Author | Zachek, Christine M. | |
Author | Coelho, Lara E. | |
Author | Clark, Jesse L. | |
Author | Domingues, Rosa M. S. M. | |
Author | Luz, Paula M. | |
Author | Friedman, Ruth K. | |
Author | Andrade, Ângela C. Vasconcelos de | |
Author | Veloso, Valdiléa G. | |
Author | Lake, Jordan E. | |
Author | Grinsztejn, Beatriz | |
Author | De Boni, Raquel B. | |
Access date | 2023-08-02T20:09:55Z | |
Available date | 2023-08-02T20:09:55Z | |
Document date | 2023 | |
Citation | ZACHEK, Christine M. et al. Reproductive health syndemics impact retention in care among women living with HIV in Rio de Janeiro, Brazil. The Brazilian Journal of Infectious Diseases, v. 27, n. 4, p. 1-10, May 2023. | en_US |
ISSN | 1413-8670 | en_US |
URI | https://www.arca.fiocruz.br/handle/icict/59884 | |
Sponsorship | We would like to thank the INI-Fiocruz study participants and staff who devoted their time and efforts to make this project possible. This work was supported in part by NIH-funded Caribbean, Central and South America network for HIV epidemiology (CCASAnet), a member cohort of the International Epidemiologic Databases to Evaluate AIDS (leDEA) (U01AI069923) and the Instituto Nacional de Infectologia Evandro Chagas, Fundac¸ ao Oswaldo Cruz. This work was also supported in part by the Doris Duke Charitable Foundation through a grant supporting the Doris Duke International Clinical Research Fellows Program at the University of California San Francisco. CMZ is a Doris Duke International Clinical Research Fellow. This work was also supported by the US National Institute of Health grants NIH R25 MH087222 to JLC and K23 AI110532 to JEL. BG acknowledges funding from Conselho Nacional de Desenvolvimento Científico e Tecnologico (CNPq) (305789/2019-8) and FAPERJ (E-26/202.915/2018). PML acknowledges funding from CNPq (316401/2021-8) and FAPERJ (E-26/201.133/2021). RBDB acknowledges funding from the Research Funding Agency of the State of Rio de Janeiro (FAPERJ) E-26/203.154/2017 and from the National Council of Technological and Scientific Development (CNPq) 310541/2017-4. | en_US |
Language | eng | en_US |
Publisher | Contexto | en_US |
Rights | open access | en_US |
Title | Reproductive health syndemics impact retention in care among women living with HIV in Rio de Janeiro, Brazil | en_US |
Type | Article | en_US |
DOI | 10.1016/j.bjid.2023.102779 | |
Abstract | Syndemic psychosocial and reproductive factors affecting women's retention in HIV care remain understudied. We analyzed correlates of non-retention in a cohort of women with HIV in Brazil from 2000‒2015. Participants self-reported exposure to physical/sexual violence, illicit drug use, adolescent pregnancy, or induced abortion. Lifetime history of these psychosocial stressors were used to create a syndemic score based on the presence or absence of these conditions. All dichotomous variables were summed (range 0 to 4), with greater scores indicating more syndemic factors experienced. Logistic regression models identified predictors of non-retention, defined as < 2 HIV viral load or CD4 results within the first year of enrollment. Of 915 women, non-retention was observed for 18%. Prevalence of syndemic factors was adolescent pregnancy (53.2%), physical/sexual violence (38.3%), induced abortion (27.3%), and illicit drug use (17.2%); 41.2% experienced ≥ 2 syndemic conditions. Syndemic scores of 2 and 3 were associated with non-retention, as well as low education, years with HIV and seroprevalent syphilis. Psychosocial and reproductive syndemics can limit women's retention in HIV care. Syphilis infection predicted non-retention and could be explored as a syndemic factor in future studies. | en_US |
Affilliation | University of California San Francisco. School of Medicine. San Francisco, CA, USA. | en_US |
Affilliation | Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brazil. | en_US |
Affilliation | University of California Los Angeles David Geffen School of Medicine. Department of Medicine. Los Angeles, CA, USA. | en_US |
Affilliation | Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brazil. | en_US |
Affilliation | Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brazil. | en_US |
Affilliation | Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brazil. | en_US |
Affilliation | Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brazil. | en_US |
Affilliation | Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brazil. | en_US |
Affilliation | The University of Texas Health Science Center at Houston. Department of Medicine. Houston, TX, USA. | en_US |
Affilliation | Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brazil. | en_US |
Affilliation | Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brazil. | en_US |
Subject | HIV | en_US |
Subject | Reproductive health | en_US |
Subject | Retention | en_US |
Subject | Syndemic | en_US |
Subject | Women | en_US |
e-ISSN | 1678-4391 | |