Factors Associated with Pregnancy Intentions Amongst Postpartum Women Living with HIV in Rural Southwestern Uganda.
Factors Associated with Pregnancy Intentions Amongst Postpartum Women Living with HIV in Rural Southwestern Uganda.
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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。
DOI：
10.1007/s10461-018-2317-9
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发表时间：
2019-06
影响因子：
4.4
通讯作者：
Matthews LT
中科院分区：
文献类型：
--
作者：
Atukunda EC;Mugyenyi GR;Atuhumuza EB;Kaida A;Boatin A;Agaba AG;Matthews LT
全面的艾滋病毒治疗和护理使感染艾滋病毒的妇女更安全地拥有她们想要的孩子，部分是通过提供和适当使用有效的避孕药具。然而，在乌干达的一个大型队列中，近三分之一的WLWH护理人员在开始抗逆转录病毒治疗后3年内怀孕，其中一半（45%）是计划外怀孕。因此，我们描述了未来的怀孕计划和相关因素之间的产后WLWH在乌干达西南部农村，以告知干预措施，促进产后避孕药的摄取。该分析包括从参加随机对照试验的成年WLWH收集的基线数据，以评估乌干达西南部产后12个月计划生育支持与标准护理的效果。入组的产后WLWH在入组时完成了一份由访谈者管理的问卷。在320名入选女性中，平均年龄、CD 4计数和ART持续时间分别为28.9（标准差[SD] 5.8）岁、395个细胞/mm 3（SD = 62）和4.6年（SD = 3.9）。189名（59%）妇女报告个人（175，55%）或伴侣（186，58%）希望在未来2年内更多的孩子。多生孩子的意愿与伴侣希望多生孩子（AOR = 31.36; P < 0.000）、计划怀孕（AOR = 2.69; P = 0.050）和家庭月收入> 150，000 Shs（AOR = 1.37; P = 0.010）密切相关。既往使用现代避孕方法（AOR = 0.07; P = 0.001）、年龄增加（AOR = 0.34; P = 0.012）、一个家庭中有2个以上的孩子（AOR = 0.42; P = 0.021）和产次> 2（AOR = 0.59; P = 0.015）与怀孕意愿的几率降低相关。我们的研究结果强调了男性伴侣在影响产后怀孕意愿方面的作用，以及让男性参与有关生育间隔的性健康和生殖健康咨询对妇女，儿童和家庭健康的重要性。这一问题应与关键的个人层面的社会、人口、经济和结构因素一并解决，在这些因素范围内，夫妇可以了解计划外怀孕的风险，并在需要或想要时获得有效的避孕方法。
Comprehensive HIV treatment and care makes it safer for women living with HIV (WLWH) to have the children they desire, partly through provision and appropriate use of effective contraception. However, nearly one third of WLWH in-care in a large Ugandan cohort became pregnant within 3 years of initiating ART and half of these incident pregnancies (45%) were unplanned. We therefore describe future pregnancy plans and associated factors among postpartum WLWH in rural southwestern Uganda in order to inform interventions promoting postpartum contraceptive uptake. This analysis includes baseline data collected from adult WLWH enrolled into a randomized controlled trial to evaluate the effect of family planning support versus standard of care at 12 months postpartum in southwestern Uganda. Enrolled postpartum WLWH completed an interviewer-administered questionnaire at enrolment. Among 320 enrolled women, mean age, CD4 count, and duration on ART was 28.9 (standard deviation [SD] 5.8) years, 395 cells/mm3 (SD = 62) and 4.6 years (SD = 3.9), respectively. One-hundred and eighty nine (59%) of women reported either personal (175, 55%) or partner (186, 58%) desire for more children in the next 2 years. Intentions to have more children was strongly associated with partner’s desire for more children (AOR = 31.36; P < 0.000), referent pregnancy planned (AOR = 2.69; P = 0.050) and higher household income > 150,000 Shs per month (AOR = 1.37; P = 0.010). Previous use of modern contraception (AOR = 0.07; P = 0.001), increasing age (AOR = 0.34; P = 0.012), having > 2 own children living in a household (AOR = 0.42; P = 0.021) and parity > 2 (AOR = 0.59; P = 0.015) were associated with reduced odds of pregnancy intention. Our findings highlight the role male partners play in influencing pregnancy intentions postpartum and the importance of engaging men in sexual and reproductive health counselling about child spacing for the health of women, children, and families. This should be addressed alongside key individual-level social, demographic, economic and structural factors within which couples can understand risks of unplanned pregnancies and access effective contraceptive methods when they need or want them.
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影响因子：
3.3
作者：
Ahluwalia, Indu B.;Helms, Kristen;Morrow, Brian
通讯作者：
Morrow, Brian
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：
Kaida A;Matthews LT;Kanters S;Kabakyenga J;Muzoora C;Mocello AR;Martin JN;Hunt P;Haberer J;Hogg RS;Bangsberg DR
通讯作者：
Bangsberg DR
影响因子：
15.8
作者：
Myer L;Carter RJ;Katyal M;Toro P;El-Sadr WM;Abrams EJ
通讯作者：
Abrams EJ
影响因子：
4.4
作者：
Guthrie, Brandon L.;Choi, Robert Y.;Farquhar, Carey
通讯作者：
Farquhar, Carey