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Women's decision-making and uptake of services to prevent mother-to-child HIV transmission in Zambia

机译：妇女的决策和吸收服务，以防止在赞比亚母婴艾滋病毒传播

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Women's empowerment is associated with engagement in some areas of healthcare, but its role in prevention of mother-to-child HIV transmission (PMTCT) services has not been previously considered. In this secondary analysis, we investigated the association of women's decision-making and uptake of health services for PMTCT. Using data from population-based household surveys, we included women who reported delivery in the 2-year period prior to the survey and were HIV-infected. We measured a woman's self-reported role in decision-making in her own healthcare, making of large purchases, schooling of children, and healthcare for children. For each domain, respondents were categorized as having an active or no active role. We investigated associations between decision-making and specific steps along the PMTCT cascade: uptake of maternal antiretroviral drugs, uptake of infant HIV prophylaxis, and infant HIV testing. We calculated unadjusted and adjusted odds ratios via logistic regression. From March to December 2011, 344 HIV-infected mothers were surveyed and 276 completed the relevant survey questions. Of these, 190 (69%) took antiretroviral drugs during pregnancy; 175 (64%) of their HIV-exposed infants received antiretroviral prophylaxis; and 160 (58%) had their infant tested for HIV. There was no association between decision-making and maternal or infant antiretroviral drug use. We observed a significant association between decision-making and infant HIV testing in univariate analyses (OR 1.56-1.85; p0.05); however, odds ratios for the decision-making indicators were no longer statistically significant predictors of infant HIV testing in multivariate analyses. In conclusion, women who reported an active role in decision-making trended toward a higher likelihood of uptake of infant testing in the PMTCT cascade. Larger studies are needed to evaluate the impact of empowerment initiatives on the PMTCT service utilization overall and infant testing in particular.
机译：妇女的赋权与一些医疗保健领域的参与有关，但其在预防母婴艾滋病毒艾滋病毒艾滋病毒艾滋病毒艾滋病毒艾滋病毒艾滋病毒艾滋病毒艾滋病病毒活动（PMTCT）服务方面尚未考虑。在这次二级分析中，我们调查了妇女决策和对PMTCT卫生服务的影响的协会。使用基于人口的家庭调查的数据，我们包括在调查前2年期间报告的妇女，并艾滋病毒感染。在她自己的医疗保健，大型购买，儿童学校教育以及儿童医疗保健中，我们在决策中衡量了一个女人的自我报告的作用。对于每个域，受访者被分类为有效或没有活动角色。我们调查了沿着PMTCT级联的决策和具体步骤之间的协会：摄取母体抗逆转录病毒药物，吸收婴儿HIV预防和婴儿HIV检测。我们通过Logistic回归计算不调整的和调整后的差距。从3月到2011年12月，344名艾滋病毒感染的母亲被调查，276次完成了相关的调查问题。其中，190（69％）在怀孕期间服用抗逆转录病毒药物; 175（64％）其艾滋病毒暴露的婴儿受到抗逆转录病毒预防; 160（58％）对艾滋病毒的婴儿进行了测试。决策和母婴抗逆转录病毒用途之间没有关联。我们在单变量分析中观察到决策和婴儿HIV测试之间的重大关联（或1.56-1.85; p <0.05）;然而，决策指标对于多变量分析中的婴儿艾滋病毒检测的差异预测因子不再是统计上显着的预测性。总之，妇女在决策中发挥积极作用，趋于更高的PMTCT级联吸收婴儿测试的可能性。需要更大的研究来评估赋权倡议对整体和婴儿测试的影响。

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