Low Birth Weight, Preterm Birth and Maternal Retention in Postpartum HIV Care

What is the project about?

Currently, we do not know the effect adverse pregnancy outcomes like low birth weight and preterm birth (PB) has on maternal retention in HIV care for their health. The main goals of this project are to 1) evaluate if caring for LBW and preterm infants has an effect on maternal follow-up in postpartum HIV care for the mother’s own health and 2) identify the process that links these adverse pregnancy outcomes to maternal follow-up in HIV care.

Why is the project important?

Caregivers of low birth weight (LBW) and preterm infants often experience high levels of depression, self-blame, guilt, and have demanding childcare responsibilities. In Ghana, caring for small babies, like low birth weight and preterm infants, is additionally associated with low social support, delayed care-seeking, and experience of perceived stigma. These psycho-social variables are known to affect the use of preventive health services, including retention in HIV care. HIV-infected patients who miss more of their scheduled HIV care visits or completely do not follow-up on their care (known as retention in HIV care) do not get continuous access to life-saving antiretroviral therapy. Consequently, they have higher risks of mortality, disease progression, and elevated viral load. Thus, identifying risk factors for poor retention in postpartum HIV care is of public health significance.

How is this project going to solve the problem?

If the low birth weight and preterm birth are influential characteristics on maternal retention in HIV care, tailored interventions can be developed using the information collected on the barriers that affect this population.

How will the study be conducted?

This is a 14-month, mixed-methods study with two components (quantitative and qualitative) to be carried out in Ghana. In the quantitative component, 165 Mothers Living with HIV (MLHIV) will be prospectively followed over six months to assess the effect of LBW and PB on retention in postpartum HIV care. The qualitative component will involve semi-structured interviews with 24-30 MLHIV who also recently gave birth (0-6 months) to gain insights as to how LBW and PB affect retention in postpartum HIV care. Multiple logistic regression and Grounded Theory will be the analytical approaches to the quantitative and qualitative components, respectively.