care (ANC) is critical to achieving zero new infections in sub-Saharan Africa. Although most women are tested at ANC, they remain at risk for HIV exposure and transmission to their infant when their partners are not tested. This study evaluates how an HIV-enhanced and Centering-based group ANC model-Group ANC+ that uses interactive learning to practice partner communication is associated with improvements in partner HIV testing during pregnancy. A randomized pilot study conducted in Malawi and Tanzania found multiple positive outcomes for pregnant women (n = 218) assigned to Group ANC+ versus individual ANC. This analysis adds previously unpublished results for two late pregnancy outcomes: communication with partner about three reproductive health topics (safer sex, HIV testing, and family planning) and partner HIV testing since the first antenatal care visit. Multivariate logistic regression models were used to assess the effect of type of ANC on partner communication and partner testing. We also conducted a mediation analysis to assess whether partner communication mediated the effect of type of care on partner HIV testing. Nearly 70% of women in Group ANC+ reported communicating about reproductive health with their partner, compared to 45% of women in individual ANC. After controlling for significant covariates, women in group ANC were twice as likely as those in individual ANC to report that their partner got an HIV test (OR 1.99; 95% CI: 1.08, 3.66). The positive effect of the Group ANC + model on partner HIV testing was fully mediated by increased partner communication. HIV prevention was included in group ANC health promotion without compromising services and coverage of standard ANC topics, demonstrating that local high-priority health promotion needs can be integrated into ANC using a Group ANC+. These findings provide evidence that greater partner communication can promote healthy reproductive behaviors, including HIV prevention. Additional research is needed to understand the processes by which group ANC allowed women to discuss sensitive topics with partners and how these communications led to partner HIV testing.
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影响因子：
7.6
作者：
BARON, RM;KENNY, DA
通讯作者：
KENNY, DA
DOI：
10.1111/jmwh.13184
发表时间：
2021-03
期刊：
Journal of midwifery & women's health
影响因子：
--
作者：
Lasater ME;Murray SM;Keita M;Souko F;Surkan PJ;Warren NE;Winch PJ;Ba A;Doumbia S;Bass JK
通讯作者：
Bass JK
影响因子：
3.3
作者：
Ickovics JR;Reed E;Magriples U;Westdahl C;Schindler Rising S;Kershaw TS
通讯作者：
Kershaw TS
影响因子：
1.6
作者：
Bello, Fatimah Oluwakemi;Musoke, Pamela;Turan, Janet M.
通讯作者：
Turan, Janet M.
影响因子：
4.4
作者：
Audet, Carolyn M.;Blevins, Meridith;Vermund, Sten H.
通讯作者：
Vermund, Sten H.