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01-09-2008

Women Identified with HIV at Labor and Delivery: Testing, Disclosing and Linking to Care Challenges

Authors: Mardge H. Cohen, Yolanda Olszewski, Mayris P. Webber, Nancy Blaney, Patricia Garcia, Robert Maupin, Steven Nesheim, Denis Agniel, Susan P. Danner, Margaret A. Lampe, Marc Bulterys

Published in: Maternal and Child Health Journal | Issue 5/2008

Abstract

Objective To determine if women with undocumented HIV status in late pregnancy or at labor and delivery who are rapidly tested and identified as HIV infected have high-risk behaviors and psychosocial obstacles hindering postpartum follow-up. Methods Consenting participants (women with undocumented HIV status and ≥24 weeks gestational age (GA) and imminent delivery or ≥34 weeks GA) in 6 cities were rapidly tested and interviewed. HIV-positive women were offered follow-up. Results From 2001–2005, 54 HIV-infected women were identified: median age 26 years; 91% African American; 11 (20%) lost custody of their infants; 30 (56%) knew they or their partner were HIV-infected, but had no antenatal HIV care; 25 met criteria for starting antiretroviral therapy. Comparison between 48 HIV-infected and 130 HIV-negative women, tested and interviewed at the same hospitals, showed HIV-infected women more likely to be African American (P < .01) and report no prenatal care (P < .001), use street drugs (P < .01), have unstable residency (P < .05), not live with the father of their infant (P < .001), and have children in foster care (P < .01). Sixteen women (30%) and 17 (31%) infants did not remain in follow-up study due to relocation, child protective custody, and psychosocial issues including frequent substance use. Conclusion Over half of HIV-infected women knew they or their partner were infected with HIV, but did not initially disclose their status. Increased support services and substance abuse treatment are critical to facilitate better continuity of care for these socially marginalized women.

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Title: Women Identified with HIV at Labor and Delivery: Testing, Disclosing and Linking to Care Challenges
Authors: Mardge H. Cohen
Yolanda Olszewski
Mayris P. Webber
Nancy Blaney
Patricia Garcia
Robert Maupin
Steven Nesheim
Denis Agniel
Susan P. Danner
Margaret A. Lampe
Marc Bulterys
Publication date: 01-09-2008
Publisher: Springer US
Published in: Maternal and Child Health Journal / Issue 5/2008
Print ISSN: 1092-7875
Electronic ISSN: 1573-6628
DOI: https://doi.org/10.1007/s10995-007-0265-5

Keynote webinar | Spotlight on medication adherence

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Women Identified with HIV at Labor and Delivery: Testing, Disclosing and Linking to Care Challenges

Abstract

Keynote webinar | Spotlight on medication adherence

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