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首页> 外文期刊>Open access Journal of Contraception >Psychosocial correlates of patient–provider family planning discussions among HIV-infected pregnant women in South Africa
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Psychosocial correlates of patient–provider family planning discussions among HIV-infected pregnant women in South Africa

机译：南非艾滋病毒感染孕妇中患者与提供者的计划生育讨论的心理社会相关性

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Patient–provider family planning discussions and preconception counseling can reduce maternal and neonatal risks by increasing adherence to provider recommendations and antiretroviral medication. However, HIV-infected women may not discuss reproductive intentions with providers due to anticipation of negative reactions and stigma. This study aimed to identify correlates of patient–provider family planning discussions among HIV-infected women in rural South Africa, an area with high rates of antenatal HIV and suboptimal rates of prevention of mother-to-child transmission (PMTCT) of HIV. Participants were N=673 pregnant HIV-infected women who completed measures of family planning discussions and knowledge, depression, stigma, intimate partner violence, and male involvement. Participants were, on average, 28 ± 6?years old, and half of them had completed at least 10–11?years of education. Most women were unemployed and had a monthly income of less than ~US$76. Fewer than half of the women reported having family planning discussions with providers. Correlates of patient–provider family planning discussions included younger age, discussions about PMTCT of HIV, male involvement, and decreased stigma ( p < 0.05). Depression was indirectly associated with patient–provider family planning discussions through male involvement ( b = ?0.010, bias-corrected 95% confidence interval [bCI] [?0.019, ?0.005]). That is, depression decreased male involvement, and in turn, male involvement increased patient–provider family planning discussions. Therefore, by decreasing male involvement, depression indirectly decreased family planning discussions. Study findings point to the importance of family planning strategies that address depression and facilitate male involvement to enhance communication between patients and providers and optimize maternal and neonatal health outcomes. This study underscores the need for longitudinal assessment of men’s impact on family planning discussions both pre- and postpartum. Increasing support for provision of mental health services during pregnancy is merited to ensure the health of pregnant women living with HIV and their infants.
机译：提供者的计划生育讨论和孕前咨询可以通过增加对提供者建议和抗逆转录病毒药物的依从性来降低孕产妇和新生儿的风险。但是，由于预期会有负面反应和污名，受艾滋病毒感染的妇女可能不与提供者讨论生殖意图。这项研究的目的是确定南非农村地区艾滋病毒感染妇女中病人与提供者的计划生育讨论的相关性，该地区的产前艾滋病毒感染率很高，并且预防母婴传播艾滋病毒（PMTCT）的比例不理想。参加者为N = 673名怀孕的HIV感染孕妇，她们完成了计划生育讨论和知识，抑郁，耻辱，亲密伴侣暴力和男性参与的措施。参与者平均年龄为28±6岁，其中一半完成了至少10-11年的教育。大多数妇女失业，月收入不到76美元。报告与提供者进行计划生育讨论的妇女不到一半。患者与提供者的计划生育讨论的相关性包括年龄较小，有关HIV PMTCT的讨论，男性参与以及污名减少（p <0.05）。抑郁症通过男性参与与患者-提供者的计划生育讨论间接相关（b = 0.010，偏差校正的95％置信区间[bCI] [0.019，0.005]）。也就是说，抑郁症降低了男性的参与度，反过来，男性参与度增加了患者与提供者的计划生育讨论。因此，通过减少男性的参与，抑郁症间接减少了计划生育的讨论。研究发现指出了计划生育策略的重要性，该策略应解决抑郁症并促进男性参与，以加强患者与提供者之间的沟通，并优化孕产妇和新生儿的健康状况。这项研究强调了对产前和产后男性对计划生育讨论的影响进行纵向评估的必要性。应当在怀孕期间提供更多的支持，以确保感染艾滋病毒的孕妇及其婴儿的健康。

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