Mobile health clinics can markedly decrease clients' transportation time and cost to access antiretroviral therapy (ART) and other health services in rural areas, potentially improving use. Close coordination with community leaders and regularly scheduled visits by the mobile clinics are critical.

Adverse infant outcomes often rise in the aftermath of disaster, but few studies have assessed the effects of disaster on maternal health. 1091 southern Louisiana women were interviewed about their pregnancy history, including pregnancy complications. Associations between oil spill exposures and gestational diabetes, hypertensive disorders, and nausea/vomiting were assessed for all reported pregnancies. 631 women had a pregnancy both before and after the oil spill. Generalized estimating equations (logistic regression) with adjustment for confounders were used. To assess possible unmeasured confounding, instead of considering oil spill exposure as a time-varying exposure, women were defined as oil spill-exposed or not. If oil spill-exposed women were equally prone to complications in pregnancies that occurred prior to the oil spill as after it, it was considered that any associations were likely due to selection or reporting issues. Women who reported oil spill exposure, particularly loss of use of the coast, were more likely to report gestational diabetes; however, the level of association was similar for pregnancies before and after the spill (p for interaction >0.10 and odds ratios (ORs) for pregnancies prior to the spill > than those after the spill). No associations were found between oil spill exposure and hypertensive disorders. This analysis does not suggest an increased risk of pregnancy complications associated with exposure to the oil spill; however, future studies should assess exposure and outcomes prospectively and clinically instead of relying on self-report.

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Seafood contains health-promoting fatty acids, but is often contaminated with mercury (Hg), complicating recommendations and choices around fish consumption during pregnancy. Self-reported diet may be subject to inaccuracy and this inaccuracy could differ according to pregnancy status. We investigated correlations between self-reported seafood consumption and blood levels of Hg and n-3 polyunsaturated fatty acids (PUFAs) in women affected by the Deepwater Horizon oil spill. Spearman correlation coefficients were calculated comparing log blood Hg and n-3 PUFAs to seafood consumption, then stratified by pregnancy status. Crude and adjusted linear regression models were constructed using biomarkers of Hg and n-3 PUFA and seafood consumption, adjusting for age and pregnancy status. Weak but significant correlations were found between log Hg levels and intake of Hg-containing seafood (r = 0.15) and were slightly stronger among pregnant women (r = 0.22, vs. r = 0.10). Biomarkers for n-3 PUFAs were significantly correlated with seafood consumption (r = 0.12). Hg-containing seafood consumption was associated with increased blood level Hg in the highest quartile in both unadjusted (β = 0.34, 95% CI: 0.15–0.53) and adjusted models (β = 0.28, 95% CI: 0.08–0.48). Self-reported seafood consumption was correlated with biomarkers of both n-3 PUFA and Hg, but this association was different when stratified by pregnancy status. Pregnant women may have better recall of Hg-containing seafood compared to nonpregnant women.

The oil spill appears to have affected reproductive decision-making. The evidence is not strong that exposure to the oil spill was associated with miscarriage or infertility.