Showing 41 - 60 of 63 Results for "antenatal care)"

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Mandating pregnant women to enroll in ART on the same day they test HIV positive may violate their human rights and may result in loss-to-follow up, increasing the risk of mortality, morbidity and drug resistance. Providing enough counseling and information to pregnant women found positive before being initiated on lifelong treatment helps in reducing cases of loss to follow up. Active tracing of women lost to follow up in a way that does not violate consent, confidentiality and human rights, may be warranted. An analysis of national facilities with over 20,000 women started on cART under Option B+ found that loss to follow up was highest in patients who began cART at large clinics on the day they were diagnosed with HIV. After controlling for age and facility type, Option B+ patients who started on ART on the same day of testing were almost twice as likely to never return to the clinic than other Option B+ patients. Note: WHO September 2015 guidelines do not specify when during pregnancy a woman living with HIV should be initiated on cART
Antenatal Care - Treatment
1 study
Interventions are needed to reduce the higher attrition rate among pregnant adolescents living with HIV, including those perinatally infected, and provide needed support by parents and others. [See also %{c:9}] Additional research may also be needed on how to best care for perinatally-infected pregnant women who have decreased virological suppression, increased risk of vertical transmission and increased challenges in remaining adherent. While currently noted in the United States, it is anticipated to be relevant to low- and middle-income countries as more perinatally-infected women give birth.
Antenatal Care - Treatment
1 study
Increased efforts are needed to address the needs of adolescents living with HIV who are pregnant and to create linkages between HIV centers and maternal health clinics. A study showed that use of maternal health services to prevent vertical transmission was lower than the proportion who attended prenatal care. In this study, less than half of pregnant adolescents attended four antenatal care visits. In addition, use of skilled attendance during or after abortion or miscarriage was low.[See also %{c:17} and %{c:25}]
Increasing Access to Services
1 study
Scaling up PMTCT programs increases the number of women who know their serostatus and improves HIV knowledge.
Structuring Health Services to Meet Women’s Needs
3 studies Gray IV, V HIV testing, PMTCT, antenatal care, treatment Cameroon, Côte d’Ivoire
Increased efforts are needed to actively plan for screening and treating HIV-TB co-infection, particularly in antenatal clinics. A study found no planning for HIV-TB co-infection across all levels of the health care system. Other studies found separate services and no information for co-infected patients on the risks of co-infection, plus no screening and treatment of co-infection. [See also %{c:17}]
Tuberculosis
1 study
Integrating HIV services with family planning, maternal health care or within primary care facilities can increase uptake of HIV testing and treatment and other reproductive health services. [See also %{s:45}]
Structuring Health Services to Meet Women’s Needs
9 studies Gray IIIa, IIIb, IV CD4 counts, HAART, HIV testing, TB, abortion, condom use, contraception, family planning, health facilities, pregnancy, testing, treatment Cambodia, Kenya, Mozambique, Nigeria, South Africa, Tanzania, Zambia
Structuring Health Services to Meet Women’s Needs
The manner in which health services are structured has an impact on HIV prevention, treatment and care services for women and girls. Women often need multiple reproductive health services such as family planning in addition to HIV prevention, treatment and care, but most health care facilities are not structured to provide integrated services. Integration can be defined broadly as 1) co-locatio...
Early postpartum visits, especially with on-site contraceptive services, can result in increased condom use, contraceptive use, HIV testing and treatment.
Postpartum
6 studies Gray IIIa, IIIb DMPA, HIV testing, PMTCT, condom use, contraception, counseling, family planning, pregnancy Côte d’Ivoire, Kenya, Russia, Rwanda, Swaziland
Adolescents can achieve viral suppression and remain adherent, with low loss to follow up
Increasing Access to Services
3 studies Gray IIIb Jamaica, South America, adherence, treatment, young people Africa, Asia, Cambodia, India, Indonesia, Malaysia, North America, Thailand, Vietnam
Safe Motherhood and Prevention of Vertical Transmission
Three vital components of AIDS programming for women living with HIV are ensuring safe motherhood through access to health care before, during and after pregnancy and childbirth; ensuring access to treatment; and ensuring access to services to prevent vertical HIV transmission. While much progress has been made in reducing vertical transmission, more could be done. A recent demographic model sh...
Pre-Conception
Safe Motherhood and Prevention of Vertical Transmission
Although many women do not learn their HIV status until they become pregnant, for those women who know they are HIV-positive prior to choosing to become pregnant, pre-conception assessments may inform both her and her partner of the safest way to become pregnant without HIV transmission to the infant or HIV transmission between serodiscordant couples. Therefore, throughout their reproductive ye...
Delivery
Safe Motherhood and Prevention of Vertical Transmission
For women with HIV, there is little evaluated evidence available regarding delivery options, though research has shown that by substantially lowering viral load, HAART can diminish the advantage of a cesarean section in reducing perinatal transmission (Sharma and Spearman, 2008; Rongkavilit and Asmar, 2011; Coovadia and Newell, 2012). Cesarean sections are not always available or safe in many d...
Decentralization and integration of HIV services may increase adherence and early access to ART. [See also %{c:25}]
Adherence and Support
7 studies Gray I, IIIa Central African Republic, adherence, and Zimbabwe, health facilities, health services, the Democratic Republic of the Congo, the Republic of the Congo, treatment Cambodia, Côte d'Ivoire, Democratic Republic of Congo, Ethiopia, India, Kenya, Lesotho, Malawi, Mozambique, Nigeria, Rwanda, South Africa, Swaziland, Tanzania, Thailand, Uganda, Zambia
When a couple is serodiscordant or both male and female partners are HIV-positive and wish to conceive, having an undetectable viral load and limiting unprotected sex to peak fertility (with the possible use of pre-exposure prophylaxis) may result in the lowest risk of perinatal transmission. [See also %{s:33}]
Pre-Conception
5 studies Gray IIIb, V pre-exposure prophylaxis, pregnancy, serodiscordant, sexual partners, transmission, treatment Kenya, Saudi Arabia, South Africa, Switzerland, Uganda
Malaria
Preventing, Detecting and Treating Critical Co-Infections
Malaria and HIV co-infection is a critical public health problem that may fuel the spread of both diseases in countries where both diseases are endemic. Malaria seems to be more common for people living with HIV and in areas of unstable malaria transmission, people living with HIV face increased risk of death (Mermin et al., 2006). Men and women living with HIV with CD4 counts below 300 cells p...
Accelerating treatment access for adults with children can reduce the number of orphans, improve pediatric mortality and social well-being. [See also %{c:13}]
Orphans and Vulnerable Children
4 studies Gray IIIa, IIIb, V child labor, education, mortality, orphans, treatment Kenya, South Africa, Uganda, Ukraine
HIV Testing and Counseling for Women
Knowing ones HIV serostatus is the first step in getting the appropriate treatment and care. According to UNAIDS, fewer than 40% of those living with HIV are aware of their serostatus (UNAIDS, 2010c). In parts of sub-Saharan Africa, more than 80% of people living with HIV do not know their positive serostatus (Anand et al., 2009). Global consensus exists that greater knowledge of HIV status is ...
Postpartum
Safe Motherhood and Prevention of Vertical Transmission
Postpartum care is the most neglected aspect of maternal health, yet a time of high risk for maternal mortality. "The majority of maternal deaths occur during or immediately after childbirth; ...up to half of all newborn deaths occur within the first 24 hours of life" (WHO et al., 2011c). While many women access antenatal care, much fewer women globally have access to postnatal care. For exampl...
Increasing Access to Services
Prevention and Services for Adolescents and Young People
While the literature on access to HIV services by adolescents is limited, the literature on access to sexual and reproductive health services more broadly demonstrates that youth-friendly approaches can increase use of reproductive health care services by female adolescents (Gay et al., 2015). Young peoples service needs are frequently overlooked in HIV programming that is not specifically for ...
Triple therapy, when used for treatment or prophylaxis through the postpartum period reduces mother-to-child HIV transmission. [See also %{s:45}].
Postpartum
14 studies Gray I, II, IIIa, IIIb, IV, V CD4 counts, HAART, PMTCT, breastfeeding, formula feeding, treatment Botswana, Burkina Faso, Côte d’Ivoire, Ethiopia, India, Kenya, Malawi, Mozambique, Rwanda, South Africa, Southern Africa, Tanzania, Uganda