HIV-INFECTED WOMEN AND INFANTS

Social and Health Factors Impeding Utilization of Health Care

Authors

  • Arlene M. Butz BSN, CPNP, ScD,

    Corresponding author
      8The Johns Hopkins University, School of Nursing, 600 North Wolfe Street, Baltimore, MD 21205.
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    • Arlene M. Butz, BSN, CPNP, ScD is currently an assistant professor at the Johns Hopkins University, School of Nursing, and a certified pediatric nurse practitioner in the newborn nursery at the Johns Hopkins Hospital, Baltimore, Maryland.

  • Nancy Hutton MD,

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    • Nancy Hutton, MD, is currently an assistant professor of pediatrics at the Johns Hopkins University, School of Medicine and is the director of the pediatric HIV/AIDS clinic at the Johns Hopkins Hospital, Baltimore, Maryland.

  • Mary Joyner RN, BS, CPNP,

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    • Mary Joyner, RN, BS, CPNP, is currently a pediatric nurse practitioner in the pediatric HIV/AIDS clinic at the Johns Hopkins Hospital, Baltimore, Maryland.

  • Judy Vogelhut RN, BS, CPNP,

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    • Judy Vogelhut, RN, BS, CPNP, was a pediatric nurse practitioner in the pediatric HIV/AIDS clinic at the Johns Hopkins Hospital, Baltimore, Maryland.

  • Donna Greenberg-Friedman BSN, MAS,

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    • Donna Greenberg-Friedman, BSN, MAS, is currently the nurse coordinator of the pediatric HIV/AIDS clinic at the Johns Hopkins Hospital, Baltimore, Maryland.

  • Deborah Schreibeis LGSW,

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    • Deborah Schreibeis, LGSW, was the social worker of the pediatric HIV/AIDS clinic at the Johns Hopkins Hospital, Baltimore, Maryland.

  • Jean R. Anderson MD

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    • Jean R. Anderson, MD, is currently an assistant professor of the department of general gynecology and obstetrics at the Johns Hopkins University, School of Medicine, Baltimore, Maryland.


8The Johns Hopkins University, School of Nursing, 600 North Wolfe Street, Baltimore, MD 21205.

ABSTRACT

The utilization of health care by HIV-seropositive pregnant women and their infants was studied in an indigent urban population. Ninety HIV-seropositive women delivered 99 HIV-exposed infants at the Johns Hopkins Hospital from August 1, 1988, to April 1, 1991. Repeat pregnancies occurred in 17 (18.9%) women during the study period. Completion of the primary immunization series by age nine months was the criteria for infant adherence to medical care. Of all infants, 72.9% achieved adequate immunization status by nine months. However, only 41 (45.6%) women reported ever seeking HIV-related health care. Factors associated with maternal adherence with HIV-related health care included HIV status of her infant, maternal drug use, and incarceration. Number of living children, maternal age, educational level, marital status, and repeat pregnancy were not associated with mothers seeking HIV-related health care. Despite low adherence to HIV-related health care in this sample of HIV-seropositive women, the majority of their infants did receive adequate immunizations, one proxy measure of adequate infant health care.

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