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Psychosocial correlates of patient–provider family planning discussions among HIV-infected pregnant women in South Africa

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 o...

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Autores principales: Rodriguez, Violeta J, Cook, Ryan R, Weiss, Stephen M, Peltzer, Karl, Jones, Deborah L
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dove Medical Press 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5473338/
https://www.ncbi.nlm.nih.gov/pubmed/28626358
http://dx.doi.org/10.2147/OAJC.S134124
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author Rodriguez, Violeta J
Cook, Ryan R
Weiss, Stephen M
Peltzer, Karl
Jones, Deborah L
author_facet Rodriguez, Violeta J
Cook, Ryan R
Weiss, Stephen M
Peltzer, Karl
Jones, Deborah L
author_sort Rodriguez, Violeta J
collection PubMed
description 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.
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spelling pubmed-54733382017-06-16 Psychosocial correlates of patient–provider family planning discussions among HIV-infected pregnant women in South Africa Rodriguez, Violeta J Cook, Ryan R Weiss, Stephen M Peltzer, Karl Jones, Deborah L Open Access J Contracept Original Research 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. Dove Medical Press 2017-04-03 /pmc/articles/PMC5473338/ /pubmed/28626358 http://dx.doi.org/10.2147/OAJC.S134124 Text en © 2017 Rodriguez et al. This work is published and licensed by Dove Medical Press Limited The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed.
spellingShingle Original Research
Rodriguez, Violeta J
Cook, Ryan R
Weiss, Stephen M
Peltzer, Karl
Jones, Deborah L
Psychosocial correlates of patient–provider family planning discussions among HIV-infected pregnant women in South Africa
title Psychosocial correlates of patient–provider family planning discussions among HIV-infected pregnant women in South Africa
title_full Psychosocial correlates of patient–provider family planning discussions among HIV-infected pregnant women in South Africa
title_fullStr Psychosocial correlates of patient–provider family planning discussions among HIV-infected pregnant women in South Africa
title_full_unstemmed Psychosocial correlates of patient–provider family planning discussions among HIV-infected pregnant women in South Africa
title_short Psychosocial correlates of patient–provider family planning discussions among HIV-infected pregnant women in South Africa
title_sort psychosocial correlates of patient–provider family planning discussions among hiv-infected pregnant women in south africa
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5473338/
https://www.ncbi.nlm.nih.gov/pubmed/28626358
http://dx.doi.org/10.2147/OAJC.S134124
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