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A mixed-methods approach to understanding barriers to postpartum retention in care among low-income, HIV-infected women.
AIDS Patient Care STDS. 2015 Mar; 29(3):126-32.AP

Abstract

Optimal retention in HIV care postpartum is necessary to benefit the health and wellbeing of mothers and their infants. However, postpartum retention in HIV care among low-income women is suboptimal, particularly in the Southern United States. A mixed-methods study was conducted to identify factors associated with postpartum retention in care among HIV-infected women. Participants (n=35) were recruited during pregnancy at two county clinics and completed self-report demographic and psychosocial surveys. Twenty-two women who returned for a postpartum appointment completed a semi-structured interview about lifestyle factors and retention in care. Of the participants enrolled at baseline, 71.4% completed a follow-up with an obstetrician (OB), while 57.1% completed a follow-up with a primary care physician (PCP). High CD4 count at delivery, low viral load at baseline, low levels of depression, high interpersonal social support, and fewer other children were significantly associated with completion of postpartum follow-up. Barriers and facilitators to retention identified during qualitative interviews included competing responsibilities for time, lack of social support outside of immediate family members, limited transportation access, experiences of institutionalized stigma, knowledge about the benefits of adherence, and strong relationships with healthcare providers. OB and PCP follow-up postpartum was suboptimal in this sample. Findings underscore the importance of addressing depressive symptoms, social support, viral suppression, competing responsibilities for time, institutionalized stigma, and transportation issues in order to reduce the barriers that inhibit women from seeking postpartum HIV care.

Authors+Show Affiliations

1 Department of Periodontics, University of Texas Health Science Center at San Antonio , San Antonio, Texas.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

25612217

Citation

Buchberg, Meredith K., et al. "A Mixed-methods Approach to Understanding Barriers to Postpartum Retention in Care Among Low-income, HIV-infected Women." AIDS Patient Care and STDs, vol. 29, no. 3, 2015, pp. 126-32.
Buchberg MK, Fletcher FE, Vidrine DJ, et al. A mixed-methods approach to understanding barriers to postpartum retention in care among low-income, HIV-infected women. AIDS Patient Care STDS. 2015;29(3):126-32.
Buchberg, M. K., Fletcher, F. E., Vidrine, D. J., Levison, J., Peters, M. Y., Hardwicke, R., Yu, X., & Bell, T. K. (2015). A mixed-methods approach to understanding barriers to postpartum retention in care among low-income, HIV-infected women. AIDS Patient Care and STDs, 29(3), 126-32. https://doi.org/10.1089/apc.2014.0227
Buchberg MK, et al. A Mixed-methods Approach to Understanding Barriers to Postpartum Retention in Care Among Low-income, HIV-infected Women. AIDS Patient Care STDS. 2015;29(3):126-32. PubMed PMID: 25612217.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A mixed-methods approach to understanding barriers to postpartum retention in care among low-income, HIV-infected women. AU - Buchberg,Meredith K, AU - Fletcher,Faith E, AU - Vidrine,Damon J, AU - Levison,Judy, AU - Peters,Marlyn Yvette, AU - Hardwicke,Robin, AU - Yu,Xiaoying, AU - Bell,Tanvir K, Y1 - 2015/01/22/ PY - 2015/1/23/entrez PY - 2015/1/23/pubmed PY - 2015/5/15/medline SP - 126 EP - 32 JF - AIDS patient care and STDs JO - AIDS Patient Care STDS VL - 29 IS - 3 N2 - Optimal retention in HIV care postpartum is necessary to benefit the health and wellbeing of mothers and their infants. However, postpartum retention in HIV care among low-income women is suboptimal, particularly in the Southern United States. A mixed-methods study was conducted to identify factors associated with postpartum retention in care among HIV-infected women. Participants (n=35) were recruited during pregnancy at two county clinics and completed self-report demographic and psychosocial surveys. Twenty-two women who returned for a postpartum appointment completed a semi-structured interview about lifestyle factors and retention in care. Of the participants enrolled at baseline, 71.4% completed a follow-up with an obstetrician (OB), while 57.1% completed a follow-up with a primary care physician (PCP). High CD4 count at delivery, low viral load at baseline, low levels of depression, high interpersonal social support, and fewer other children were significantly associated with completion of postpartum follow-up. Barriers and facilitators to retention identified during qualitative interviews included competing responsibilities for time, lack of social support outside of immediate family members, limited transportation access, experiences of institutionalized stigma, knowledge about the benefits of adherence, and strong relationships with healthcare providers. OB and PCP follow-up postpartum was suboptimal in this sample. Findings underscore the importance of addressing depressive symptoms, social support, viral suppression, competing responsibilities for time, institutionalized stigma, and transportation issues in order to reduce the barriers that inhibit women from seeking postpartum HIV care. SN - 1557-7449 UR - https://www.unboundmedicine.com/medline/citation/25612217/A_mixed_methods_approach_to_understanding_barriers_to_postpartum_retention_in_care_among_low_income_HIV_infected_women_ L2 - https://www.liebertpub.com/doi/full/10.1089/apc.2014.0227?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -