以妇幼保健网络为基础的健康教育对孕妇接受HIV抗体检测的干预效果评价

目的 评价以妇幼保健网络为基础的预防艾滋病母婴传播(Prevention of mother to child transmission,PMTCT)健康教育干预措施,对孕妇孕期艾滋病病毒(HIV)抗体检测率的影响.方法 现场干预研究.选择社会特征相近的两个地区分别作为干预地区和对照地区,在基线调查的基础上,对干预地区的孕妇开展为期一年的预防艾滋病母婴传播健康教育干预活动.干预前后分别对两地区孕妇进行问卷调查,比较调查对象孕期HIV抗体检测率的变化,评价健康教育的干预效果.结果 共调查1 541名孕妇,其中干预地区933人,对照地区组608人.干预后,干预地区孕妇孕期HIV抗体检测率,由干预前的34.27%提高至干预后的72.49%;对照地区孕妇孕期HIV抗体检测则由5.83%提高到20.38%.干预地区孕妇孕期HIV抗体检测率高于对照区52.11%,差异有显著的统计学意义(X2=24.60,P<0.01).多因素分析结果显示,预防艾滋病母婴传播健康教育干预措施有效,干预效应OR值为2.01(95%CI:1.60,2.49).结论 依托妇幼县、乡、村三级保健网络,由基层妇幼保健工作人员具体实施,针对育龄妇女(包括孕妇)的预防艾滋病母婴传播健康教育,可有效提高孕妇对HIV抗体检测服务的接受和利用.     

预防艾滋病母婴传播项目长效工作机制研究

目的通过对深圳市预防艾滋病母婴传播项目工作,与卫生系统多部门常规工作相整合的运行机制进行系统的研究,为其他地区提供有益的借鉴。方法采用定性研究和定量研究。通过文献检索和现有资料收集的方法,了解2008-2010年深圳市孕产妇艾滋病病毒(HIV)抗体检测情况和感染HIV孕妇抗病毒治疗情况。通过小组访谈方法,了解项目运行机制。结果深圳市预防艾滋病母婴传播项目的覆盖率为100%,孕产妇检测率超过95%,孕妇和分娩儿童抗病毒治疗率超过90%。HIV感染孕产妇的产前保健和助产服务整合入妇幼保健常规工作,母婴随访整合入疾控系统HIV感染者随访工作,孕期抗病毒治疗整合入医政系统抗病毒治疗工作。结论与卫生系统多部门的常规工作相整合的工作机制,能够明显提高项目的运行质量,有助于建立高标准的长效运作机制。     

我国艾滋病母婴传播水平传播时期及干预效果研究

目的 了解我国部分艾滋病高流行地区艾滋病母要传播水平、传播时期及预防艾滋病母婴传播干预措施的效果.方法 在艾滋病病毒(HIV)感染相对高发的4个省15个县/市/区,于2004年12月至2007年6月,对287名确诊的艾滋病病毒Ⅰ型(HIV-1)感染孕产妇进行问卷调查及追踪管理,对其分娩的287名婴幼儿进行HIV-1DNAPCR检测和HIV抗体检测.结果 287名HIV-1感染孕产妇分娩的婴幼儿中,38名婴幼儿感染了HIV,艾滋病母婴传播总体水平为13.24%(38/287);未采取任何干预措施的孕产妇组艾滋病母婴传播水平为34.78%,规范应用抗逆转录病毒药物和采取人工喂养措施组的母婴传播率为4.48%,人群水平的总体母婴传播率从34.78%下降到13.24%,下降率为61.94%(x2=7.82,P＜0.01).24例HIV感染婴幼儿可明确其发生艾滋病母婴传播的时期,37.50%(9/24)母婴传播发生在宫内,33.33%(8/24)发生在产时,29.17%(7/24)为产后经母乳喂养传播.结论 预防艾滋病母婴传播干预措施能有效降低艾滋病母婴传播水平,应加强提供规范的预防艾滋病母婴传播干预措施,进一步降低母婴传播率.     

乙肝疫苗对母婴传播预防效果的评价

乙型肝炎疫苗预防乙型肝炎的效果已被公认,观察其阻断母婴传播的效果国内、外已有不少报导,根据我国乙型肝炎病毒的传播研究,母婴传播是主要传播途径之一,目前我国已开始对新生儿采取计划免疫,但在采用何种方案免疫效果最佳?免疫剂量和免疫效果的关系、如何评价其免疫效果及复种之时间等,意见尚不完全统一。根据国内、外的报导及我们多年的实践,简单介绍如下。     

南阳市2003-2007年预防艾滋病母婴传播工作情况分析

预防艾滋病母婴传播是艾滋病防治工作的重点之一。南阳市自2003年10月开展了预防艾滋病母婴传播工作,为了解目前预防艾滋病母婴传播工作的开展情况及干预效果,现将有关情况分析如下。     

广西横县2010-2015年预防艾滋病母婴传播效果分析北大核心

艾滋病是威胁人类健康及社会经济发展的重大卫生和社会问题。感染艾滋病病毒（Human immuno deficiency virus,HIV）的妇女在怀孕、分娩或产后哺乳等过程中均可能将HIV传染给其所娩婴儿。近年来,全国HIV感染者中母婴传播的比例为1%左右,预防艾滋病母婴传播是艾滋病防治的工作重点之一。     

HIV的母婴传播及干预措施

艾滋病病毒(HIV)感染的妇女在怀孕、分娩和产后哺乳等过程中可将HIV传染给胎儿或婴儿。加强孕产妇和育龄期妇女HIV监测、积极开展健康教育,做好咨询,实施预防性抗病毒治疗和非母乳化喂养等措施,可以降低母婴传播的几率,有效地保护儿童健康。     

不同用药方法阻断艾滋病母婴传播73例临床观察

目的 观察不同用药方法 阻断艾滋病母婴传播效果.方法 2005~2007年应用维乐命方案(方案1)阻断HIV母婴传播26例,2008~2010年联合应用三联抗病毒药物方案(方案2)阻断HIV母婴传播47例.所出生的婴儿均采用人工喂养,随访观察至18月龄.结果 两种方案出生的婴儿外观均未见畸形,方案1出现2例婴儿HIV阳性(母儿均服药及仅婴儿服药各1例);方案2出现1例婴儿HIV阳性(仅婴儿服药),母儿均服药均为阴性.结论 对HIV阳性孕妇采取综合干预措施(抗病毒药物治疗、婴儿人工喂养)能有效阻断HIV母婴传播.     

云南省4个地区780名孕产妇预防HIV/AIDS母婴垂直传播知识态度调查

目的 了解云南省艾滋病病毒(HIV)不同流行地区孕妇时艾滋病(AIDS)的知识、态度及行为，为开展宣传教育、阻断母曼垂直传播自愿咨询、检测提供依据。方法 选择省、地区、县不同地理分布，孕妇HIV感染率高、中、低的4个地区孕产妇为调查对象，用问卷调查表收集关于AIDS，特别是母婴垂直传播有关的知识、态度及行为方面资料。结果 4个地区共调查780名孕产妇，其中641人听说过AIDS，占82．2％，有关三种传播途径的正确回答率为55．0％一83．7％，但73％的孕产妇认为日常生活中共餐、接吻、握手或入厕等会传播，37．2％的人对婚前姓行为的观念表示接受，77．2％一81．8％的孕产妇认为婚检及产前检查中应加入HIV检测，91．4％的孕产妇愿意医生为其提供有关HIV知识宣传；83．6％一84．5％孕产妇愿意接受人工流产术、剖腹产及降低垂直传播的药物治疗。62．1％的孕产妇认识到安全套可预防AIDS传播。结论 孕产妇对AIDS的认识比较低，但愿意积极参与降低HIV垂直传播的工作。应加强预防AIDS宣传教育，特别是尽快在重点地区探索开展降低孕妇HIV垂直传播的工作，以预防AIDS的母婴垂直传播。     

兰州市孕妇AIDS/STI健康教育及相关知识分析

目的 了解兰州市孕妇艾滋病病毒(HIV)感染情况和艾滋病／性传播感染(AIDS／STI)及相关知识的现状。方法 对2所妇幼保健医院的孕妇进行匿名问券调查，同时进行HIV抗体检测。结果 共调查300名孕妇，未检出HIV阳性者。孕妇平均年龄27岁，以汉族、高中及以上文化程度、本地户口、工人和干部占大多数，安全套为首选避孕措施。对一般性AIDS／STI知识及性、血液、母婴三个传播途径知晓率较高。但对游泳、同厕、蚊虫叮咬认识有偏差。部分调查对象及配偶有吸毒、有偿供血、患过性病、流动性等高危行为存在。绝大多数未参加过AIDS／STD知识的宣传，其相关知识的获得以广播、电视等大众传媒为主。结论 HIV已由特殊人群向一般人群扩散蔓延，应有针对性的加强宣传，提高认识，改善检测条件，并进行大样本调查以明确事实。     

Knowledge of HIV transmission through breast milk among drug-dependent pregnant women

Abstract The current study examined the correlates of knowledge about human immunodeficiency virus (HIV) transmission through breast milk among drug-dependent pregnant women. There is a tremendous need to examine the knowledge about HIV transmission through breastfeeding among this largely understudied, but high-risk subset of pregnant women in order to minimize the extent to which they pass HIV to their children after giving birth. Participants included 97 pregnant women from Baltimore, MD, USA. Prevalence of drug use over the last 6 months included 37.1% reporting smoking marijuana, 36.1% injecting heroin, and 67.0% smoking crack. When asked whether HIV could be transmitted through breast milk, 72 women (74.2%) answered correctly. Our results indicate that the overall knowledge about transmission through breast milk is relatively low. Furthermore, participants who smoked crack during the past 6 months and participants who were white were significantly less likely to have correct knowledge about this topic. Our findings have important implications with regard to preventive interventions for this population. Future research is needed to determine how to best modify these interventions to address the specific needs of drug-dependent pregnant women, and how to specifically target white women and women who smoke crack.     

170例HIV感染孕妇的妊娠结局分析

目的探讨并分析HIV感染孕妇的临床特征及妊娠结局。方法收集本院2007年1月—2018年11月期间HIV感染孕妇的流行病学资料,分析其流行病学特征以及妊娠结局。结果共纳入170例HIV感染孕妇,感染的主要方式为异性性传播。近3年诊治的HIV感染孕妇数量较前几年明显增多。孕妇的主要抗病毒方案为齐多夫定或替诺福韦+拉米夫定+洛匹那韦/利托那韦。婴儿主要抗病毒方案为齐多夫定或奈韦拉平。母婴阻断成功率100%。结论HIV感染孕妇数量呈上升趋势,及时对HIV感染孕妇进行规范系统的抗病毒治疗及对HIV暴露婴儿进行预防可有效阻断HIV母婴传播。     

Non-disclosure to male partners and incomplete PMTCT regimens associated with higher risk of mother-to-child HIV transmission: a national survey in Kenya

Health worker experience and community support may be higher in high HIV prevalence regions than low prevalence regions, leading to improved prevention of mother-to-child HIV transmission (PMTCT) programs. We evaluated 6-week and 9-month infant HIV transmission risk (TR) in a high prevalence region and nationally. Population-proportionate-to-size sampling was used to select 141 clinics in Kenya, and mobile teams surveyed mother-infant pairs attending 6-week and 9-month immunizations. HIV DNA testing was performed on HIV-exposed infants. Among 2521 mother-infant pairs surveyed nationally, 2423 (94.7%) reported HIV testing in pregnancy or prior diagnosis, of whom 200 (7.4%) were HIV-infected and 188 infants underwent HIV testing. TR was 8.8% (4.0%–18.3%) in 6-week and 8.9% (3.2%–22.2%) in 9-month cohorts including mothers with HIV diagnosed postpartum, of which 53% of infant infections were due to previously undiagnosed mothers. Of 276 HIV-exposed infants in the Nyanza survey, TR was 1.4% (0.4%–5.3%) at 6-week and 5.1% (2.5%–9.9%) at 9-months. Overall TR was lower in Nyanza, high HIV region, than nationally (3.3% vs. 7.2%, P?=?0.02). HIV non-disclosure to male partners and incomplete ARVs were associated with TR in both surveys [aOR?=?12.8 (3.0–54.3); aOR?=?5.6 (1.2–27.4); aOR?=?4.5 (1.0–20.0), aOR?=?2.5, (0.8–8.4), respectively]. TR was lower in a high HIV prevalence region which had better ARV completion and partner HIV disclosure, possibly due to programmatic efficiencies or community/peer/partner support. Most 9-month infections were among infants of mothers without prior HIV diagnosis. Strategies to detect incident or undiagnosed maternal infections will be important to achieve PMTCT.     

Effect of exposure to clinic-based health education interventions on behavioural intention to prevent mother-to-child transmission of HIV infection

HIV and AIDS incidence among infants in South Africa is on the increase. The uptake of prevention of mother-to-child transmission (PMTCT) interventions is often said to be dependent on the beliefs and educational needs of those requiring PMTCT services. This study therefore sought to examine the effect of clinic-based health education interventions (HEI) on behavioural intention of PMTCT among 300 pregnant women from 4 primary health care clinics in Tshilidzini Hospital catchments area, South Africa. An interview schedule was used to obtain information regarding participants' demographic characteristics, level of exposure to clinic-based HEI, salient beliefs and behavioural intention on PMTCT. The major findings included that approximately 85% of the participants had heard of PMTCT. There was very little association between frequency of antenatal clinic (ANC) visits and level of exposure to PMTCT information. Condom use had the lowest set of salient belief scores. Control belief was the most common belief contributing to behavioural intention. Generally, the association between PMTCT salient beliefs and behavioural intention was weak. Clinic-based HEI had an impact on behavioural intention of HIV testing, normative belief of regular ANC visit and nevirapine use. The vital contribution of alternative PMTCT information sources such as the radio and television was observed. Enhancing initiatives that empower women, and a better coordination of the existing HEI through better implementation of health education strategy may strengthen the prevailing moderate PMTCT intention in the area investigated.     

河南省2005-2007年孕产妇HIV检测情况分析

目的了解河南省孕产妇艾滋病病毒（HIV）感染状况,为开展预防艾滋病母婴传播工作提供决策依据。方法对2005年1月-2007年5月,河南省艾滋病疫情相对集中的31个县（区）孕产妇的HIV检测结果进行分析。结果共对31个艾滋病重点县720605名孕妇和产妇检测HIV抗体,检测率93.11%;检测出HIV抗体阳性541例,阳性率0.08%。其中364例为阳性孕妇,223例自愿终止妊娠（占61.27%）,5例失访（1.37%）,136例选择继续妊娠待分娩（占37.36%）。3年间选择继续妊娠的HIV阳性孕妇,分别为31.51%（46/146）、36.31%（57/157）、54.10%（33/61）,呈逐年上升趋势。284例分娩阳性产妇中,250例（88%）采取了母婴阻断预防措施。结论加强孕产妇HIV检测和阳性育龄妇女的孕检工作,早期发现、早期管理HIV阳性孕妇,可以进一步提高HIV阳性产妇的药物阻断率。