ABSTRACT
The objective of this epidemiological study with cross-sectional design was to examine the rate of loss to postpartum follow-up in mothers with HIV infection and associated factors. This study comprised 468 mothers with HIV infection, both symptomatic and asymptomatic, who delivered their babies at a university hospital in Bangkok during the 4-year period from November 1, 2000 to October 31, 2004. The Risk Factors Assessment and Counseling Record Forms of the mothers were reviewed. Data were analyzed using frequency distributions, percentages, means, standard deviations, chi-square test, odds ratio calculation with 95% confidence interval (OR, 95% CI), and multiple logistic regression analysis. Results showed that, from 2001 to 2004, the rates of loss to postpartum follow-up in mothers with HIV infection were 32.8, 40.2, 46.5, and 37.0%, respectively, with a 4-year average of 38.7%. Factors significantly associated with the loss to postpartum follow-up in mothers with HIV infection included marital status (OR=3.5, 95% CI=1.94-6.33), adequacy of income (OR=2.13, 95% CI=1.45-3.14), antenatal care (OR=7.32, 95% CI=4.82-11.12), disclosure of HIV infection (OR=3.26, 95% CI=2.21-4.81), and marital relationship (OR=2.12, 95% CI=1.45-3.10). Multiple logistic regression analysis showed that two factors were predictive factors to the loss-to-postpartum follow-up rate in mothers with HIV infection including poor antenatal care (adjusted OR=5.15, 95% CI=3.29-8.05) and non disclosure of HIV infection (adjusted OR=2.15, 95% CI=1.38-3.36). Both factors could explain approximately 28.1% of the variance in the loss-to-follow-up rate in mothers with HIV infection. It is suggested that disclosure of HIV infection is another important issue that nurses should be concerned about. Nurses should be aware about the impacts of disclosing the infection status on mothers with HIV. Nurses should help the mother to explore the problems and barriers related to this issue for continuing of care in the future.