Public Health Commons^™

Reproductive Intentions And Corresponding Use Of Safer Conception Methods And Contraception Among Ugandan Hiv Clients In Serodiscordant Relationships., Glenn J. Wagner, Deborah Mindry, Emily A. Hurley, Jolly Beyeza-Kashesya, Violet Gwokyalya, Sarah Finocchario-Kessler, Rhoda K. Wanyenze, Mastula Nanfuka, Mahlet G. Tebeka, Kathy Goggin

Manuscripts, Articles, Book Chapters and Other Papers

CONTEXT: Among people living with HIV in Uganda, desires to have a child and unplanned pregnancies are both common, while utilization of safer conception methods (SCM) and modern contraceptives are low.

METHODS: Three hundred eighty-nine HIV clients who reported considering childbearing with their uninfected partner enrolled in a safer conception counseling intervention trial in Uganda. Multiple regression analysis and baseline data were used to examine correlates of reproductive intentions and behaviors, including use of safer conception methods and contraception.

RESULTS: Most (n = 313; 80.5%) reported that both they and their partner wanted to have a child now, which was …

Maternal Viral Load Monitoring: Coverage And Clinical Action At 4 Kenyan Hospitals., Matthew Sandbulte, Melinda Brown, Catherine Wexler, May Maloba, Brad Gautney, Kathy Goggin, Elizabeth Muchoki, Shadrack Babu, Nicodemus Maosa, Sarah Finocchario-Kessler

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Kenya's guidelines for prevention of mother-to-child transmission of HIV (PMTCT) recommend routine viral load (VL) monitoring for pregnant and breastfeeding women.

METHOD: We assessed PMTCT VL monitoring and clinical action occurring between last menstrual period (LMP) and 6 months postpartum at 4 Kenyan government hospitals. Pregnant women enrolled in the HIV Infant Tracking System from May 2016-March 2018 were included. We computed proportions who received VL testing within recommended timeframes and who received clinical action after unsuppressed VL result.

RESULTS: Of 424 participants, any VL testing was documented for 305 (72%) women and repeat VL testing was documented for …

Progress Toward Eliminating Mother To Child Transmission Of Hiv In Kenya: Review Of Treatment Guideline Uptake And Pediatric Transmission At Four Government Hospitals Between 2010 And 2012., Sarah Finocchario-Kessler, Kristine F. Clark, Samoel Khamadi, Brad J. Gautney, Vincent Okoth, Kathy Goggin, Hitsystem Study Team

Manuscripts, Articles, Book Chapters and Other Papers

We analyzed prevention of mother-to-child transmission (PMTCT) data from a retrospective cohort of n = 1365 HIV+ mothers who enrolled their HIV-exposed infants in early infant diagnosis services in four Kenyan government hospitals from 2010 to 2012. Less than 15 and 20 % of mother-infant pairs were provided with regimens that met WHO Option A and B/B+ guidelines, respectively. Annually, the gestational age at treatment initiation decreased, while uptake of Option B/B+ increased (all p's < 0.001). Pediatric HIV infection was halved (8.6-4.3 %), yet varied significantly by hospital. In multivariable analyses, HIV-exposed infants who received no PMTCT (AOR 4.6 [2.49, 8.62], p < 0.001), mixed foods (AOR 5.0 [2.77, 9.02], p < 0.001), and care at one of the four hospitals (AOR 3.0 [1.51, 5.92], p = 0.002) were more likely to be HIV-infected. While the administration and uptake of WHO PMTCT guidelines is improving, an expanded focus on retention and medication adherence will further reduce pediatric HIV transmission.

“I’M Just Like Everyone Else, I Just Happen To Be Hiv Positive”: Challenges Faced By Young Urban Black Women As They Strive To Achieve Normative Life Goals, M N. Mabachi, J K. Dariotis, J Anderson, S Finocchario-Kessler

Manuscripts, Articles, Book Chapters and Other Papers

Younger, low-income, black women are disproportionately affected by the HIV/AIDS epidemic in the U.S. Using thematic analysis of 20 semi-structured interviews with young women receiving HIV care in an urban east coast setting, this study provides insights on how living with HIV influences these women’s future aspirations including economic independence, intimate relationships, and family formation in the context of their socio-cultural and economic environment. One major emergent theme expressed by participants was the desire to be considered normal while seeking to meet the developmental benchmarks of emerging adulthood. Gaining economic independence through education and career opportunities was important, as was …