Factors Associated with Postpartum Loss to Follow-Up and Detectable Viremia After Delivery Among Pregnant Women Living with HIV

Adhikari, Emily H.; Yule, Casey S.; Roberts, Scott W.; Rogers, Vanessa; Sheffield, Jeanne S.; Kelly, Mary Ann; McIntire, Donald D.; Barnes, Allan J.

doi:10.1089/apc.2018.0117

Cited by 8 publications

(9 citation statements)

References 23 publications

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“…Notably, engagement at 3 months post-partum was a significant predictor of treatment engagement at 12 months. Many studies focused on US sample of post-partum women have recorded similar results (Adhikari et al, 2019;Meade et al, 2018Meade et al, , 2019. Our finding further contributes to evidence that the 3 months post-partum mark is a critical time point in which a significant number of WLWH are likely to disengage from treatment (Buchberg et al, 2015;Meade et al, 2018Meade et al, , 2019.…”

Section: Discussionsupporting

confidence: 79%

“…Also, for the PCE final model, we included PPE as an independent variable to examine for any relationship between engagement at 3 months and at 12 months. This decision was supported by literature findings that have noted such associations (Adhikari et al, 2019;Meade et al, 2018Meade et al, , 2019. The final model for PCE (Table 7) was significant at p < .001.…”

Section: Re Sultssupporting

confidence: 78%

“…to longer term treatment engagement and viral suppression for postpartum WLWH (Adhikari et al, 2019;Meade et al, 2019). Therefore, immediate post-partum healthcare providers may proactively act to identify women likely to be lost at 3 months and intervene accordingly to retain them in care for longer periods.…”

Section: Discussionmentioning

confidence: 99%

“…Thus, studies in the United States have documented suboptimal post-partum HIV treatment engagement rates ranging from 37% to 65% (Adhikari et al, 2019;Meade et al, 2018;Siddiqui et al, 2014).…”

Section: Introductionmentioning

confidence: 99%

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Predictors and social determinants of HIV treatment engagement among post‐partum Black women living with HIV in southeastern United States

Ojukwu

Cianelli

Rodriguez

et al. 2023

Journal of Advanced Nursing

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AimGuided by Mcleroy's socio‐ecological model, this study explored the predictors and social determinants of HIV treatment engagement among Black post‐partum women living with HIV.MethodQuantitative, research methodology.DesignWe conducted a retrospective, secondary data analysis of 143 Black post‐partum women living with HIV who received peripartum care in South‐Florida, United States, from 2009 to 2017. We examined odds of immediate post‐partum engagement at 3 months post‐partum, and ongoing primary care engagement at 12 months post‐partum.ResultsThe independent group analyses showed low levels of immediate post‐partum (32.9%) and ongoing primary care engagement (24.5%). At the intrapersonal level, maternal prenatal health significantly affected both immediate post‐partum and ongoing primary care engagement; and at the interpersonal level, HIV disclosure and intimate partner violence/abuse significantly affected immediate post‐partum engagement. Also, immediate post‐partum disengagement was a significant predictor for ongoing primary care disengagement.ConclusionThis study provides timely and critical information to address recent calls for awareness and interventions to address issues on health disparities and inequities among racialized communities.ImpactThe study provides significant evidence on the effects of social determinants of health on health outcomes for Black women living with HIV. Critical understanding and assessment of these factors, together with proper, proactive interventions may help to gauge such negative effects. Healthcare providers taking care of Black women living with HIV ought to be cognizant of these factors, assess at‐risk women and intervene accordingly to ensure that their care is not marginalized.Patient/Public ContributionThis study includes direct patient data from Black post‐partum women living with HIV who were seen at prenatal and post‐partum clinics wherein data for this study were obtained. The study results were presented locally, nationally and internationally to communities, organizations of healthcare providers, stakeholders and service‐users, who further corroborated our findings, and provided insights and future recommendations.

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Section: Discussionsupporting

confidence: 79%

Section: Re Sultssupporting

confidence: 78%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Predictors and social determinants of HIV treatment engagement among post‐partum Black women living with HIV in southeastern United States

Ojukwu

Cianelli

Rodriguez

et al. 2023

Journal of Advanced Nursing

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“…37 More comprehensive postpartum care may improve not only reproductive timing but viral control by ensuring adequate follow-up with the primary care, subspecialty, and pediatric/adolescent providers; indeed, failure to attend the postpartum visit is predictive of loss to longitudinal HIV care, along with viremia at delivery and pill burden during pregnancy. 38 Further analysis of our patient population will be required to determine whether similar findings exist.…”

Section: Discussionmentioning

confidence: 89%

Pregnancy in an Urban Cohort of Adolescents Living with Human Immunodeficiency Virus: Characteristics and Outcomes in Comparison to Adults

Murphy

Keller

Argani

et al. 2021

AIDS Patient Care and STDs

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Adolescents (13-24 years of age) account for more than one-fifth of new HIV diagnoses yearly, and the United States has one of the highest rates of adolescent pregnancy among high resource countries. However, there is limited information on the characteristics and outcomes of adolescents living with HIV (ALWHIV) during pregnancy and differences with pregnancy in adults living with HIV. We performed a retrospective cohort study to compare demographic characteristics, HIV viral suppression, and pregnancy outcomes in adolescents (n = 90) as compared with adults (n = 250) in an urban HIV pregnancy clinic from 2003 to 2015. Seventy-one women overall were diagnosed with HIV during pregnancy (adolescents, 25/90; adults, 46/250). One-fifth of adolescents acquired HIV perinatally. Adolescents were more likely than adults to have unintended pregnancy (83.6% vs. 68.7%, p = 0.016) and were less likely to be virally suppressed at delivery (50.0% vs. 69.7% overall, p = 0.001; 48.0% vs. 78.2% in postuniversal antiretroviral therapy era, p = 0.007%). Over one-third of adolescents reported a history of any illicit substance use, and adolescents were more likely than adults to use marijuana during pregnancy (29.2% vs. 16.9%, p = 0.013). Adolescents were less likely to experience preterm labor (11.0% vs. 24.1%, p = 0.012) or preterm premature rupture of membranes (3.7% vs. 16.7%, p = 0.003). There was one case of maternal-fetal transmission, which occurred in an adult pregnancy. Despite the high rate of unintended pregnancy, one-third of adolescents were discharged without an identified contraception plan. We identify several opportunities for intervention to improve reproductive health outcomes in ALWHIV.

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Viral suppression and retention in HIV care during the postpartum period among women living with HIV: a longitudinal multicenter cohort study

Paioni,

Aebi-Popp,

Martinez de Tejada

et al. 2023

The Lancet Regional Health - Europe

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Factors Associated with Postpartum Loss to Follow-Up and Detectable Viremia After Delivery Among Pregnant Women Living with HIV

Cited by 8 publications

References 23 publications

Predictors and social determinants of HIV treatment engagement among post‐partum Black women living with HIV in southeastern United States

Predictors and social determinants of HIV treatment engagement among post‐partum Black women living with HIV in southeastern United States

Pregnancy in an Urban Cohort of Adolescents Living with Human Immunodeficiency Virus: Characteristics and Outcomes in Comparison to Adults

Viral suppression and retention in HIV care during the postpartum period among women living with HIV: a longitudinal multicenter cohort study

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