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"I am scared, I do not want to lie": exploring the impacts of COVID-19 on engagement in care, perceived health, relationship dynamics, and parenting among postpartum women with HIV in South Africa.
Stanton, Amelia M; Blyler, Abigail P; Mosery, Nzwakie; Goodman, Georgia R; Vanderkruik, Rachel; Sithole, Kedibone; Bedoya, C Andres; Smit, Jennifer; Psaros, Christina.
Afiliação
  • Stanton AM; Department of Psychological and Brain Sciences, Boston University, Boston, MA, USA.
  • Blyler AP; Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA.
  • Mosery N; The Fenway Institute, Fenway Health, Boston, MA, USA.
  • Goodman GR; Department of Psychology, Positive Psychology Center, University of Pennsylvania, Pennsylvania, PA, USA.
  • Vanderkruik R; Wits MatCH Research Unit (WMRU), Department of Obstetrics and Gynaecology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
  • Sithole K; Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA.
  • Bedoya CA; The Fenway Institute, Fenway Health, Boston, MA, USA.
  • Smit J; Department of Emergency Medicine, Brigham and Women's Hospital, Boston, MA, USA.
  • Psaros C; Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA.
BMC Pregnancy Childbirth ; 23(1): 223, 2023 Apr 03.
Article em En | MEDLINE | ID: mdl-37013509
ABSTRACT

BACKGROUND:

COVID-19 and efforts to manage widespread infection may compromise HIV care engagement. The COVID-19-related factors linked to reduced HIV engagement have not been assessed among postpartum women with HIV, who are at heightened risk of attrition under non-pandemic circumstances. To mitigate the effects of the pandemic on care engagement and to prepare for future public health crises, it is critical to understand how COVID-19 has impacted (1) engagement in care and (2) factors that may act as barriers to care engagement.

METHODS:

A quantitative assessment of COVID-19-related experiences was added to a longitudinal cohort study assessing predictors of postpartum attrition from HIV care among women in South Africa. Participants (N = 266) completed the assessment at 6, 12, 18, or 24 months postpartum between June and November of 2020. Those who endorsed one or more challenge related to engagement in care (making or keeping HIV care appointments, procuring HIV medications, procuring contraception, and/or accessing immunization services for infants; n = 55) were invited to complete a brief qualitative interview, which explored the specific factors driving these challenges, as well as other impacts of COVID-19 on care engagement. Within this subset, 53 participants completed an interview; qualitative data were analyzed via rapid analysis.

RESULTS:

Participants described key challenges that reduced their engagement in HIV care and identified four other domains of COVID-19-related impacts physical health, mental health, relationship with a partner or with the father of the baby, and motherhood/caring for the new baby. Within these domains, specific themes and subthemes emerged, with some positive impacts of COVID-19 also reported (e.g., increased quality time, improved communication with partner, HIV disclosure). Coping strategies for COVID-19-related challenges (e.g., acceptance, spirituality, distraction) were also discussed.

CONCLUSIONS:

About one in five participants reported challenges accessing HIV care, medications, or services, and they faced complex, multilayered barriers to remaining engaged. Physical health, mental health, relationships with partners, and ability to care for their infant were also affected. Given the dynamic nature of the pandemic and general uncertainty about its course, ongoing assessment of pandemic-related challenges among postpartum women is needed to avoid HIV care disruptions and to support wellbeing.
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Texto completo: 1 Base de dados: MEDLINE Assunto principal: Complicações Infecciosas na Gravidez / Infecções por HIV / COVID-19 Tipo de estudo: Observational_studies / Prognostic_studies / Qualitative_research / Risk_factors_studies Limite: Female / Humans / Infant / Pregnancy País como assunto: Africa Idioma: En Ano de publicação: 2023 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Complicações Infecciosas na Gravidez / Infecções por HIV / COVID-19 Tipo de estudo: Observational_studies / Prognostic_studies / Qualitative_research / Risk_factors_studies Limite: Female / Humans / Infant / Pregnancy País como assunto: Africa Idioma: En Ano de publicação: 2023 Tipo de documento: Article