"I am scared, I do not want to lie": exploring the impacts of COVID-19 on engagement in care, perceived health, relationship dynamics, and parenting among postpartum women with HIV in South Africa.
"I am scared, I do not want to lie": exploring the impacts of COVID-19 on engagement in care, perceived health, relationship dynamics, and parenting among postpartum women with HIV in South Africa.
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DOI：
10.1186/s12884-023-05520-w
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发表时间：
2023-04-03
影响因子：
3.1
通讯作者：
中科院分区：
文献类型：
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新冠肺炎和管理广泛感染的努力可能会影响艾滋病毒护理的参与。尚未在产后感染艾滋病毒的妇女中评估与减少艾滋病毒接触有关的与新冠肺炎有关的因素，这些妇女在非大流行情况下面临更高的自然减员风险。为了减轻疫情对护理投入的影响并为未来的公共卫生危机做好准备，了解新冠肺炎是如何影响(1)护理投入和(2)可能成为护理投入障碍的因素是至关重要的。对新冠肺炎相关经历的定量评估被添加到一项纵向队列研究中，该研究评估了南非妇女因艾滋病毒护理而产生的产后自然减退的预测因素。参与者(N = 266)在2020年6月至11月期间于产后6个月、12个月、18个月或24个月完成了评估。那些支持与护理投入有关的一个或多个挑战(预约或保持艾滋病毒护理预约、采购艾滋病毒药物、获得避孕药具和/或获得婴儿免疫接种服务；n = 55)的人被邀请完成一次简短的定性访谈，探讨推动这些挑战的具体因素，以及新冠肺炎对护理投入的其他影响。在这个子集中，53名参与者完成了一次访谈；定性数据通过快速分析进行了分析。参与者描述了减少他们参与艾滋病毒护理的关键挑战，并确定了其他四个与新冠肺炎相关的影响领域：身体健康、精神健康、与伴侣或婴儿父亲的关系以及母亲/照顾新生儿。在这些领域内，出现了具体的主题和次主题，还报告了新冠肺炎的一些积极影响(例如，增加优质时间、改善与合作伙伴的沟通、披露艾滋病毒)。对新冠肺炎相关挑战的应对策略(如接受、灵性、分心)也进行了讨论。大约五分之一的参与者报告说，他们在获得艾滋病毒护理、药物或服务方面遇到了挑战，他们在保持参与方面面临着复杂的、多层次的障碍。身体健康、精神健康、与伴侣的关系以及照顾婴儿的能力也受到了影响。鉴于大流行的动态性质和对其进程的普遍不确定性，需要对产后妇女中与大流行有关的挑战进行持续评估，以避免艾滋病毒护理中断和支持福祉。
COVID-19 and efforts to manage widespread infection may compromise HIV care engagement. The COVID-19-related factors linked to reduced HIV engagement have not been assessed among postpartum women with HIV, who are at heightened risk of attrition under non-pandemic circumstances. To mitigate the effects of the pandemic on care engagement and to prepare for future public health crises, it is critical to understand how COVID-19 has impacted (1) engagement in care and (2) factors that may act as barriers to care engagement. A quantitative assessment of COVID-19-related experiences was added to a longitudinal cohort study assessing predictors of postpartum attrition from HIV care among women in South Africa. Participants (N = 266) completed the assessment at 6, 12, 18, or 24 months postpartum between June and November of 2020. Those who endorsed one or more challenge related to engagement in care (making or keeping HIV care appointments, procuring HIV medications, procuring contraception, and/or accessing immunization services for infants; n = 55) were invited to complete a brief qualitative interview, which explored the specific factors driving these challenges, as well as other impacts of COVID-19 on care engagement. Within this subset, 53 participants completed an interview; qualitative data were analyzed via rapid analysis. Participants described key challenges that reduced their engagement in HIV care and identified four other domains of COVID-19-related impacts: physical health, mental health, relationship with a partner or with the father of the baby, and motherhood/caring for the new baby. Within these domains, specific themes and subthemes emerged, with some positive impacts of COVID-19 also reported (e.g., increased quality time, improved communication with partner, HIV disclosure). Coping strategies for COVID-19-related challenges (e.g., acceptance, spirituality, distraction) were also discussed. About one in five participants reported challenges accessing HIV care, medications, or services, and they faced complex, multilayered barriers to remaining engaged. Physical health, mental health, relationships with partners, and ability to care for their infant were also affected. Given the dynamic nature of the pandemic and general uncertainty about its course, ongoing assessment of pandemic-related challenges among postpartum women is needed to avoid HIV care disruptions and to support wellbeing.
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DOI：
10.1016/j.jana.2013.03.004
发表时间：
2013-07-01
影响因子：
2
作者：
Aaron, Erika;Criniti, Shannon;Geller, Pamela A.
通讯作者：
Geller, Pamela A.
DOI：
10.1016/s2352-3018(20)30359-3
发表时间：
2021-03
期刊：
The lancet. HIV
影响因子：
--
作者：
Dorward J;Khubone T;Gate K;Ngobese H;Sookrajh Y;Mkhize S;Jeewa A;Bottomley C;Lewis L;Baisley K;Butler CC;Gxagxisa N;Garrett N
通讯作者：
Garrett N
影响因子：
2.2
作者：
Fox, Ashley M.;Jackson, Sharon S.;Sikkema, Kathleen J.
通讯作者：
Sikkema, Kathleen J.
影响因子：
4.6
作者：
Blashill, Aaron J;Perry, Nicholas;Safren, Steven A
通讯作者：
Safren, Steven A
影响因子：
7.2
作者：
Tsai AC;Tomlinson M
通讯作者：
Tomlinson M