Mother-to-child HIV transmission prevention in Thailand: physician zidovudine use and willingness to provide care.

Bhatta MP, Stringer JS, Phanuphak P, Vermund SH
Int J STD AIDS. 2003 14 (6): 404-10

PMID: 12816669 · DOI:10.1258/095646203765371303

We conducted a mail survey of Thai physicians involved in obstetric care to assess attitudes and practices regarding zidovudine use during pregnancy and willingness to provide care for HIV-infected women in 1999. Of 845 respondents, 57% reported using perinatal zidovudine prophylaxis, an increase from 20% reported in 1997. Highest failure-to-use rates (52%) were among the respondents from Central and Southern Thailand and lowest failure rate was among those from the North (37%). Predictors of failure to use zidovudine in a multivariable logistic regression analysis were not knowing a source from which to obtain zidovudine (odds ratio [OR]=3.1), working in smaller hospitals (district/provincial/private hospitals) (OR=2.0), being from Eastern/Central/Southern Thailand (OR=1.4), unwillingness to perform caesarean section delivery on a HIV-positive women (OR=1.8), having provided antenatal care to fewer than 100 women in 1998 (OR=1.7), and unfamiliarity with Pediatric AIDS Clinical Trial Group 076 protocol (OR=2.9). A number of respondents described themselves as unwilling to perform pelvic examinations (15%), vaginal delivery (29%), or caesarean sections (37%) on HIV-infected pregnant women. About 39% of the respondents advocated elective terminations of pregnancy for HIV-infected women. Our survey indicates an increasing willingness of Thai physicians to use antiretroviral therapy to prevent mother-to-child HIV transmission and to provide obstetric care to HIV-infected women. However, availability and affordability remained major barriers to more widespread antiretroviral use in 1999.

MeSH Terms (22)

Adult Anti-HIV Agents Attitude of Health Personnel Drug Utilization Family Practice Female Gynecology Health Knowledge, Attitudes, Practice HIV Infections Humans Infectious Disease Transmission, Vertical Logistic Models Male Multivariate Analysis Obstetrics Physicians Practice Patterns, Physicians' Pregnancy Pregnancy Complications, Infectious Surveys and Questionnaires Thailand Zidovudine

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