Previous reproductive history and post-natal family planning among HIV-infected women in Ukraine.
Previous reproductive history and post-natal family planning among HIV-infected women in Ukraine.
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DOI：
10.1093/humrep/deq093
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发表时间：
2010-09
期刊：
影响因子：
--
通讯作者：
Thorne C
中科院分区：
文献类型：
--
作者：
Saxton J;Malyuta R;Semenenko I;Pilipenko T;Tereshenko R;Kulakovskaya E;Adejnova I;Kvasha L;Thorne C
乌克兰是欧洲产前艾滋病毒感染率最高的国家。国家预防母婴传播（MTCT）方案降低了母婴传播率，但对预防艾滋病毒阳性妇女意外怀孕的关注较少。我们的目标是描述艾滋病毒呈阳性的乌克兰育龄妇女的生殖健康、安全套使用和计划生育 (FP) 做法，并确定与不同产后避孕方法相关的因素。自 2007 年 12 月起，在怀孕前或怀孕期间被诊断出感染艾滋病毒的育龄妇女前瞻性地参加了乌克兰四个地区艾滋病毒/艾滋病中心的一项产后队列研究。逻辑回归模型用于确定与产后计划生育实践相关的因素。截至 2009 年 3 月，已有 371 名女性登记的数据可用； 82% (n = 303) 已婚或同居，27%（363 人中的 97 人）报告其当前的 HIV 阴性性伴侣，69% 在最近怀孕期间被诊断出感染 HIV。总体而言，21%（349 名中的 75 名）女性在产后没有使用避孕措施（其中 80% 的女性报告目前没有性活动），50%（349 名中的 174 名）使用避孕套，20%（349 名中的 74 名）完全/部分依赖体外射精，4% 使用激素方法或宫内节育器。在已婚/同居女性中，上一次怀孕时持续使用安全套[AOR 1.96 (95%CI 1.06–3.62)]、有艾滋病毒阳性伴侣[AOR 0.42 (0.20–0.87)]、当前性活动[AOR 4.53 (1.19–17.3)]和研究地点与产后安全套使用显着相关； 16% 的艾滋病毒阴性伴侣没有使用安全套。不使用 FP 的危险因素是缺乏负担能力 [AOR 6.34 (1.73–23.2)] 和在前一次怀孕期间不一致使用安全套 [AOR 7.25 (1.41–37.2)]。该人群中超过 40% 的艾滋病毒呈阳性女性面临意外怀孕的风险，而艾滋病毒不一致的夫妇中，六分之一的女性如果不使用屏障方法，就有可能将艾滋病毒传播给其伴侣。我们的研究结果受到数据的观察性质以及测量和未测量混杂的可能性的限制。
Ukraine has the highest antenatal HIV prevalence in Europe. The national prevention of mother-to-child transmission (MTCT) programme has reduced the MTCT rate, but less attention has been given to the prevention of unintended pregnancy among HIV-positive women. Our objectives were to describe the reproductive health, condom use and family planning (FP) practices of HIV-positive childbearing Ukrainian women and to identify factors associated with different methods of post-natal contraception. HIV-infected childbearing women, diagnosed before or during pregnancy, were enrolled prospectively in a post-natal cohort study in four regional HIV/AIDS centres in Ukraine from December 2007. Logistic regression models were used to identify factors associated with post-natal FP practices. Data were available for 371 women enrolled by March 2009; 82% (n = 303) were married or cohabiting, 27% (97 of 363) reported a current HIV-negative sexual partner and 69% were diagnosed with HIV during their most recent pregnancy. Overall, 21% (75 of 349) of women were not using contraception post-natally (of whom 80% reported no current sexual activity), 50% (174 of 349) used condoms, 20% (74 of 349) relied solely/partially on coitus interruptus and 4% used hormonal methods or intrauterine device. Among married/cohabiting women, consistent use of condoms in the previous pregnancy [AOR 1.96 (95%CI 1.06–3.62)], having an HIV-positive partner [AOR 0.42 (0.20–0.87)], current sexual activity [AOR 4.53 (1.19–17.3)] and study site were significantly associated with post-natal condom use; 16% of those with HIV-negative partners did not use condoms. Risk factors for non-use of FP were lack of affordability [AOR 6.34 (1.73–23.2)] and inconsistent use of condoms in the previous pregnancy [AOR 7.25 (1.41–37.2)]. More than 40% of HIV-positive women in this population are at risk of unintended pregnancy and the one in six women in HIV-discordant couples not using barrier methods risk transmitting HIV to their partners. Our study results are limited by the observational nature of the data and the potential for both measured and unmeasured confounding.
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影响因子：
3.7
作者：
Campbell MS;Gottlieb GS;Hawes SE;Nickle DC;Wong KG;Deng W;Lampinen TM;Kiviat NB;Mullins JI
通讯作者：
Mullins JI
DOI：
10.1097/01.aids.0000363779.65827.e0
发表时间：
2009-11
期刊：
AIDS (London, England)
影响因子：
--
作者：
Stringer EM;Giganti M;Carter RJ;El-Sadr W;Abrams EJ;Stringer JS;MTCT-Plus Initiative
通讯作者：
MTCT-Plus Initiative
影响因子：
56.3
作者：
Boily, Marie-Claude;Baggaley, Rebecca F.;Wang, Lei;Masse, Benoit;White, Richard G.;Hayes, Richard J.;Alary, Michel
通讯作者：
Alary, Michel
影响因子：
3.8
作者：
Mwapasa, Victor;Rogerson, Stephen J.;Meshnick, Steven R.
通讯作者：
Meshnick, Steven R.
影响因子：
2.5
作者：
Radestad, Ingela;Olsson, Ann;Rubertsson, Christine
通讯作者：
Rubertsson, Christine