Considering childbearing in the age of highly active antiretroviral therapy (HAART): Views of HIV-positive couples

Objectives: Based on a qualitative study conducted in Bulawayo, Zimbabwe, this article examines how the availability of HAART since April 2004 may impact the views and choices of HIV-positive couples on childbearing. Methods: In-depth interviews were conducted with 15 couples where at least one partner was HIV positive. All respondents were of reproductive age and had or were confronting reproductive and sexual decision-making. Results: HAART seems to have had a profound impact on the subject of childbearing among those who still desire to have children. Where hitherto individuals had only a desire for a child many are now, as a result of the availability of HAART, actively planning to have one. HAART has not only transformed their physical state but it has also transformed mostly what had been desire into intention. The impact, however, has not been uniform. Some respondents still desired to have a child but were not yet convinced about the efficacy of HAART in preventing vertical transmission. Some respondents felt that HAART may have a negative impact on the foetus and as such were against childbearing by HIV-positive people. No respondent indicated that their desire or intention to have a child had been extinguished by the advent of HAART. Conclusion: Based on the findings of the study, HAART seems to have had a differential but nonetheless significant role in the reproductive plans of HIV-positive couples. The study also notes that there is a need to make available complete and unbiased information on HAART, mother-to-child transmission risk (MTCT) and pregnancy to HIV-positive couples so as to enable them to make informed decisions.     

育龄妇女生殖道感染病原学调查及药敏结果分析

目的：探讨本地育龄妇女生殖道感染的基本情况，包括致病病原体种类以及各病原体对抗生素的敏感性等，为临床治疗和用药提供指导。方法：选择2015年1～10月我院妇科门诊收治的1956例诊断为生殖道感染的育龄女性为研究对象，根据临床表现分为宫颈炎组、阴道炎组和单纯白带异常组。回顾性分析临床资料，包括阴道分泌物病原学检测结果以及病原体的药物敏感试验结果等。结果：1956份从生殖道感染的育龄妇女采集的阴道分泌物标本中检出病原体1030份，检出率为52.7％。1030例病原学检查阳性标本中，细菌所占比例最高（491/47.6％），其次依次为霉菌（476/46.2％）、支原体（41/4.0％）、衣原体（14/1.4％）、阴道毛滴虫（5/0.5％）和淋病奈瑟菌（3/0.3％）。病原体对抗生素均存在不同程度的耐药性。结论：本地育龄妇女生殖道感染发病率较高，由于用药不规范和患者自行用药，抗生素误用、滥用情况严重，病原体耐药情况不容乐观，必须引起重视。临床医生要根据病原体种类和药敏试验结果，合理使用抗生素，避免耐药情况进一步加剧。     

To have or not to have another child: life cycle, health and cost considerations of Ghanaian women

Given that fertility rates are high in most sub-Saharan countries, it is critically important to understand the drivers of the demand for children to inform population reduction policies. Yet little is known about the individual-level factors that drive the desire for fertility limitation. The desire to limit births may be driven by the achievement of family size targets. However, since children are born at different stages of the life course, fertility desires may also be influenced by past reproductive, socio-economic experiences, and perceptions about future welfare. In this study, the determinants of the desire to stop childbearing were analyzed at the individual-level using prospective longitudinal data (1998-2003) on the reproductive lives of women in six communities in southern Ghana. Using variation within-woman, we modeled the impact of changes in reproductive life cycle events, health status, perceptions of future household economic conditions, perceptions of the cost of additional children, and spousal interactions on a woman's fertility preferences. We found that the desire to stop childbearing is influenced by reproductive life stage (such as age, parity); events (marital transitions, child death); perceptions of personal health (particularly anticipated demands of the next pregnancy on the woman's health); the household's economic welfare; and the overall subjective cost of children. The economic utility models which emphasize cost/benefit considerations, as well as the anthropological and sociological theories which emphasize norms, appear to be validated in this empirical analysis in that both subjective elements and normative considerations are incorporated into fertility decisions.     

健康教育提高育龄妇女避孕效率降低人工流产率的研究

对1800例已婚育龄妇女的避孕和人工流产情况进行流行病学调查,94.7％妇女正在避孕,58.4％妇女有过人工流产。对IUD、避孕药和阴茎套的续用率进行生命表分析,IUD15年累积续用率0.51。用Tietze法分析了原因和Cox模型检测与人工流产发生有关因素,提示妇女避孕知识缺乏与操作人不认真是最主要的,通过健康教育人工流产率明显下降。     

陕西省农村地区育龄妇女生殖道感染现状分析

目的:了解农村已婚育龄妇女生殖道感染现状并分析其危险因素。方法:采用多阶段随机抽样的方法,对陕西省农村已婚育龄妇女进行问卷调查、妇科和实验室检查。结果:生殖道感染的检出率为76.57％。其中附件炎的检出率为11.65％,宫颈炎的检出率为38.74％,滴虫性阴道炎及念珠菌阴道炎的检出率分别为16.23％和9.95％。单因素分析发现,农村已婚育龄妇女生殖道感染的危险因素有既往曾患滴虫性阴道炎、不洁水洗澡、性生活次数多、经期有性生活、患病时丈夫态度消极及本人无经济来源。多因素Logistic回归分析发现既往曾患滴虫性阴道炎、经期性生活及不洁水洗澡为已婚育龄妇女生殖道感染的主要危险因素。结论:农村已婚育龄妇女生殖道感染的患病率较高,并存在多种危险因素。     

湖北省农村已婚育龄妇女慢性宫颈炎患病情况及其影响因素分析

目的 了解湖北省农村已婚育龄妇女慢性宫颈炎的患病情况及危险因素。方法 采用多级抽样方法，对湖北省大冶市、仙桃市、安陆市农村1003名已婚育龄妇女的慢性宫颈炎患病情况及其影响因素进行了研究，并应用Logistic回归进行多因素分析。结果 农村妇女慢性宫颈炎的患病率为46．1％，其中宫颈糜烂占65．6％。慢性宫颈炎的主要危险因素为过去生殖道感染病史、妊娠次数、是否用过避孕方法、经期下水田及是否使用单独浴巾。结论 湖北省农村妇女的慢性宫颈炎患病率较高，已成为一个严重的公共卫生问题。减少妊娠次数、规范基层计划生育站的结扎和放环操作、注意个人卫生等是减少慢性宫颈炎发病的重要措施。     

中国2013年18~49岁育龄妇女2型糖尿病患病率、知晓率、治疗率和控制率状况分析

目的 分析2013年中国18~49岁育龄妇女2型糖尿病患病水平及知晓、治疗和控制情况。方法 2013年在中国慢性病及其危险因素监测的302个监测点,采用多阶段分层整群随机抽样方法调查≥ 18岁居民共计176 534人,其中18~49岁女性46 674人。每名调查对象抽取静脉血测定FPG和糖化血红蛋白。自报无糖尿病病史者测定服糖后2 h血糖（OGTT-2 h）。糖尿病诊断标准依据1999年WHO糖尿病诊断标准FPG ≥ 7.0 mmol/L和/或OGTT-2 h ≥ 11.1 mmol/L。对样本经过复杂加权后,计算不同年龄、教育程度、城乡地区居民的糖尿病患病率及知晓率、治疗率和控制率。结果 中国18~49岁育龄妇女2型糖尿病患病率为5.6%,其中城市为5.7%,农村为5.4%;东、中、西部地区分别为5.8%、6.2%和4.4%,中、东部地区高于西部地区。在糖尿病人群中,患病知晓率、治疗率和控制率分别为29.3%、27.9%和29.4%;知晓自己患糖尿病的育龄妇女治疗率为95.4%,采取措施治疗的育龄妇女糖尿病控制率为38.9%;育龄妇女糖尿病知晓率呈现城市高于农村,治疗率在不同教育程度组间的差异有统计学意义,但趋势检验差异无统计学意义。结论 中国18~49岁育龄妇女2型糖尿病患病率较高,且无明显的城乡差异;而糖尿病知晓率、治疗率和控制率均处于较低水平,具有明显的城乡差异。     

育龄期慢性乙型肝炎女性患者的抗病毒治疗

本文介绍了近年来育龄期慢性乙型肝炎女性患者抗病毒治疗的一些研究结果,分析了育龄期女性干扰素的应用、核苷(酸)类药物在妊娠患者中应用的临床依据以及核苷(酸)类药物在阻断乙型肝炎病毒母婴传播中的意义及母乳喂养问题,指出对于育龄期未怀孕患者来说首选干扰素治疗,同时对于妊娠的患者来说,选择相对安全的核苷(酸)类药物抗病毒治疗可...     

肥胖与育龄期女性生殖功能研究进展

女性生殖功能受众多因素影响,肥胖是引起育龄期女性生殖能力降低的重要因素之一.育龄期肥胖女性可表现为月经紊乱,排卵障碍甚至不孕.肥胖与多囊卵巢综合征互为因果.肥胖影响辅助生殖技术的结局,使自然流产的风险增高,影响到妊娠的结局.避免超重及肥胖,积极控制多余体重,提高肥胖女性生育能力.     

不同避孕节育技术对已婚育龄妇女性生活质量影响的观察研究

目的：探讨不同避孕节育技术对已婚育龄女性性生活质量的影响,指导女性选择合适的避孕节育措施。方法：选取已婚育龄女性2384例作为调查对象,对其基本资料进行登记,要求所有被调查者对性生活质量满意程度进行评价,并通过《女性性生活质量量表》对其性生活质量进行评价。结果：被调查者有无生育史所采取的避孕措施存在着明显差异,无生育史者以避孕套、计算排卵期最为常见,分别占54．11％和31．32％,其次是采用避孕药避孕,占14．11％,没有人采用宫内节育器或者是结扎避孕。而有生育者多采用宫内节育器避孕,占59．34％,其次是避孕套和避孕药,分别占21．85％和15．01％,仅有少数患者采取结扎以及计算排卵期避孕。被调查是否有生育史所采取的避孕方式具有明显的差异,且这种差异具有统计学意义（P〈0．05）。未生育女性以及各种分娩方式的已经分娩女性采取不同避孕节育措施对性生活满意程度无明显差异,且《女性性生活质量量表》评分也无明显差异（P〉0．05）。结论：不同的避孕方式不会对女性的性生活质量造成明显的影响,已婚育龄女性可以根据自身的生育需求选择适宜的避孕措施。