Maternal Motivation to Take Preventive Therapy in Antepartum and Postpartum Among HIV-Positive Pregnant Women in South Africa: A Choice Experiment.
Maternal Motivation to Take Preventive Therapy in Antepartum and Postpartum Among HIV-Positive Pregnant Women in South Africa: A Choice Experiment.
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DOI：
10.1007/s10461-018-2324-x
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发表时间：
2019-07
影响因子：
4.4
通讯作者：
Hanrahan CF
中科院分区：
文献类型：
--
作者：
Kim HY;Dowdy DW;Martinson NA;Kerrigan D;Tudor C;Golub J;Bridges JFP;Hanrahan CF
艾滋病毒阳性孕妇开始终身抗逆转录病毒治疗（ART）和异烟肼预防性治疗（IPT）有较低的坚持率在分娩后。我们量化了新诊断为艾滋病毒感染的孕妇在分娩前后采取预防性治疗的动机。我们在南非Matlosana的14家公共初级卫生诊所招募了最近诊断为HIV（<6个月）的孕妇（≥18岁），并在产后期间对其进行了随访。参与者接受了8项选择任务，比较了通过文献综述和关键线人访谈确定的与预防性治疗相关的7种可能益处的两个互斥子集。在产前与产后期间使用条件logit回归分析数据。报告的系数具有95%置信区间（CI）。65名妇女在入学时和产后期间完成了调查。所有妇女都已接受抗逆转录病毒治疗，而21人（32%）在入学时接受了IPT。平均CD 4计数为436（±246）个细胞/mm 3。在产前阶段，预防艾滋病病毒传播给伴侣是最重要的益处（系数（）=0.87，95% CI：0.64，1.11），其次是保持家庭健康（=0.75，95% CI：0.52，0.97）。这种优先顺序在产后显著降低（p<0.001）。与其他激励因素相比，保持较高的CD 4计数在产前最不受重视（CI =0.19，95% CI：-0.04，0.43），但在产后最受重视（CI =0.39，95% CI：0.21，0.57）。这些结果强调，关于家庭的信息可能在产前时期特别突出，并在产后时期保持CD 4计数高。了解产妇的动机可能有助于在分娩前后向艾滋病毒抗体阳性的妇女提供有针对性的健康促进信息。
HIV-positive pregnant women who are initiated on lifelong antiretroviral therapy (ART) and isoniazid preventive therapy (IPT) have lower adherence rates after delivery. We quantified maternal motivation to take preventive therapy before and after delivery among pregnant women newly diagnosed with HIV. We enrolled pregnant women (≥18 years) with a recent HIV diagnosis (<6 months) at 14 public primary health clinics in Matlosana, South Africa and followed them in the postpartum period. Participants received eight choice tasks comparing two mutually exclusive sub-sets of seven possible benefits related to preventive therapy identified through literature reviews and key informant interviews. Data was analyzed using conditional logit regression in the antepartum vs. postpartum periods. Coefficients are reported with 95% confidence intervals (CI). Sixty-five women completed surveys both at enrollment and in the postpartum period. All women were already on ART, while 21 (32%) were receiving IPT at enrollment. The mean CD4 count was 436 (±246) cells/mm3. In the antepartum period, preventing HIV transmission to partners was the most important benefit (coefficients (ß)=0.87, 95% CI: 0.64, 1.11), followed by keeping healthy for family (ß =0.75, 95% CI: 0.52, 0.97). Such prioritization significantly decreased in the postpartum period (p<0.001). Compared to other motivators, keeping a high CD4 count was least prioritized in the antepartum period (ß =0.19, 95% CI: −0.04, 0.43) but was most prioritized in the postpartum period (ß =0.39, 95% CI 0.21, 0.57). These results highlight that messages on family might be particularly salient in the antepartum period, and keeping CD4 count high in the postpartum period. Understanding maternal motivation may help to design targeted health promotion messages to HIV-positive women around the time of delivery.
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DOI：
10.1111/tmi.12072
发表时间：
2013-04
期刊：
Tropical medicine & international health : TM & IH
影响因子：
--
作者：
Clouse K;Pettifor A;Shearer K;Maskew M;Bassett J;Larson B;Van Rie A;Sanne I;Fox MP
通讯作者：
Fox MP
影响因子：
4.5
作者：
Johnson, F. Reed;Lancsar, Emily;Bridges, John F. P.
通讯作者：
Bridges, John F. P.
影响因子：
3.7
作者：
Finitsis DJ;Pellowski JA;Johnson BT
通讯作者：
Johnson BT
DOI：
10.1097/qai.0b013e31821ac9c1
发表时间：
2011-08-01
影响因子：
3.6
作者：
Gounder, Celine R.;Wada, Nikolas I.;Martinson, Neil A.
通讯作者：
Martinson, Neil A.
影响因子：
2.8
作者：
Kerrigan, Deanna;Tudor, Carrie;Golub, Jonathan E.
通讯作者：
Golub, Jonathan E.