BMC Public Health
Volume 15, Issue 1, 2015

Adequacy of prenatal care among women living with human immunodeficiency virus: A population-based study (Article) (Open Access)

Ng R. , Macdonald E.M. , Loutfy M.R. , Yudin M.H. , Raboud J. , Masinde K.-I. , Bayoumi A.M. , Tharao W.E. , Brophy J. , Glazier R.H. , Antoniou T.*
  • a Institute for Clinical Evaluative Sciences, Toronto, ON, Canada
  • b Institute for Clinical Evaluative Sciences, Toronto, ON, Canada
  • c Institute for Clinical Evaluative Sciences, Toronto, ON, Canada, Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada, Department of Medicine, University of Toronto, Toronto, ON, Canada, Women's College Research Institute, Women's College Hospital, Toronto, ON, Canada
  • d Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada, Centre for Research on Inner City Health, St. Michael's Hospital, Toronto, ON, Canada, Department of Obstetrics and Gynecology, St. Michael's Hospital, University of Toronto, Toronto, ON, Canada
  • e Institute for Clinical Evaluative Sciences, Toronto, ON, Canada, Toronto General Research Institute, University Health Network, Toronto, ON, Canada, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
  • f Women's College Research Institute, Women's College Hospital, Toronto, ON, Canada
  • g Institute for Clinical Evaluative Sciences, Toronto, ON, Canada, Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada, Department of Medicine, University of Toronto, Toronto, ON, Canada, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada, Centre for Research on Inner City Health, St. Michael's Hospital, Toronto, ON, Canada
  • h Women's Health in Women's Hands Community Health Centre, Toronto, ON, Canada
  • i Children's Hospital of Eastern Ontario, University of Ottawa, Ottawa, ON, Canada
  • j Institute for Clinical Evaluative Sciences, Toronto, ON, Canada, Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada, Centre for Research on Inner City Health, St. Michael's Hospital, Toronto, ON, Canada, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada, Department of Family and Community Medicine, St. Michael's Hospital, University of Toronto, Toronto, ON, Canada
  • k Institute for Clinical Evaluative Sciences, Toronto, ON, Canada, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada, Department of Family and Community Medicine, St. Michael's Hospital, University of Toronto, Toronto, ON, Canada

Abstract

Background: Prenatal 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. Methods: Using 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. Results: Between 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. Conclusion: Despite 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. © 2015 Ng et al.; licensee BioMed Central.

Author Keywords

Prenatal care Disparity Immigrant Population-based HIV

Index Keywords

prenatal care Human immunodeficiency virus infection human middle aged Odds Ratio HIV Seropositivity ethnology Young Adult Humans migrant Adolescent Canada Emigrants and Immigrants female Africa pregnancy Caribbean Region prevalence Caribbean Ontario adult Healthcare Disparities health care disparity
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-84938976213&doi=10.1186%2fs12889-015-1842-y&partnerID=40&md5=e185d19d84020758e8d6bfedf6add0a5
DOI: 10.1186/s12889-015-1842-y
ISSN: 14712458
Cited by: 5
Original Language: English