A qualitative study on factors impacting HIV care adherence among postpartum HIV-infected women in the rural southeastern USA
A qualitative study on factors impacting HIV care adherence among postpartum HIV-infected women in the rural southeastern USA
复制标题
DOI：
10.1080/09540121.2013.844759
复制
发表时间：
2014-05-04
影响因子：
1.7
通讯作者：
Kempf, Mirjam-Colette
中科院分区：
文献类型：
--
作者：
Boehme, Amelia K.;Davies, Susan L.;Kempf, Mirjam-Colette
艾滋病毒感染妇女从怀孕到产后期间艾滋病毒护理和治疗依从性的下降对艾滋病毒感染妇女的临床结果和整体福祉具有重大影响，特别是由于产后免疫抑制。虽然与停止艾滋病毒护理相关的总体死亡风险增加是众所周知的，但艾滋病毒感染的产后妇女不坚持艾滋病毒护理的原因在很大程度上是未知的。从阿拉巴马州的四个诊所招募了18名感染艾滋病毒的妇女参加焦点小组或个人访谈，以讨论影响产后艾滋病毒护理坚持的障碍和促进者。会议被录音、转录和编码；内容分析被用来分析逐字记录。使用混合方法分析程序对来自三个来源的数据进行三角划分(焦点小组成绩单、根据名义小组技术对障碍和促进者的个人排名、以及社会人口统计学和依从性数据的个人问卷)。大多数参与者是非洲裔美国人(83.3%)，单身(66.7%)，超过一半的参与者每月生活费不到1000美元(55.6%)。保留艾滋病毒护理的障碍包括获得和支付交通费用，以及将艾滋病毒护理纳入工作和育儿时间表。坚持艾滋病毒护理的促进者包括希望为了自己的福祉以及为了照顾孩子而保持健康，接受家庭支持，以及预约提醒。目前的研究强调了导致感染艾滋病毒的产后妇女对艾滋病毒护理依从性较差的背景因素。干预研究需要认识到感染艾滋病毒的产后妇女的具体需求，以改善这些有孩子的人群的长期临床结果。
Declines in HIV care and treatment adherence among HIV-infected women from pregnancy to the postpartum period have significant implications for the clinical outcomes and overall well-being of HIV-infected women, especially due to immunosuppression during the postpartum period. While the overall increased risk for mortality associated with HIV care discontinuation is well established, the reasons for HIV care nonadherence among HIV-infected postpartum women are largely unknown. Eighteen HIV-infected women were recruited from four clinics in Alabama to participate in focus groups or individual interviews to discuss barriers and facilitators impacting postpartum HIV care adherence. Sessions were audio-recorded, transcribed, and coded; content analysis was used to analyze the verbatim transcripts. Mixed methods analysis procedures were used to triangulate data from three sources (focus group transcripts, individual rankings of barriers and facilitators according to the Nominal Group Technique, and individual questionnaires of sociodemographic and adherence data). The majority of participants were African-American (83.3%), single (66.7%), with more than half of the participants living on less than $1000 a month (55.6%). Barriers to retention in HIV care included access to and cost of transportation and fitting HIV care into work and childcare schedules. Facilitators to HIV care adherence included wanting to stay healthy for their own well-being as well as for the care of their children, receiving family support, and appointment reminders. The current study highlights contextual factors contributing to poor HIV care adherence among HIV-infected postpartum women. Intervention studies need to be cognizant of the specific needs of HIV-infected postpartum women to improve long-term clinical outcomes among this population, who have children.