A Systematic Review of the Current Status of Safer Conception Strategies for HIV Affected Heterosexual Couples in Sub-Saharan Africa.
A Systematic Review of the Current Status of Safer Conception Strategies for HIV Affected Heterosexual Couples in Sub-Saharan Africa.
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DOI：
10.1007/s10461-018-2170-x
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发表时间：
2018-09
影响因子：
4.4
通讯作者：
Wall KM
中科院分区：
文献类型：
--
作者：
Joseph Davey D;West S;Umutoni V;Taleghani S;Klausner H;Farley E;Shah R;Madni S;Orewa S;Kottamasu V;Rice V;Robbin Z;Wall KM
我们对撒哈拉以南非洲受艾滋病毒感染的夫妇的安全受孕策略(SCS)进行了系统的审查，以提供基于证据的更安全受孕干预措施。根据PRISMA指南，我们使用以下纳入标准搜索了15个电子数据库：在艾滋病毒感染夫妇中的SCS研究；2007年后发表；在撒哈拉以南非洲；初步研究；同行评审；并涉及感兴趣的主要主题(SCS的可用性、可行性和可接受性，和/或教育和促进)。研究人员使用标准化工具独立审查了每项研究的合格性。我们根据研究的主题领域对研究进行分类。我们确定了符合纳入标准的41项研究(26项定性研究和15项定量研究)。综述的SCS包括：抗逆转录病毒治疗(ART)、暴露前预防、定时无保护性行为、人工/自授精、精子洗涤和自愿男性医学包皮环切术(VMMC)。除了ART和VMMC的普遍可获得性(即，不是专门为了更安全的概念)，在研究环境之外，SCS基本上是不可用的。SCS的可接受性受到以下因素的影响：客户和提供者对更安全的受孕服务的了解较低，对受艾滋病毒影响的夫妇想要孩子的耻辱，以及受艾滋病毒影响的夫妇难以披露艾滋病毒。夫妇们表示希望更多地了解SCS；然而，提供者培训、患者教育、SCS宣传以及生殖健康和艾滋病毒服务的整合仍然有限。对提供者培训和基于夫妇的教育的研究表明，围绕生育意向和SCS知识的沟通有所改善。受艾滋病毒感染的非洲夫妇还没有广泛获得SCS。SCS的成功实施要求提供者接受关于有效SCS的培训，并提供以夫妇为基础的更安全的受孕咨询，以改善关于生育意向和生殖健康的披露和沟通。
We conducted a systematic review of safer conception strategies (SCS) for HIV-affected couples in sub-Saharan Africa to inform evidence-based safer conception interventions. Following PRISMA guidelines, we searched fifteen electronic data-bases using the following inclusion criteria: SCS research in HIV-affected couples; published after 2007; in sub-Saharan Africa; primary research; peer-reviewed; and addressed a primary topic of interest (SCS availability, feasibility, and acceptability, and/or education and promotion). Researchers independently reviewed each study for eligibility using a standardized tool. We categorize studies by their topic area. We identified 41 studies (26 qualitative and 15 quantitative) that met inclusion criteria. Reviewed SCSs included: antiretroviral therapy (ART), pre-exposure prophylaxis, timed unprotected intercourse, manual/self-insemination, sperm washing, and voluntary male medical circumcision (VMMC). SCS were largely unavailable outside of research settings, except for general availability (i.e., not specifically for safer conception) of ART and VMMC. SCS acceptability was impacted by low client and provider knowledge about safer conception services, stigma around HIV-affected couples wanting children, and difficulty with HIV disclosure in HIV-affected couples. Couples expressed desire to learn more about SCS; however, provider training, patient education, SCS promotions, and integration of reproductive health and HIV services remain limited. Studies of provider training and couple-based education showed improvements in communication around fertility intentions and SCS knowledge. SCS are not yet widely available to HIV-affected African couples. Successful implementation of SCS requires that providers receive training on effective SCS and provide couple-based safer conception counseling to improve disclosure and communication around fertility intentions and reproductive health.
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DOI：
10.1097/qad.0000000000001555
发表时间：
2017-08-24
期刊：
AIDS (London, England)
影响因子：
--
作者：
Dalal S;Johnson C;Fonner V;Kennedy CE;Siegfried N;Figueroa C;Baggaley R
通讯作者：
Baggaley R
影响因子：
6
作者：
Crankshaw, Tamaryn L.;Mindry, Deborah;Maharaj, Pranitha
通讯作者：
Maharaj, Pranitha
影响因子：
6
作者：
Asiimwe, Stephen;Ross, Jennifer M.;Barnabas, Ruanne V.
通讯作者：
Barnabas, Ruanne V.
提供者对马拉维的两个艾滋病毒诊所的生育和了解更安全的概念的态度。
影响因子：
3.4
作者：
Kawale P;Mindry D;Phoya A;Jansen P;Hoffman RM
通讯作者：
Hoffman RM
影响因子：
3.7
作者：
Kaida A;Matthews LT;Kanters S;Kabakyenga J;Muzoora C;Mocello AR;Martin JN;Hunt P;Haberer J;Hogg RS;Bangsberg DR
通讯作者：
Bangsberg DR