Sexual and reproductive health in HIV-positive women: a dedicated clinic improves service

Coyne, Katherine; Hawkins, F; Desmond, N

doi:10.1258/095646207781024766

Cited by 25 publications

(27 citation statements)

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“…have demonstrated positive effects on condom use, contraceptive use, STI screening, and quality of services. Only three of these studies evaluated a comprehensive sexual health care package that addressed both women and men [24-26]. None of these studies examined the pre-test needs of patients, a key factor in the successful integration of services.…”

Section: Introductionmentioning

confidence: 99%

Improving sexual health for HIV patients by providing a combination of integrated public health and hospital care services; a one-group pre- and post test intervention comparison

et al. 2012

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BackgroundHospital HIV care and public sexual health care (a Sexual Health Care Centre) services were integrated to provide sexual health counselling and sexually transmitted infections (STIs) testing and treatment (sexual health care) to larger numbers of HIV patients. Services, need and usage were assessed using a patient perspective, which is a key factor for the success of service integration.MethodsThe study design was a one-group pre-test and post-test comparison of 447 HIV-infected heterosexual individuals and men who have sex with men (MSM) attending a hospital-based HIV centre serving the southern region of the Netherlands. The intervention offered comprehensive sexual health care using an integrated care approach. The main outcomes were intervention uptake, patients’ pre-test care needs (n=254), and quality rating.ResultsPre intervention, 43% of the patients wanted to discuss sexual health (51% MSM; 30% heterosexuals). Of these patients, 12% to 35% reported regular coverage, and up to 25% never discussed sexual health topics at their HIV care visits. Of the patients, 24% used our intervention. Usage was higher among patients who previously expressed a need to discuss sexual health. Most patients who used the integrated services were new users of public health services. STIs were detected in 13% of MSM and in none of the heterosexuals. The quality of care was rated good.ConclusionsThe HIV patients in our study generally considered sexual health important, but the regular counselling and testing at the HIV care visit was insufficient. The integration of public health and hospital services benefited both care sectors and their patients by addressing sexual health questions, detecting STIs, and conducting partner notification. Successful sexual health care uptake requires increased awareness among patients about their care options as well as a cultural shift among care providers.

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Section: Introductionmentioning

confidence: 99%

Improving sexual health for HIV patients by providing a combination of integrated public health and hospital care services; a one-group pre- and post test intervention comparison

et al. 2012

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“…Such integrated services have been shown to improve sexual and reproductive service provision in HIV-positive women. 6 Extra vigilance has been required as most of our patients belong to ethnic minority and refugee groups and low coverage has been documented among this group of women, who are also a mobile population (22 patients in our audit were lost to follow-up after initial screening). [7][8][9] They may have originated from countries where there is no screening programme and therefore do not realise the importance of screening.…”

Section: Discussionmentioning

confidence: 99%

Cervical surveillance in HIV-positive women: a genitourinary medicine clinic experience

Ibrahim

Schembri²,

Taha³

et al. 2009

j fam plann reprod health care

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Background The prevalence of cervical intraepithelial neoplasia (CIN) is increased in HIV infection. The UK National Health Service Cervical Screening Programme (NHSCSP) guidelines therefore provide specific recommendations for HIV-positive women. An audit of cervical surveillance in HIV-positive women who attend the genitourinary medicine (GUM) department at the Leicester Royal Infirmary, Leicester, UK was conducted. The objectives were to assess adherence to UK and local screening guidelines, prevalence of cervical pathology and appropriate referral for colposcopy. Results Results showed that 76.2% of patients had cervical cytology within a year of HIV diagnosis and 42.4% of patients had abnormal cytology. All patients with dyskaryosis were referred for colposcopy according to local and national guidelines. Cytology results were 101 ©FSRH

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“…Guidelines for organization of such clinics were recently published by the British Association for Sexual Health and HIV (). Evaluation of one such clinic showed that all aspects of sexual health services were improved following integration of these different aspects of female health (Coyne et al ., 2007). …”

Section: Methodsmentioning

confidence: 99%

Contraception and HIV infection in women

Heikinheimo

Lähteenmäki

2008

Human Reproduction Update

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BACKGROUNDMore than 15 million women, many of reproductive age, were infected with human immunodeficiency virus (HIV) at the end of 2007. As the HIV epidemic evolves, heterosexual intercourse is increasingly risky: the risk of infection in exposed young women is 4- to 7-fold higher than in young men and nearly half a million newborns annually have HIV. This review aims to show the effect of contraceptive choices on risk of HIV and on the course of disease in women with HIV.METHODSRelevant citations were selected by agreement between the authors after a search of MEDLINE using the terms HIV/AIDS and contraception.RESULTSRisk of transmission of HIV varies from 1 in 200 to 1 in 10 000 coital incidents, depending in part on the integrity of the vaginal epithelium. Consistent use of male condoms has been proven to reduce horizontal transmission of HIV by 80% among HIV-serodiscordant couples. Hormonal contraception may increase the risk of HIV acquisition in high-risk women such as commercial sex workers, but not in women at low risk of HIV. While hormonal contraception did not affect progression of disease in two cohort studies involving 370 women, in a randomized trial among women not receiving antiretroviral medication, clinical disease accelerated in the oral contraception group (13.2/100 woman-years) compared with the copper intrauterine devices group (8.6/100 woman-years; hazard ratio, 1.5; 95% confidence interval, 1.04–2.1). Hormonal contraception does not interfere with antiviral drug effectiveness.CONCLUSIONSAll the available reversible contraceptive methods can generally be used by women at risk of HIV infection and by HIV-infected women. Further studies are needed to investigate the safety and efficiency of hormonal contraception in women living with HIV/AIDS.

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Sexual and reproductive health in HIV-positive women: a dedicated clinic improves service

Abstract: We run a one-stop clinic for HIV-positive women, offering sexually transmitted infection screening, cervical cytology and family planning. We completed an audit cycle, and showed that all aspects of our care had improved since the introduction of this integrated service.

Cited by 25 publications

References 0 publications

Improving sexual health for HIV patients by providing a combination of integrated public health and hospital care services; a one-group pre- and post test intervention comparison

Improving sexual health for HIV patients by providing a combination of integrated public health and hospital care services; a one-group pre- and post test intervention comparison

Cervical surveillance in HIV-positive women: a genitourinary medicine clinic experience

Contraception and HIV infection in women

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