Factors related to medical appointment attendance after childbirth among HIV-infected women in the Paris region

Abstract

This study examined factors related to medical appointment attendance after childbirth among HIV-infected women in the Paris region. We hypothesized that despite regular utilization of prenatal care, many women may not attend medical appointments after delivery for their own HIV infection. This was an observational cohort study of HIV-seropositive women delivering in four Paris hospitals in 2001. Follow-up attendance through 24 months after delivery was defined as ‘regular’ for women who had ≥4 HIV visits during the period, ‘irregular’ for <4 visits in the 24-months period and/or a gap between two visits >12 months, and ‘no attendance’ when ≤1 visit in the 2-year period. Of 169 women enrolled, 125 (75%) had regular attendance, 24 (14%) had irregular attendance, and 18 (11%) had no attendance. Multivariate analysis found the greater number of HIV visits during pregnancy and the prescription of combination therapy (versus zidovudine monotherapy) during pregnancy to be significantly related to regular attendance. Of the 18 women who had no attendance, 8 women (47%) continued to attend regular paediatric appointments with their infants during the 24-month period. Scheduling more frequent HIV visits during pregnancy may establish a pattern that will improve attendance during the post-partum period. In addition, increased communication between the health care providers of the mother and child may increase appointment attendance following delivery.

Acknowledgments

Diana Lemly received funding from the Fulbright Commission (Advanced Student Grant) The French Perinatal HIV Cohort (EP 13) is supported and funded by the Agence Nationale de Recherches sur le Sida, France.

We are especially grateful to Catherine Briquet, Catherine Crenn Hébert, MD, Corinne Floch Tudal, MD, and the Archives Department (Louis Mourier Hospital); Emmanuelle Pannier, MD and Nadia Moudoub, RNM, (Port-Royal/Cochin Hospital); Sylvie Tassi (Jean Verdier Hospital); Martine Levine, MD, and Mme Cotton (Robert Debre Hospital); and Sylvie Le Gac (Bichat Hospital) for help in obtaining files and contacting referring physicians.