Loss to Follow-Up After Pregnancy Among Sub-Saharan Africa-Born Women Living With Human Immunodeficiency Virus in England, Wales and Northern Ireland

Tariq, Shema; Elford, Jonathan; Chau, Cuong; French, Clare E; Cortina‐Borja, Mario; Brown, Alison E; Delpech, Valérie; Tookey, P

doi:10.1097/olq.0000000000000442

Cited by 9 publications

(11 citation statements)

References 25 publications

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“…It is important to be aware that there may be issues with retention in care after pregnancy, with disengagement of care rates estimated at 12% in both the NSHPC and the Swiss Cohort, and caring responsibilities identified as a barrier to accessing care . It is essential to see all women in the postpartum period for follow‐up of both medical and social issues, and to promote linkage back to general HIV care.…”

Section: Postpartum Management Of Womenmentioning

confidence: 99%

British HIV Association guidelines for the management of HIV in pregnancy and postpartum 2018

et al. 2019

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Section: Postpartum Management Of Womenmentioning

confidence: 99%

British HIV Association guidelines for the management of HIV in pregnancy and postpartum 2018

et al. 2019

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“…Postpartum retention in HIV care and ART adherence in the postpartum period affect HIV-infected women universally around the globe. [19][20][21][22][23]…”

Section: Discussionmentioning

confidence: 99%

High Proportion of Deaths Attributable to HIV Among Postpartum Women in Botswana Despite Widespread Uptake of Antiretroviral Therapy

Zash

Souda

Leidner³

et al. 2017

AIDS Patient Care and STDs

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Mortality in the postpartum period may be impacted by antiretroviral therapy (ART) received in pregnancy, and whether ART is continued in the postpartum period. HIV-infected and HIV-uninfected mothers were enrolled within 48 h of delivery at five public hospital maternity wards throughout Botswana and followed for 24 months. Maternal deaths were reported by one of the approved contacts given by the mother at enrollment. Detailed information on the cause of death was not available. Risk factors for 24-month mortality were assessed using Cox proportional hazard models. From February 2012 to March 2013, 3000 mothers (1499 HIV infected and 1501 HIV uninfected) were enrolled, and 2985 (99.5%) were followed to 24 months or death, or until the death of their child. There were 26 total maternal deaths through 24 months postpartum [439 per 100,000 person-years (p-y)], 22 among HIV-infected women (758 per 100,000 p-y) and 4 among HIV-uninfected women (132 per 100,000 p-y). Maternal HIV-infection (aHR 5.0, 95% CI 1.6-15.2) and infant birth injury (aHR 3.8, 95% CI 1.3-11.4) were independent risk factors for maternal death. Universal ART in pregnancy became the standard-of-care after June 2012, and 978 (65%) women received ART in pregnancy; by 24 months postpartum or end of follow-up, 1148 (79%) had started ART overall. There was no significant difference in 24-month mortality among HIV-infected women who took ART in pregnancy and continued throughout the follow-up period compared with HIV-infected women who took ART or zidovudine in pregnancy and stopped postpartum (aHR 0.6, 95% CI 0.2-1.7). Despite high uptake of ART in pregnancy and postpartum, women with HIV infection in Botswana are five times more likely to die than HIV-uninfected women in the 24 months postpartum.

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“…Em alguns estudos, as mulheres negras e com menor idade mais frequentemente não compareciam a suas consultas médicas após o parto (Siddiqui, Bell, Sangi-Haghpeykar, Minard, & Levison, 2014;Tariq et al, 2016). Como discutido por Tariq et al (2016), possivelmente, as mulheres negras residentes na Inglaterra, que eram migrantes, enfrentavam muitos desafios para continuidade do tratamento, incluindo desde pobreza, dificuldades de acesso à medicação e isolamento social. De fato, a falta de apoio social é uma das barreiras, que leva as mulheres a descontinuarem o próprio tratamento (Buchberg et al, 2015).…”

Section: Introductionunclassified

“…Geralmente, essas mulheres com início tardio das consultas do pré-natal têm pouco tempo para serem aconselhadas sobre o tratamento. Em contrapartida, no que tange ao estágio da infecção pelo HIV, tem-se evidenciado que aquelas com melhores condições clínicas, com contagem de TCD4 acima de 350 células/ml, mais frequentemente abandonaram o próprio tratamento (Tariq et al, 2016). Diferentemente da gestação em que a motivação para tratamento é a responsabilidade com o bebê, após o parto, a continuidade dele dependerá da noção de autocuidado da mulher (Siddiqui et al, 2014) e da preocupação com sua própria saúde (Kempf et al, 2010).…”

Section: Introductionunclassified

Maternidade e HIV: Continuidade do Tratamento e Adesão em Mulheres após Parto

2021

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Resumo O estudo examinou fatores sociodemográficos, clínicos e psicossociais que afetam a continuidade do tratamento e a adesão à medicação antirretroviral em mulheres nos primeiros três meses após o parto. Participaram 56 mulheres vivendo com HIV, com idades entre 18 e 43 anos, na sua grande maioria brancas e casadas. Foram utilizadas entrevistas sobre dados sociodemográficos e clínicos, exames laboratoriais e escalas psicológicas. Análises estatísticas revelaram que mais de um terço das participantes (37,5%) descontinuaram o próprio tratamento após o parto. A qualidade de vida e o apoio instrumental podem favorecer a continuidade do tratamento de HIV após o parto, e as condições de trabalho e a situação clínica dessas mulheres pode afetar a adesão após o parto. Tais resultados podem contribuir para o desenvolvimento de intervenções que favoreçam a continuidade do tratamento e adesão das mulheres no pós-parto.

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Loss to Follow-Up After Pregnancy Among Sub-Saharan Africa-Born Women Living With Human Immunodeficiency Virus in England, Wales and Northern Ireland

Abstract: Combining 2 national United Kingdom data sets, we found that 1 in 8 human immunodeficiency virus–positive women were lost to follow-up in the year after pregnancy. This was associated with being Sub-Saharan Africa-born and recent migration.

Cited by 9 publications

References 25 publications

British HIV Association guidelines for the management of HIV in pregnancy and postpartum 2018

British HIV Association guidelines for the management of HIV in pregnancy and postpartum 2018

High Proportion of Deaths Attributable to HIV Among Postpartum Women in Botswana Despite Widespread Uptake of Antiretroviral Therapy

Maternidade e HIV: Continuidade do Tratamento e Adesão em Mulheres após Parto

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