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1.
BMC Med Ethics ; 25(1): 57, 2024 May 16.
Artigo em Inglês | MEDLINE | ID: mdl-38755578

RESUMO

BACKGROUND: The involvement of pregnant women in vaccine clinical trials presents unique challenges for the informed consent process. We explored the expectations and experiences of the pregnant women, spouses/partners, health workers and stakeholders of the consent process during a Group B Streptococcus maternal vaccine trial. METHODS: We interviewed 56 participants including pregnant women taking part in the trial, women not in the trial, health workers handling the trial procedures, spouses, and community stakeholders. We conducted 13 in-depth interviews and focus group discussions with 23 women in the trial, in-depth interviews with 5 spouses, and 5 women not in the trial, key informant interviews with 5 health workers and 5 other stakeholders were undertaken. RESULTS: Decision-making by a pregnant woman to join a trial was done in consultation with spouse, parents, siblings, or trusted health workers. Written study information was appreciated by all but they suggested the use of audio and visual presentation to enhance understanding. Women stressed the need to ensure that their male partners received study information before their pregnant partners joined a clinical trial. Confidentiality in research was emphasised differently by individual participants; while some emphasised it for self, others were keen to protect their family members from being exposed, for allowing them to be involved in research. However, others wanted their community participation to be acknowledged. CONCLUSION: We found that pregnant women make decisions to join a clinical trial after consulting with close family. Our findings suggest the need for an information strategy which informs not only the pregnant woman, but also her family about the research she is invited to engage in.


Assuntos
Aleitamento Materno , Tomada de Decisões , Consentimento Livre e Esclarecido , Gestantes , Pesquisa Qualitativa , Humanos , Feminino , Gravidez , Uganda , Consentimento Livre e Esclarecido/ética , Adulto , Gestantes/psicologia , Masculino , Cônjuges , Grupos Focais , Ensaios Clínicos como Assunto/ética , Infecções Estreptocócicas/prevenção & controle , Confidencialidade , Sujeitos da Pesquisa/psicologia , Adulto Jovem , Pessoal de Saúde/psicologia , Streptococcus agalactiae
2.
BMC Womens Health ; 24(1): 266, 2024 Apr 27.
Artigo em Inglês | MEDLINE | ID: mdl-38678278

RESUMO

BACKGROUND: Uganda has approximately 1.2 million people aged 15-64 years living with human immunodeficiency virus (HIV). Previous studies have shown a higher prevalence of premalignant cervical lesions among HIV-positive women than among HIV-negative women. Additionally, HIV-infected women are more likely to have human papilloma virus (HPV) infection progress to cancer than women not infected with HIV. We determined the prevalence of premalignant cervical lesions and their association with HIV infection among women attending a cervical cancer screening clinic at Mbarara Regional Referral Hospital (MRRH) in southwestern Uganda. METHODS: We conducted a comparative cross-sectional study of 210 women aged 22-65 years living with HIV and 210 women not living with HIV who were systematically enrolled from March 2022 to May 2022. Participants were subjected to a structured interviewer-administered questionnaire to obtain their demographic and clinical data. Additionally, Papanicolaou smears were obtained for microscopy to observe premalignant cervical lesions. Multivariate logistic regression was performed to determine the association between HIV status and premalignant cervical lesions. RESULTS: The overall prevalence of premalignant cervical lesions in the study population was 17% (n = 72; 95% C.I: 14.1-21.4), with 23% (n = 47; 95% C.I: 17.8-29.5) in women living with HIV and 12% (n = 25; 95% C.I: 8.2-17.1) in women not living with HIV (p < 0.003). The most common premalignant cervical lesions identified were low-grade squamous intraepithelial lesions (LSIL) in both women living with HIV (74.5%; n = 35) and women not living with HIV (80%; n = 20). HIV infection was significantly associated with premalignant lesions (aOR: 2.37, 95% CI: 1.27-4.42; p = 0.007). CONCLUSION: Premalignant cervical lesions, particularly LSILs, were more common in HIV-positive women than in HIV-negative women, highlighting the need to strengthen the integration of cervical cancer prevention strategies into HIV care programs.


Assuntos
Detecção Precoce de Câncer , Infecções por HIV , Lesões Pré-Cancerosas , Neoplasias do Colo do Útero , Humanos , Feminino , Adulto , Estudos Transversais , Uganda/epidemiologia , Neoplasias do Colo do Útero/epidemiologia , Neoplasias do Colo do Útero/diagnóstico , Pessoa de Meia-Idade , Adulto Jovem , Detecção Precoce de Câncer/métodos , Detecção Precoce de Câncer/estatística & dados numéricos , Infecções por HIV/complicações , Infecções por HIV/epidemiologia , Prevalência , Lesões Pré-Cancerosas/epidemiologia , Idoso , Teste de Papanicolaou/estatística & dados numéricos , Centros de Atenção Terciária/estatística & dados numéricos , Soropositividade para HIV/epidemiologia , Soropositividade para HIV/complicações , Displasia do Colo do Útero/epidemiologia , Displasia do Colo do Útero/diagnóstico , Infecções por Papillomavirus/epidemiologia , Infecções por Papillomavirus/complicações , Esfregaço Vaginal/estatística & dados numéricos
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