Do HIV-Infected Women Want to Discuss Reproductive Plans with Providers, and Are Those Conversations Occurring?
Do HIV-Infected Women Want to Discuss Reproductive Plans with Providers, and Are Those Conversations Occurring?
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DOI：
10.1089/apc.2009.0293
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发表时间：
2010-05-01
影响因子：
4.9
通讯作者：
Anderson, Jean R.
中科院分区：
文献类型：
--
作者：
Finocchario-Kessler, Sarah;Dariotis, Jacinda K.;Anderson, Jean R.
这项研究的目的是评估艾滋病毒感染的妇女和艾滋病毒提供者之间关于生育计划的讨论的频率和决定因素，并确定未满足的生殖咨询需求。我们进行了一个横截面，音频计算机辅助自我采访（ACASI）181主要是非洲裔美国人艾滋病毒感染的育龄妇女接受艾滋病毒的临床护理在两个城市的卫生诊所。我们使用描述性统计来确定未满足的生殖咨询需求，通过确定希望但尚未与主要艾滋病毒护理提供者讨论未来生殖计划的妇女比例。多变量分析确定哪些因素与关于怀孕的一般和个性化讨论相关。在接受采访的181名妇女中，67%的人报告了关于怀孕和艾滋病毒的一般性讨论，而31%的人报告了关于未来生育计划的个性化讨论。在个性化讨论中，64%是患者发起的。未得到满足的生殖咨询需求更高的个性化讨论未来怀孕（56%）比一般讨论艾滋病毒和怀孕（23%）。年龄较小是提供者沟通怀孕的最有力的决定因素。很大一部分感染艾滋病毒的妇女希望与其艾滋病毒提供者讨论生殖计划;然而，许多人没有这样做。艾滋病毒护理提供者和妇科医生可以通过与所有育龄妇女讨论生殖计划来解决这一未满足的沟通需求，以便在适当的时候提供孕前咨询。如果提供者只与年轻患者讨论生殖计划，他们将错过帮助妇女安全计划怀孕的机会。
The purpose of the study is to assess frequency and determinants of discussions between HIV-infected women and their HIV providers about childbearing plans, and to identify unmet need for reproductive counseling. We conducted a cross-sectional, audio computer-assisted self-interview (ACASI) among 181 predominately African American HIV-infected women of reproductive age receiving HIV clinical care in two urban health clinics. We used descriptive statistics to identify unmet need for reproductive counseling by determining the proportion of women who want to, but have not, discussed future reproductive plans with their primary HIV care provider. Multivariate analysis determined which factors were associated with general and personalized discussions about pregnancy. Of the 181 women interviewed, 67% reported a general discussion about pregnancy and HIV while 31% reported a personalized discussion about future childbearing plans with their provider. Of the personalized discussions, 64% were patient initiated. Unmet reproductive counseling needs were higher for personalized discussions about future pregnancies (56%) than general discussions about HIV and pregnancy (23%). Younger age was the most powerful determinant of provider communication about pregnancy. A significant proportion of HIV-infected women want to talk about reproductive plans with their HIV provider; however, many have not. HIV care providers and gynecologists can address this unmet communication need by discussing reproductive plans with all women of childbearing age so that preconception counseling can be provided when appropriate. Providers will miss opportunities to help women safely plan pregnancy if they only discuss reproductive plans with younger patients.