Antiretroviral medications during pregnancy for therapy or prophylaxis

Stek, Alice

doi:10.1007/s11904-009-0011-2

Cited by 11 publications

(5 citation statements)

References 50 publications

(30 reference statements)

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“…45 Additionally, prophylactic use of antiretroviral therapy during pregnancy and in the newborn has decreased mother-to-child-transmission to less than 1%. 46,47 Although it is possible that participants interpreted this item as referring to pregnant mothers not treated with antiretroviral therapy and ignored the difference between HIV and AIDS, the misconception that mother-to-child-transmission is unavoidable may decrease motivation for prenatal HIV testing among young pregnant African Americans.…”

Section: Discussionmentioning

confidence: 99%

HIV Knowledge and Its Contribution to Sexual Health Behaviors of Low-Income African American Adolescents

Swenson

Rizzo

Brown

et al. 2010

Journal of the National Medical Association

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Objectives Although many factors contribute to racial disparities in HIV/AIDS among young African Americans, knowledge is a particularly modifiable factor. However, little information has been published about the current HIV knowledge of African American teens or to what extent knowledge independently contributes to their sexual behavior and health. This study aimed to describe the level of knowledge among this at-risk population and determine whether knowledge contributes to variance in sexual behavior and health beyond that of sociodemographic and psychological factors. Methods African American adolescents (n = 1,658) were recruited in two northeast and two southeast U.S. cities (74% eligible for free/reduced-price school lunch). Analyses utilized data gathered from adolescents using an audio computer-assisted self-interview (ACASI) program. Results On average, participants answered only 50% of HIV knowledge items correctly and were least accurate concerning effective condom use and HIV testing. Controlling for associated sociodemographic and psychological factors, greater knowledge was associated with sexual experience and, among experienced adolescents, with STI/HIV testing and, unexpectedly, less condom use. Conclusions HIV knowledge, which is modifiable, is limited among at-risk African American adolescents and is an important contributor to sexual behavior and health. Findings indicate a need for more comprehensive HIV/AIDS education, particularly with regard to condom use and the benefits of routine STI/HIV testing. Although knowledge might not be sufficiently protective in and of itself, having accurate information about HIV may benefit sexual health by impacting health-promoting attitudes necessary for successful engagement in healthcare-seeking behavior.

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Section: Discussionmentioning

confidence: 99%

HIV Knowledge and Its Contribution to Sexual Health Behaviors of Low-Income African American Adolescents

Swenson

Rizzo

Brown

et al. 2010

Journal of the National Medical Association

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“…Infectious complications of IDU include but are not limited to HIV, hepatitis B, and hepatitis C 43–45 . While the negative consequences of IDU are not unique to pregnant women, special consideration must be paid to pregnant women with HIV in order to prevent perinatal transmission 46 . This is further complicated for women in rural areas where access to specialized HIV care may be limited 47 .…”

Section: Discussionmentioning

confidence: 99%

Examining Differences in Substance Use among Rural and Urban Pregnant Women

2010

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Substance use during pregnancy is a major public health concern. This study examined differences in substance use among pregnant women from rural and urban areas. Participants were 114 pregnant women entering a hospital-based inpatient detoxification unit primarily for Opiate Dependence who voluntarily agreed to a face-to-face interview. Substance use measures were based on the Addiction Severity Index gathering information about lifetime, past 12 months, and 30 days prior to admission. Rural pregnant women had higher rates of illicit opiate use, illicit sedative/benzodiazepine use, and injection drug use (IDU) in the 30 days prior to admission. Additionally, a greater proportion of rural pregnant women reported the use of multiple illegal/illicit substances in the 30 days prior to entering detoxification. More specifically, pregnant women from rural areas were 8.4 times more likely to report illicit opiate use, 5.9 times more likely to report IDU, 3.3 times more likely to report illicit sedative/benzodiazepine use, and 2.8 times more likely to report the use of multiple illegal/illicit substances in the 30 days prior to entering inpatient detoxification, after adjustment for socio-demographic characteristics (including education and income), pregnancy characteristics, physical and mental health indicators, and criminal justice system involvement. The increased rates of prescription opiate and benzodiazepine use as well as IDU among rural pregnant women are concerning. In order to begin to understand the elevated rates of substance abuse among rural pregnant women, substance use must be considered within the context of demographic, geographic, social, and economic conditions of the region.

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“…Factors specific to pregnancy may include increased medication intolerance (especially gastrointestinal), increased medication side effects (anemia’s or other), or altered pharmacokinetics. 20, 21, 22 Several studies have reported lower area under the plasma concentration time curve (AUC) in the third trimester with both lopinavir/ritonavir 23,24 and nelfinavir, 24 but the association between lower drug levels during pregnancy and virologic outcome at delivery has not been studied. Many experts, however, consider it to be reasonable to increase the dose of certain PI’s during the third trimester when viral load remains unsuppressed in the setting of good medication adherence.…”

Section: Discussionmentioning

confidence: 99%