A mixed-methods approach to understanding barriers to postpartum retention in care among low-income, HIV-infected women

Meredith K. Buchberg, Faith E. Fletcher, Damon J. Vidrine, Judy Levison, Marlyn Yvette Peters, Robin Hardwicke, Xiaoying Yu, Tanvir K. Bell

Research output: Contribution to journalArticle

31 Citations (Scopus)

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.

Original languageEnglish (US)
Pages (from-to)126-132
Number of pages7
JournalAIDS Patient Care and STDs
Volume29
Issue number3
DOIs
StatePublished - Mar 1 2015
Externally publishedYes

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Postpartum Period
HIV
Social Support
Postnatal Care
Primary Care Physicians
Interviews
Depression
Insurance Benefits
CD4 Lymphocyte Count
Viral Load
Health Personnel
Self Report
Life Style
Appointments and Schedules
Mothers
Demography
Pregnancy

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Infectious Diseases

Cite this

Buchberg, M. K., Fletcher, F. E., Vidrine, D. J., Levison, J., Peters, M. Y., Hardwicke, R., ... 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), 126-132. https://doi.org/10.1089/apc.2014.0227

A mixed-methods approach to understanding barriers to postpartum retention in care among low-income, HIV-infected women. / Buchberg, Meredith K.; Fletcher, Faith E.; Vidrine, Damon J.; Levison, Judy; Peters, Marlyn Yvette; Hardwicke, Robin; Yu, Xiaoying; Bell, Tanvir K.

In: AIDS Patient Care and STDs, Vol. 29, No. 3, 01.03.2015, p. 126-132.

Research output: Contribution to journalArticle

Buchberg, MK, Fletcher, FE, Vidrine, DJ, Levison, J, Peters, MY, Hardwicke, R, Yu, X & Bell, TK 2015, '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, pp. 126-132. https://doi.org/10.1089/apc.2014.0227
Buchberg, Meredith K. ; Fletcher, Faith E. ; Vidrine, Damon J. ; Levison, Judy ; Peters, Marlyn Yvette ; Hardwicke, Robin ; Yu, Xiaoying ; Bell, Tanvir K. / A mixed-methods approach to understanding barriers to postpartum retention in care among low-income, HIV-infected women. In: AIDS Patient Care and STDs. 2015 ; Vol. 29, No. 3. pp. 126-132.
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