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BMC Public Health

, 15:514

First Online: 29 May 2015Received: 12 August 2014Accepted: 14 May 2015DOI: 10.1186-s12889-015-1842-y

Cite this article as: Ng, R., Macdonald, E.M., Loutfy, M.R. et al. BMC Public Health 2015 15: 514. doi:10.1186-s12889-015-1842-y

Abstract

BackgroundPrenatal care reduces perinatal morbidity. However, there are no population-based studies examining the adequacy of prenatal care among women living with HIV. Accordingly, we compared the prevalence of adequate prenatal care among women living with and without HIV infection in Ontario, Canada.

MethodsUsing administrative data in a universal single-payer setting, we determined the proportions of women initiating care in the first trimester and receiving adequate prenatal care according to the Revised-Graduated Prenatal Care Utilization Index . We also determined the proportion of women with HIV receiving adequate prenatal care by immigration status. We used generalized estimating equations with a logit link function to derive adjusted odds ratios aORs and 95 % confidence intervals CI for all analyses.

ResultsBetween April 1, 2002 and March 31, 2011, a total of 1,132,135 pregnancies were available for analysis, of which 634 0.06 % were among women living with HIV. Following multivariable adjustment, women living with HIV were less likely to receive adequate prenatal care 36.1 % versus 43.3 %; aOR 0.74, 95 % CI 0.62 to 0.88 or initiate prenatal care in the first trimester 50.8 % versus 70.0 %; aOR 0.51, 95 % CI 0.43 to 0.60 than women without HIV. Among women with HIV, recent i.e. ≤ 5 years immigrants from Africa and the Caribbean were less likely to receive adequate prenatal care 25.5 % versus 38.5 %; adjusted odds ratio 0.51; 95 % CI, 0.32 to 0.81 than Canadian-born women.

ConclusionDespite universal health care, disparities exist in the receipt of adequate prenatal care between women living with and without HIV. Interventions are required to ensure that women with HIV receive timely and adequate prenatal care.

KeywordsPrenatal care HIV Disparity Population-based Immigrant AbbreviationsHIVHuman immunodeficiency virus

OHIPOntario health insurance plan

R-GINDEXRevised-graduated prenatal care utilization index

aORAdjusted odds ratio

CIConfidence interval

Electronic supplementary materialThe online version of this article doi:10.1186-s12889-015-1842-y contains supplementary material, which is available to authorized users.

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Autor: Ryan Ng - Erin M Macdonald - Mona R Loutfy - Mark H Yudin - Janet Raboud - Khatundi-Irene Masinde - Ahmed M Bayoumi - W

Fuente: https://link.springer.com/







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