Maternal Health Care Utilization Among HIV-Positive Female Adolescents in Kenya
Maternal Health Care Utilization Among HIV-Positive Female Adolescents in Kenya
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DOI：
10.1363/3714311
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发表时间：
2011-09-01
影响因子：
4.4
通讯作者：
Namwebya, Jane Harriet
中科院分区：
文献类型：
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作者：
Birungi, Harriet;Obare, Francis;Namwebya, Jane Harriet
背景：鉴于艾滋病毒/艾滋病的健康风险和总体上少女怀孕的风险，肯尼亚怀孕的艾滋病毒阳性青少年需要产妇保健服务，以说明他们的艾滋病毒状况。方法：对肯尼亚393名15-19岁HIV阳性少女的孕产史资料进行统计分析，以了解孕产妇保健服务的利用情况。多水平Logit模型被用来识别与使用产前护理、预防艾滋病毒母婴传播(PMTCT)、熟练护理妊娠结局和产后/流产后护理相关的变量。结果：在HIV阳性的青少年中，使用PMTCT服务的比例低于使用产前护理的比例(67%对84%)。这些青少年只在45%的怀孕期间进行了四次或更多的产前检查。此外，在流产或流产期间或之后使用熟练护理的比例很低(20%)。内罗毕获得预防母婴传播服务和技术援助(对于任何妊娠结局)的几率高于其他区域(优势比分别为3.8和2.7)。艾滋病毒阳性的青少年在高位妊娠时使用孕产妇保健的可能性低于低位妊娠(0.4-0.6)。然而，当她们的丈夫而不是其他人对怀孕负有责任时，她们更有可能接受产前护理和母婴传播服务(分别为3.7和4.9)。结论：怀孕的HIV阳性青少年需要考虑到产次、父权动态和使用的地区差异的孕产妇保健服务，包括母婴传播保健。性与生殖健康的国际视角，2011年，37(3)：143149，DOI：10.1363/3714311
CONTEXT: Given the health risks of HIV/AIDS and the risks of teenage pregnancy in general, pregnant HIV-positive adolescents in Kenya need maternal health care services that account for their HIV status. However, research on their access to and use of these services is scant.METHODS: To examine maternal health care utilization,pregnancy history data collected in 2009 on 506 pregnancies among 393 HIV-positive female adolescents aged 15-19 enrolled in HIV/AIDS programs in Kenya were analyzed. Multilevel logit models were used to identify the variables associated with use of prenatal care, prevention of mother-to-child transmission (PMTCT) of HIV, skilled attendance at pregnancy outcomes and postnatal/postabortion care.RESULTS: Use of PMTCT services was less common than use of prenatal care among HIV-positive adolescents (67% of pregnancies vs. 84%). These adolescents made four or more prenatal care visits in only 45% of pregnancies. In addition, use of skilled care during or after abortion or miscarriage was low (20%). The odds of receiving PMTCT services and skilled assistance (for any pregnancy outcome) were higher in Nairobi than in other regions (odds ratios, 3.8 and 2.7, respectively). HIV-positive adolescents were less likely to use maternal health care for higher-order pregnancies than for lower-order pregnancies (0.4-0.6). They were, however, more likely to receive prenatal care and PMTCT services when their husband rather than someone else was responsible for the pregnancy (3.7 and 4.9, respectively).CONCLUSION: Pregnant, HIV-positive adolescents need maternal health care services-including PMTCT care-that take into account parity, paternity dynamics and regional variations in use. International Perspectives on Sexual and Reproductive Health, 2011, 37(3):143-149,doi:10.1363/3714311