Preferences for enhanced treatment options to address HIV care engagement among women living with HIV and perinatal depression in Malawi.
Preferences for enhanced treatment options to address HIV care engagement among women living with HIV and perinatal depression in Malawi.
复制标题
DOI：
10.1186/s12889-023-16835-w
复制
发表时间：
2023-10-04
影响因子：
4.5
通讯作者：
中科院分区：
文献类型：
--
作者：
选项B + 为怀孕或哺乳母亲提供终身抗逆转录病毒治疗，但产后失去艾滋病毒护理（部分由围产期抑郁症（PND）驱动）威胁到了这一政策的影响。本研究旨在了解妇女和医疗服务提供者对制定可行的干预措施来解决 PND 的偏好，并支持感染 PND 和 HIV 的妇女参与 HIV 护理。从 2018 年 12 月到 2019 年 2 月，我们总共进行了 6 次焦点小组讨论 (FGD)，涉及利隆圭区的 4 家诊所。我们在 3 个利益相关者群体中各进行了 2 次 FGD：临床工作人员、产前妇女和产后妇女。围产期参与者感染了 HIV，并使用经过验证的爱丁堡产后抑郁量表 (EPDS) 对 PND 进行了阳性筛查。临床工作人员是接受过抗逆转录病毒治疗（ART）培训的护士。采访者使用半结构化指南在奇切瓦领导 FGD。在 NVivo 12 软件中使用演绎和归纳编码来分析数据。女性青睐 ART 链接服务，但服务提供者表示他们已经提供此类服务，但结果好坏参半。个人咨询受到普遍支持。团体咨询的一个明显好处是同伴支持，但女性对保密和耻辱感到担忧。女性喜欢手机预约提醒，但认为手机拥有率低是一个障碍。参与者建议家访作为额外的护理参与策略。妇女们一致讨论需要家庭成员和朋友提供社会支持，以解决 PND 问题并支持参与艾滋病毒护理。这项研究强调了同伴鼓励对于支持感染艾滋病毒和产后抑郁症的妇女参与围产期艾滋病毒护理的重要性。这项研究的结果可用于支持干预措施的制定，以增加艾滋病毒护理参与度并改善患有 PND 的女性的长期艾滋病毒结局。
Option B + offers lifelong ART to pregnant or breastfeeding mothers, but postpartum loss to HIV care, partially driven by perinatal depression (PND), threatens the impact of this policy. This study aims to understand women’s and providers’ preferences for developing a feasible intervention to address PND and support engagement in HIV care among women living with PND and HIV. We conducted a total of 6 focus group discussions (FGDs) involving 4 clinics in Lilongwe District from December 2018 through February 2019. We conducted 2 FGDs each among 3 stakeholder groups: clinical staff, prenatal women, and postnatal women. Perinatal participants were living with HIV and screened positively for PND using the validated Edinburgh Postnatal Depression Scale (EPDS). Clinical staff were nurses who were trained antiretroviral therapy (ART) providers. Interviewers led FGDs in Chichewa using a semi-structured guide. Data were analyzed using deductive and inductive coding in NVivo 12 software. Women favored ART linkage services, but providers said they already offered such services, with mixed results. Individual counselling was universally supported. A perceived benefit of group counselling was peer support, but there were concerns among women regarding confidentiality and stigma. Women liked mobile appointment reminders but identified low phone ownership as a barrier. Participants recommended home visits as an additional care engagement strategy. Women consistently discussed the need for social support from family members and friends to address PND and support engagement in HIV care. This study highlights the importance of peer encouragement to support perinatal HIV care engagement among women with HIV and PND. The results from this study can be used to support intervention development to increase HIV care engagement and improve long-term HIV outcomes in women with PND.
登录
查看更多内容
影响因子：
4.5
作者：
Callaghan M;Ford N;Schneider H
通讯作者：
Schneider H
影响因子：
15.8
作者：
Mills EJ;Nachega JB;Bangsberg DR;Singh S;Rachlis B;Wu P;Wilson K;Buchan I;Gill CJ;Cooper C
通讯作者：
Cooper C
影响因子：
2.8
作者：
Atuyambe LM;Ssegujja E;Ssali S;Tumwine C;Nekesa N;Nannungi A;Ryan G;Wagner G
通讯作者：
Wagner G
DOI：
10.1056/nejmoa1600693
发表时间：
2016-09-01
期刊：
The New England journal of medicine
影响因子：
--
作者：
Cohen MS;Chen YQ;McCauley M;Gamble T;Hosseinipour MC;Kumarasamy N;Hakim JG;Kumwenda J;Grinsztejn B;Pilotto JH;Godbole SV;Chariyalertsak S;Santos BR;Mayer KH;Hoffman IF;Eshleman SH;Piwowar-Manning E;Cottle L;Zhang XC;Makhema J;Mills LA;Panchia R;Faesen S;Eron J;Gallant J;Havlir D;Swindells S;Elharrar V;Burns D;Taha TE;Nielsen-Saines K;Celentano DD;Essex M;Hudelson SE;Redd AD;Fleming TR;HPTN 052 Study Team
通讯作者：
HPTN 052 Study Team
影响因子：
6
作者：
Orza, Luisa;Bewley, Susan;Welbourn, Alice
通讯作者：
Welbourn, Alice