Characterizing Healthcare Professionals Practices, Facilitators, and Barriers in Delivering Preconception Counseling: Perceived Impact on Prevention and Improvement of Outcomes for Birthing People Living with HIV Open Access
Thomas, Zahrya (Summer 2024)
Abstract
Background: Integrating preconception counseling (PCC) into HIV care is crucial for improving reproductive health outcomes for birthing people living with HIV. Despite its importance, there are various challenges in effectively delivering PCC in this context.
Goal: This project aims to explore how healthcare providers approach and deliver PCC, the barriers and facilitators faced in incorporating PCC into HIV care, and the impact of its integration on reproductive outcomes.
Methods: Seven healthcare professionals participated in in-depth interviews, which were transcribed and coded using a pre-developed codebook in MAXQDA. The data was analyzed to identify themes related to current PCC practices, perceived barriers and facilitators, and its impact on outcomes for birthing people living with HIV.
Results: Providers frequently discussed PCC, integrating these discussions into routine visits and emphasized ongoing conversations about fertility desires. Interdisciplinary and multidisciplinary collaboration between specialties was noted as beneficial. However, time constraints, lack of resources, and institutional and systemic barriers were significant obstacles. Patient-related barriers, cultural beliefs and socioeconomic factors also hindered effective PCC delivery into HIV care. Providers highlighted that PCC integration empowers patients and improves health planning, leading to better reproductive outcomes for birthing people living with HIV.
Conclusions: Systematic integration of PCC into HIV care is essential for enhancing reproductive health outcomes for birthing people living with HIV. Addressing barriers through policy changes, increased training, and resource allocation can significantly improve PCC delivery and empower birthing people living with HIV in their reproductive health decisions.
Table of Contents
Chapter I: Introduction 1
Introduction and Rationale 1
Overview of PCC in HIV care 6
What is PCC? 6
Significance of PCC 7
Context of PCC in HIV care and reproductive health 8
PCC Approaches and Labor & Delivery 9
Current approaches of PCC used by healthcare providers 9
Strategies of engaging those with reproductive potential living with HIV in PCC 11
Role of PCC in improving reproductive health outcomes for people living with HIV 16
Contribution in improving health and minimizing disparities 16
Impact on maternal and child health outcomes 18
Effectiveness in optimizing reproductive outcomes among birthing people living with HIV 19
Perceived barriers among healthcare providers 22
Problem Statement 23
Purpose Statement 24
Research Questions 25
Significance Statement 25
Chapter II: Methods 26
Population and Sample 26
Procedures 27
Instruments 28
Data Analysis 28
Ethical Considerations 29
Chapter III: Results 29
How do healthcare providers currently approach and deliver preconception counseling (PCC) for people living with HIV? 30
What are the perceived barriers among healthcare providers in incorporating preconception counseling into HIV care? 31
How does the integration of preconception counseling into HIV care improve reproductive outcomes for people living with HIV? 32
Chapter IV: Discussion 33
How do healthcare providers currently approach and deliver preconception counseling (PCC) for people living with HIV? 34
What are the perceived barriers among healthcare providers in incorporating preconception counseling into HIV care? 37
How does the integration of preconception counseling into HIV care improve reproductive outcomes for people living with HIV? 40
Limitations and Delimitations 42
Chapter V: Public Health Implications & Recommendations 42
Chapter VI: Conclusion 44
Chapter VII: References 45
About this Master's Thesis
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