Showing 1 - 20 of 62 Results for "delivery"

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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...
In addition to the use of antiretroviral drug regimens for either treatment of the mother’s health or prophylaxis to prevent mother-to-child transmission of HIV, elective cesareans (if safely available) may further reduce the risk of vertical transmission.
Delivery
2 studies Gray IIIb, V HAART, PMTCT, cesarean section, delivery Brazil
Efforts are needed to ensure HIV-positive women have information on birthing options and the right to make choices based on that information. Studies found that HIV-positive women were not given information on birthing options.
Delivery
1 study
Interventions are needed to ensure that stigma from health care workers does not discourage HIV-positive women from giving birth in safer settings. [See also %{s:67}] Studies found that HIV-positive women experienced discrimination by providers in ANC services or did not attend ANC services due to fear of mistreatment by health providers.
Delivery
1 study
Efforts are needed to ensure that health care workers protect the confidentiality of HIV-positive women’s serostatus. A study found that health workers violated women’s confidentiality.
Delivery
1 study
Interventions are needed to provide HIV testing and counseling during labor and delivery that respects informed consent. [See %{c:11} and %{s:43}]
Delivery
1 study
Health care providers must have access to gowns, gloves, needle-less systems and eye protection to decrease the risk of occupational exposure to HIV. [See %{c:25}]
Delivery
Policy guidelines, including service delivery guidelines, need to specify how contraception should be addressed in HIV prevention, treatment and care. [See %{c:15}]
Structuring Health Services to Meet Women’s Needs
1 study
Policy guidelines, including service delivery guidelines, need to specify how contraception should be addressed in HIV prevention, treatment and care. [See %{c:15}]
Preventing Unintended Pregnancies
1 study
Increased support is needed for HIV serostatus disclosure, particularly at key times such as delivery, infant weaning, and at the resumption of sexual activity. Studies found that disclosure to partners was low and women reported needing additional support to disclose.
Antenatal Care - Testing and Counseling
1 study
Further interventions are needed to reduce barriers to HIV testing. Studies found that fear of partner notification, risk of domestic violence, the unreliability of rapid HIV tests, test availability, long waiting times at the clinic, costs for transport, lack of childcare and the need for partner consent were barriers to HIV testing. The impact of rapid testing during labor and delivery for HIV-positive women has yet to be assessed and HIV test results were not provided prior to delivery.
Antenatal Care - Testing and Counseling
1 study
Health care providers must have access to gowns, gloves, needle-less systems and eye protection to decrease the risk of occupational exposure to HIV. [See also %{s:47}] Studies noted that gowns, gloves and eye protection should be used in all deliveries and in examinations or procedures likely to generate the splashing of blood or amniotic fluid.
Structuring Health Services to Meet Women’s Needs
1 study
Policy guidelines, including service delivery guidelines, need to specify how contraception should be addressed in HIV prevention, treatment and care. Studies found that many guidelines did not explicitly address family planning in VCT and PMTCT guidelines and that providers and policymakers felt they had insufficient knowledge.
Meeting the Sexual and Reproductive Health Needs of Women Living With HIV
1 study
Improved integration is needed between maternal, sexual and reproductive health services and HIV treatment services. A study found that even though 11.6% of 1,369 pregnant women were eligible for ARV treatment based on their low CD4 counts prior to delivery and 6 % were eligible postpartum, these women were not integrated into ARV treatment programs; another study found high rates of HIV in STI patients.
Structuring Health Services to Meet Women’s Needs
1 study
Efforts are needed to effectively implement Option B+ in non-prejudicial ways. Women who were sex workers reported being denied care until delivery. Women who were not accompanied by husbands were denied any health services during pregnancy. A sign on health centers read: “Notice: all pregnant women are supposed to come with their husbands/partners at their first visit. You will not be given services without implementing this” (Beckham et al., 2015: 66).
Antenatal Care - Treatment
1 study
More research is needed to understand the relationship between maternal single-dose nevirapine administered during delivery and postpartum nevirapine resistance found in breastmilk, and its impact on postnatal transmission to infants. [See also %{s:45}] A study detected nevirapine resistance in 40% of breast milk samples collected from 30 HIV-positive mothers after four weeks of single-dose nevirapine exposure. Breastmilk samples were collected from 19 mothers whose infants tested HIV negative and 11 mothers who infants tested HIV positive by 6 weeks of age.
Postpartum
1 study
Barriers such as cost of medications, stigma, long clinic waits, lack of food, and child-care responsibilities, among others, may discourage women living with HIV from accessing antiretroviral therapy. A study found that patients who were living with HIV but did not access antiretroviral therapy were twice as likely as patients on antiretroviral therapy to report not having enough food to take with treatment as a concern, in addition to concerns about cost barriers. Another study found that cost of ARVs, with direct out of pocket payment at point of care delivery decreased access to ARVs. Another study found transport costs and waiting time a barrier to access to treatment. Increased efforts are needed so that those in pre-ART care understand that HIV can be transmitted prior to ART eligibility.
Provision and Access
1 study
Additional efforts are needed to improve information and counseling about HIV during ANC to ensure that pregnant women and their sexual partners have adequate information. Studies found significant numbers of pregnant women received HIV tests with no counseling and reported that HIV testing was a mandatory part of their antenatal care. Studies also found that HIV-positive women feared transmitting HIV to their babies through casual contact. Studies found some providers assured women that treatment guaranteed that there would be no vertical transmission. In addition, studies found that some couples erroneously believed that sex during pregnancy causes miscarriages. Studies have also found that women who have tested HIV-negative at their first antenatal visit had seroconverted to HIV-positive by 12 months following delivery.
Antenatal Care - Testing and Counseling
1 study
Interventions are needed for male involvement that do not such reinforce harmful gender norms or increase risk for violence, stigma or discrimination. “Evidence for effectiveness of male involvement in PMTCT programs is scant” (Beckham et al., 2015: 67). One study only evaluated male involvement as accompanying their pregnant partner to ANC care with no HIV related outcomes listed and tasking the woman to require her male partner to come to ANC (Nyondo et al., 2015). Most approaches only reach men through their pregnant spouse, with no services for men beyond HIV testing and use men as an instrument solely to increase access to services by women. Men have been denied involvement in antenatal care, birth and delivery even if the couple so chooses.
Antenatal Care - Treatment
1 study
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