Incidence of home delivery among women living with HIV in Lira, Northern Uganda: a prospective cohort study

Abstract Background Home delivery has been associated with mother-to-child transmission of HIV and remains high among HIV-infected women. Predictors for home delivery in the context of HIV have not been fully studied and understood in Northern Uganda. We therefore aimed to find out the incidence and...

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Autores principales:	Agnes Napyo Kasede, Thorkild Tylleskär, David Mukunya, Josephine Tumuhamye, Grace Ndeezi, Anna Agnes Ojok Arach, Paul Waako, James K. Tumwine
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	HIV Women Home delivery Facility delivery PMTCT Gynecology and obstetrics RG1-991
Acceso en línea:	https://doaj.org/article/ccc6cf2e3c6a407f9089bd553e67916d
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spelling	oai:doaj.org-article:ccc6cf2e3c6a407f9089bd553e67916d2021-11-14T12:32:33ZIncidence of home delivery among women living with HIV in Lira, Northern Uganda: a prospective cohort study10.1186/s12884-021-04222-51471-2393https://doaj.org/article/ccc6cf2e3c6a407f9089bd553e67916d2021-11-01T00:00:00Zhttps://doi.org/10.1186/s12884-021-04222-5https://doaj.org/toc/1471-2393Abstract Background Home delivery has been associated with mother-to-child transmission of HIV and remains high among HIV-infected women. Predictors for home delivery in the context of HIV have not been fully studied and understood in Northern Uganda. We therefore aimed to find out the incidence and risk factors for home delivery among women living with HIV in Lira, Northern Uganda. Methods This prospective cohort study was conducted between August 2018 and January 2020 in Lira district, Northern Uganda. A total of 505 HIV infected women receiving antenatal care at Lira regional referral hospital were enrolled consecutively and followed up at delivery. We used a structured questionnaire to obtain data on exposures which included: socio-demographic, reproductive-related and HIV-related characteristics. Data was analysed using Stata version 14.0 (StataCorp, College Station, Texas, U.S.A.). We estimated adjusted risk ratios using Poisson regression models to ascertain risk factors for the outcome of interest which was home delivery (which is delivering an infant outside a health facility setting under the supervision of a non-health worker). Results The incidence of home delivery among women living with HIV was 6.9% (95%CI: 4.9–9.5%). Single women were more likely to deliver at home (adjusted risk ratio = 4.27, 95%CI: 1.66–11). Women whose labour started in the night (night time onset of labour ARR = 0.39, 95%CI: 0.18–0.86) and those that were adherent to their ART (ARR = 0.33, 95%CI: 0.13–0.86) were less likely to deliver at home. Conclusion Home delivery remains high among women living with HIV especially those that do not have a partner. We recommend intensified counselling on birth planning and preparedness in the context of HIV and PMTCT especially for women who are: separated, divorced, widowed or never married and those that are not adherent to their ART.Agnes Napyo KasedeThorkild TylleskärDavid MukunyaJosephine TumuhamyeGrace NdeeziAnna Agnes Ojok ArachPaul WaakoJames K. TumwineBMCarticleHIVWomenHome deliveryFacility deliveryPMTCTGynecology and obstetricsRG1-991ENBMC Pregnancy and Childbirth, Vol 21, Iss 1, Pp 1-8 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	HIV Women Home delivery Facility delivery PMTCT Gynecology and obstetrics RG1-991
spellingShingle	HIV Women Home delivery Facility delivery PMTCT Gynecology and obstetrics RG1-991 Agnes Napyo Kasede Thorkild Tylleskär David Mukunya Josephine Tumuhamye Grace Ndeezi Anna Agnes Ojok Arach Paul Waako James K. Tumwine Incidence of home delivery among women living with HIV in Lira, Northern Uganda: a prospective cohort study
description	Abstract Background Home delivery has been associated with mother-to-child transmission of HIV and remains high among HIV-infected women. Predictors for home delivery in the context of HIV have not been fully studied and understood in Northern Uganda. We therefore aimed to find out the incidence and risk factors for home delivery among women living with HIV in Lira, Northern Uganda. Methods This prospective cohort study was conducted between August 2018 and January 2020 in Lira district, Northern Uganda. A total of 505 HIV infected women receiving antenatal care at Lira regional referral hospital were enrolled consecutively and followed up at delivery. We used a structured questionnaire to obtain data on exposures which included: socio-demographic, reproductive-related and HIV-related characteristics. Data was analysed using Stata version 14.0 (StataCorp, College Station, Texas, U.S.A.). We estimated adjusted risk ratios using Poisson regression models to ascertain risk factors for the outcome of interest which was home delivery (which is delivering an infant outside a health facility setting under the supervision of a non-health worker). Results The incidence of home delivery among women living with HIV was 6.9% (95%CI: 4.9–9.5%). Single women were more likely to deliver at home (adjusted risk ratio = 4.27, 95%CI: 1.66–11). Women whose labour started in the night (night time onset of labour ARR = 0.39, 95%CI: 0.18–0.86) and those that were adherent to their ART (ARR = 0.33, 95%CI: 0.13–0.86) were less likely to deliver at home. Conclusion Home delivery remains high among women living with HIV especially those that do not have a partner. We recommend intensified counselling on birth planning and preparedness in the context of HIV and PMTCT especially for women who are: separated, divorced, widowed or never married and those that are not adherent to their ART.
format	article
author	Agnes Napyo Kasede Thorkild Tylleskär David Mukunya Josephine Tumuhamye Grace Ndeezi Anna Agnes Ojok Arach Paul Waako James K. Tumwine
author_facet	Agnes Napyo Kasede Thorkild Tylleskär David Mukunya Josephine Tumuhamye Grace Ndeezi Anna Agnes Ojok Arach Paul Waako James K. Tumwine
author_sort	Agnes Napyo Kasede
title	Incidence of home delivery among women living with HIV in Lira, Northern Uganda: a prospective cohort study
title_short	Incidence of home delivery among women living with HIV in Lira, Northern Uganda: a prospective cohort study
title_full	Incidence of home delivery among women living with HIV in Lira, Northern Uganda: a prospective cohort study
title_fullStr	Incidence of home delivery among women living with HIV in Lira, Northern Uganda: a prospective cohort study
title_full_unstemmed	Incidence of home delivery among women living with HIV in Lira, Northern Uganda: a prospective cohort study
title_sort	incidence of home delivery among women living with hiv in lira, northern uganda: a prospective cohort study
publisher	BMC
publishDate	2021
url	https://doaj.org/article/ccc6cf2e3c6a407f9089bd553e67916d
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Incidence of home delivery among women living with HIV in Lira, Northern Uganda: a prospective cohort study

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