Mothers on the Margins : Implications for Eradicating Perinatal HIV  

Oleh:

Lindau, Stacy Tessler ; Jerome, Jessica ; Miller, Kate ; Monk, Elizabeth ; Garcia, Patricia ; Cohen, Mardge

Jenis: Article from Journal - ilmiah internasional
Dalam koleksi: Social Science & Medicine (www.elsevier.com/locate/sosscimed) vol. 62 no. 1 (Jan. 2006), page 59-69.
Topik: AIDS/HIV; perinatal HIV transmission; marginalized women; USA

Ketersediaan

Perpustakaan Pusat (Semanggi) Nomor Panggil: SS53.1 Non-tandon: 1 (dapat dipinjam: 0) Tandon: tidak ada

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Isi artikel

Tactics aimed at reducing perinatal transmission of HIV are proving ineffective at accomplishing complete eradication, a group of women with HIV remain at very high risk for transmitting the virus to their newborns. This study engaged a uniquely high risk group of HIV infected mothers as expert informats on childbearing with HIV to inform strategies to eradicate perinatal HIV transmission. The sample fraws from an illionois department of children and family sevices (DCFS) database of 1104 HIV seropositive women with children in protective services between 1989 and 2001. Of these, 32 women knew their HIV positive status and gave birth to at least two children after 1997 (zidovudine widely implemented as standard of care). Twelve were accessible and consented to participate. Three others, currently pregnant, also participated. Fifteen interviews were completed. The 15 women had given birth to 78 children (9 HIV infected), fathered by 62 men. Respondents were severely socioeconomically marginalized. They were aware of their HIV status and the benefits of prophylaxia, most desired health babies to parent, and most delivered their babies in hospitals equipped to provide adequate prophylaxis. Yet most received inadequate or no prenatal care and did not disclose their HIV status at delivery. Women indicateed that denial and substance use were the primary intrinsic barriers and disresectful treatment was the primary extrinsic barrier to disclosure and care. Women's recommendations about eradication of perinatal HIV transmission emphasized the problem of substance use, the need for private and through communication with medical and DCFS personnel and the need for positive social relationships to eneble HIV positive mothers to engage in care. Attention to potent social and institutional barriers that impair the ability of the most marginalized women to disclose their HIV status and accept care is essential to realize eradication of perinatal transmission.

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