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Plagens-Rotman K, Merks P, Pisarska-Krawczyk M, Kędzia W, Justyna J, Czarnecka-Operacz M, Jarząbek-Bielecka G. Possible Interdisciplinar Standard for the Care of Pregnant Women Living with HIV-Polish Experience. Healthcare (Basel) 2022; 10:healthcare10101949. [PMID: 36292396 PMCID: PMC9602101 DOI: 10.3390/healthcare10101949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2022] [Revised: 09/25/2022] [Accepted: 09/27/2022] [Indexed: 11/04/2022] Open
Abstract
HIV data for 2020 show a decline in the number and rate of new HIV cases diagnosed in the EU during the last decade. The COVID-19 pandemic has paralyzed the functioning of healthcare facilities in Poland and worldwide, also impacting the detection of HIV infection. Early diagnosis of HIV and implementation of antiretroviral treatment limit HIV transmission. A woman with HIV diagnosed during pregnancy should be under the care of a specialist in infectious diseases experienced in antiretroviral treatment. In this way, she will be properly protected during the delivery, and relevant medications can be implemented for the newborn baby. Taking these aspects into account, the medical team should consist of: A specialist in infectious diseases, an obstetrician, a neonatologist and pediatrician, a midwife, and a dermato-venereologist. Every effort should be made to increase the scope and quality of monitoring of the spread of the epidemic in Poland, with special emphasis on diagnostics based on specific tests among populations particularly exposed to HIV infections cooperating with non-governmental organizations.
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Affiliation(s)
- Katarzyna Plagens-Rotman
- Center for Pediatric, Adolescent Gynecology and Sexology Division of Gynecology, Department of Perinatology and Gynecology, Poznan University of Medical Sciences, 61-758 Poznan, Poland
- Correspondence:
| | - Piotr Merks
- Department of Pharmacology and Clinical Pharmacology, Faculty of Medicine, Collegium Medicum, Cardinal Stefan Wyszynski University in Warsaw, 01-938 Warszawa, Poland
| | | | - Witold Kędzia
- Division of Gynecology, Department of Perinatology and Gynecology, Poznan University of Medical Sciences, 61-758 Poznan, Poland
| | - Jaskulska Justyna
- Higher School of Strategic Planning in Dąbrowa Górnicza, Kościelna 4, 41-303 Dąbrowa Górnicza, Poland
| | - Magdalena Czarnecka-Operacz
- Allergic and Occupational Skin Diseases Unit, Department of Dermatology, Medical University of Poznań, 60-355 Poznan, Poland
| | - Grażyna Jarząbek-Bielecka
- Center for Pediatric, Adolescent Gynecology and Sexology Division of Gynecology, Department of Perinatology and Gynecology, Poznan University of Medical Sciences, 61-758 Poznan, Poland
- Division of Gynecology, Department of Perinatology and Gynecology, Poznan University of Medical Sciences, 61-758 Poznan, Poland
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Kyne LT, Yudin MH, Bekele T, Loutfy M, Rourke SB, Watson J, Nguemo Djiometio J, Antoniou T, Globerman J, McGee A, Kennedy VL. Understanding the Importance of Fatherhood among Men Living with HIV in Ontario. J Int Assoc Provid AIDS Care 2021; 20:23259582211016133. [PMID: 34000889 PMCID: PMC8135195 DOI: 10.1177/23259582211016133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
While pregnancy and motherhood have become paramount clinical issues for women living with HIV, parenting has received less attention among men living with HIV (MLWH). We conducted a secondary analysis of a cross-sectional study assessing fertility desires and intentions of MLWH using a 5-point Likert scale based on the question: "Being a father is important to me". Logistic regression models were fit to calculate unadjusted and adjusted odds ratios (ORs) and confidence intervals (CIs) for significant correlates. Of the 276 respondents, 118 were heterosexual, 158 were gay, bisexual, 2-spirit, or queer (GBTQ), 55% had never parented before, and 65% wanted to parent. 191 (69%) respondents agreed that fatherhood was important to them. In unadjusted analyses, heterosexuality (OR 1.52; 95% CI 1.15 to 2.03), African/Caribbean/Black ethnicity (OR 1.57; 95% CI 1.12 to 2.19), African/Caribbean birthplace (OR 1.48; 95% CI 1.06 to 2.05), and history of parenting (OR 1.60; 95% CI 1.10 to 2.39) were significantly (p < 0.05) associated with importance of fatherhood. However, none of these variables were significant in adjusted analyses. From the unadjusted model, factors such as sexual orientation, ethnicity, and current parenthood may influence how MLWH value fatherhood, suggesting HIV and fatherhood is complex and must be explored further.
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Affiliation(s)
- Luke Thomas Kyne
- Women's College Research Institute, Women's College Hospital, Toronto, Ontario, Canada
| | - Mark H Yudin
- Department of Obstetrics and Gynecology, University of Toronto, Toronto, Ontario, Canada.,10071St. Michael's Hospital, Toronto, Ontario, Canada.,Li Ka Shing Knowledge Institute, Toronto, Ontario, Canada
| | - Tsegaye Bekele
- 269770Ontario HIV Treatment Network (OHTN), Toronto, Ontario, Canada
| | - Mona Loutfy
- Women's College Research Institute, Women's College Hospital, Toronto, Ontario, Canada.,Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Sean B Rourke
- 10071St. Michael's Hospital, Toronto, Ontario, Canada.,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.,Centre for Urban Health Solutions, Toronto, Ontario, Canada
| | - James Watson
- 10071St. Michael's Hospital, Toronto, Ontario, Canada
| | | | - Tony Antoniou
- 10071St. Michael's Hospital, Toronto, Ontario, Canada.,Li Ka Shing Knowledge Institute, Toronto, Ontario, Canada.,Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Jason Globerman
- 269770Ontario HIV Treatment Network (OHTN), Toronto, Ontario, Canada
| | - Adam McGee
- 269770Ontario HIV Treatment Network (OHTN), Toronto, Ontario, Canada
| | - V Logan Kennedy
- Women's College Research Institute, Women's College Hospital, Toronto, Ontario, Canada
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Toupin I, Engler K, Lebouché B, Otis J, Lévy JJ, Fernet M. Decision-making about motherhood among women living with HIV in Canada: a negotiation of multidimensional risks. CULTURE, HEALTH & SEXUALITY 2019; 21:432-446. [PMID: 29993351 DOI: 10.1080/13691058.2018.1487585] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/04/2017] [Accepted: 06/07/2018] [Indexed: 06/08/2023]
Abstract
Little research in Canada has examined the perspectives of women living with HIV on decision-making across the stages of motherhood. In 2004-2005, semi-structured interviews were conducted with 42 African, Caucasian and Haitian HIV-positive women recruited in Montreal. All were or wished to be biological mothers. Transcripts underwent thematic analysis organised by three culturally informed models of motherhood described by the participants, which influenced decision-making and perceived risks. For women who saw motherhood as 'self-fulfilment and completeness', vertical HIV transmission was a primary concern. It threatened their identity as a 'good mother', which also meant adhering to antiretrovirals. For women who viewed motherhood as a 'social realisation' (all African or Haitian), fears of compromised fertility dominated. Not becoming pregnant threatened their social status and presumed health within their community. Antiretrovirals were abandoned after delivery, fearing they would reveal their HIV status. For women endorsing a 'personal growth' model of motherhood (all Caucasian), threats to personal health were paramount. Pregnancy meant purifying body and soul. Antiretrovirals, seen as pollutants, were stopped after delivery. These findings can inform current research and sensitise health providers to the complex biological, psychological, social and spiritual risks that HIV-positive women negotiate in motherhood-related decision-making, towards more patient-centred care.
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Affiliation(s)
- Isabelle Toupin
- a Department of Sexology , Université du Québec à Montréal , Montreal , Canada
- b École de santé publique , Université de Montréal , Montreal , Canada
- c Centre for Outcomes Research & Evaluation , Research Institute of the McGill University Health Centre , Montreal , Canada
- d Department of Family Medicine , McGill University , Montreal , Canada
| | - Kim Engler
- c Centre for Outcomes Research & Evaluation , Research Institute of the McGill University Health Centre , Montreal , Canada
- d Department of Family Medicine , McGill University , Montreal , Canada
| | - Bertrand Lebouché
- c Centre for Outcomes Research & Evaluation , Research Institute of the McGill University Health Centre , Montreal , Canada
- d Department of Family Medicine , McGill University , Montreal , Canada
| | - Joanne Otis
- a Department of Sexology , Université du Québec à Montréal , Montreal , Canada
| | - Joseph J Lévy
- a Department of Sexology , Université du Québec à Montréal , Montreal , Canada
| | - Mylène Fernet
- a Department of Sexology , Université du Québec à Montréal , Montreal , Canada
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Hanefeld J, Bond V, Seeley J, Lees S, Desmond N. Considerations for a Human Rights Impact Assessment of a Population Wide Treatment for HIV Prevention Intervention. Dev World Bioeth 2013; 15:115-24. [PMID: 26524615 DOI: 10.1111/dewb.12038] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Increasing attention is being paid to the potential of anti-retroviral treatment (ART) for HIV prevention. The possibility of eliminating HIV from a population through a universal test and treat intervention, where all people within a population are tested for HIV and all positive people immediately initiated on ART, as part of a wider prevention intervention, was first proposed in 2009. Several clinical trials testing this idea are now in inception phase. An intervention which relies on universally testing the entire population for HIV will pose challenges to human rights, including obtaining genuine consent to testing and treatment. It also requires a context in which people can live free from fear of stigma, discrimination and violence, and can access services they require. These challenges are distinct from the field of medical ethics which has traditionally governed clinical trials and focuses primarily on patient researcher relationship. This paper sets out the potential impact of a population wide treatment as prevention intervention on human rights. It identifies five human right principles of particular relevance: participation, accountability, the right to health, non-discrimination and equality, and consent and confidentiality. The paper proposes that explicit attention to human rights can strengthen a treatment as prevention intervention, contribute to mediating likely health systems challenges and offer insights on how to reach all sections of the population.
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Lesser J, Koniak-Griffin D. Using qualitative inquiry and participatory research approaches to develop prevention research: validating a life course perspective. FAMILY & COMMUNITY HEALTH 2013; 36:34-41. [PMID: 23168344 DOI: 10.1097/fch.0b013e31826d75a7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Application of life course theory (LCT) holds promise for advancing knowledge toward the elimination of health disparities. This article validates the usefulness of employing a life course perspective when conducting health disparities research. We provide an overview of LCT as it applies to our research program in prevention of human immunodeficiency virus (HIV) among Latino teen parents. We illustrate the goodness-of-fit of our research with the basic premises of LCT. Though early adverse life experiences impact health over the lifespan, strength-based HIV prevention programs designed for Latino teen parents that recognize the reality of their lives may alter their health trajectory.
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Affiliation(s)
- Janna Lesser
- Center for Community-Based Health Promotion with Women and Children, Department of Family and Community Health Systems, UT Health Science Center at San Antonio School of Nursing, San Antonio, TX 78229, USA.
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Rotheram-Borus MJ, Rice E, Comulada WS, Best K, Li L. Comparisons of HIV-Affected and Non-HIV-Affected Families Over Time. VULNERABLE CHILDREN AND YOUTH STUDIES 2012; 7:299-314. [PMID: 23671458 PMCID: PMC3650635 DOI: 10.1080/17450128.2012.713532] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
This study compares HIV-affected families and their non-HIV-affected neighbors' behavioral health outcomes and family conflict. To compare two groups from the same neighborhoods at four points over 18 months, mothers with HIV (MLH) (N=167) and their school-age children (age 6 to 20) were recruited from clinical care settings in Los Angeles, CA and neighborhood control mothers (NCM) without HIV (N=204) were recruited from modal neighborhoods. In addition, children living at home who were 12 years and older were recruited. We assessed parenting behaviors, family conflict, mental health, sexual behavior, substance use, and HIV-related health behaviors over time. MLH perceived greater economic insecurity at baseline, less employment, and involvement in romantic relationships. MLH reported more emotional distress and substance use than NCM. MLH, however, reported lowered HIV transmission risk. The random regressions indicated that MLH exhibited higher levels and became significantly less depressed and less anxious over time than their non-HIV-affected neighbors. MLH also reported less initial family violence and conflict reasoning than NCM; violence decreased and conflict increased over time for MLH relative to NCM. Children of MLH decreased their marijuana use but hard drug users of MLH increased their risk, over time, compared to children of NCM. Moreover, children of MLH reported more internalizing behaviors than children of NCM. Even when compared to other families living in the same economically disadvantaged communities, MLH and their children continue to face challenges surrounding family conflict, and key behavioral health outcomes, especially with respect to substance use and mental health outcomes. These families, however, show much resilience and MLH report lowered levels of HIV transmission risk, their children report no greater levels of HIV transmission risk and levels of family violence were lower than reported by families in the same neighborhoods.
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Affiliation(s)
- Mary Jane Rotheram-Borus
- Affiliation (all authors except Rice): Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, U.S.A.; Rice: School of Social Work, University of Southern California, Los Angeles, U.S.A
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