The Impact of Delivery in a Rural County on a Cohort of Women Living with HIV Infection and Their Infants

Abstract

Delivery in a rural county was not associated with an increased risk of perinatal HIV transmission. Women delivering in rural counties taking ART were less likely to have HIV viral suppression, which is a risk factor for perinatal HIV infection.

Factors associated with viral suppression among cisgender women living with human immunodeficiency virus in the United States: An integrative review

“… 13 However, drug use was reportedly higher among women who resided in urban regions compared with women in rural regions. 13 …”

“…HIV treatment regimens were associated with viral loads and ART adherence, as reported by three studies (see Figure 2 ). 13 , 24 , 30 One 24 of these studies reported that protease inhibitor-based regimens were associated with high viral loads, low CD4 count, and incidence of AIDS. Another study reported that women on protease inhibitor-based regimens were less likely to be virally suppressed than those not on protease inhibitor-based regimens.…”

“…Although not statistically significant, a single-tablet regimen was associated with improved quality of life and lower incidence of AIDS compared with those on multiple tablet regimens. 24 Similarly, Lazenby et al 13 examined women on single or multiple HIV treatment regimens and found that those on three or more had higher viral loads than women on fewer.…”

“…9 Taking antiretroviral therapy (ART) as prescribed can make HIV viral loads low enough that it is not detected in a standardized blood test, which is referred to as “undetectable viral load.” 9 People living with HIV who take their medication as prescribed and become virally suppressed have a 1% or less risk of transmitting the virus to others, including vertical transmission, as long as the virus remains “undetectable.” 10 Furthermore, viral suppression improves health outcomes, including reduced morbidity, increased longevity, and improved birth outcomes (such as birth weight and term birth) among pregnant women living with HIV. 11 – 13 …”

Article of the Year, Telehealth Services, and More in the Summer 2019 Issue of The Journal of Rural Health

“…In addition to rural telehealth, this issue of The Journal of Rural Health covers several other timely and important issues for rural health research, policy, and practice, including perinatal HIV transmission, alcohol use and treatment among patients with HIV, drunk driving among high school students, primary care providers’ knowledge of LGBTQ health concerns, social support and physical activity among American Indians, FQHC expansion, e‐cigarette use, and access to health information sources . I am sure that you will find each of these articles both interesting and applicable to advancing rural health research, policy, and practice.…”