A review of prenatal HIV screening practices among physicians at a tertiary care center in Lebanon: is it culture?
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Abstract
HIV remains one of the major causes of mortality and morbidity among women of reproductive age; given the risk of vertical transmission to the fetus, timely prevention, monitoring and management are imperative (Melaku et al. [2014]. Causes of death among females-investigating beyond maternal causes: A community-based longitudinal study. BMC Research Notes, 7(1), 629. https://doi.org/10.1186/1756-0500-7-629). Most HIV studies in Lebanon focus on men who have sex with men, people diagnosed with sexually transmitted infections, intravenous (IV) drug users, and people infected by blood transfusion products Ministry of Public Health [2017]. National AIDS Control Program in Lebanon. https://www.moph.gov.lb/en/Pages/2/4000/aids#/en/Pages/2/4000/aids; Shaheen [2014]. Around 3,750 HIV/AIDS cases in Lebanon. The Daily Star. https://www.dailystar.com.lb/News/Lebanon-News/2014/Dec-02/279570-around-3750-hivaidscases-in-lebanon.ashx). We conducted a retrospective review of women who delivered at a tertiary academic hospital in Beirut between January 2016-Decemeber 2017 to assess prenatal HIV screening practices. In total, 1500 charts were randomly selected and reviewed: 137 (9%) women were screened for HIV, 2 (1.5%) tested positive. Odds rations were calculated for screening in relation to religion, parity, previous abortions, and mode of delivery: none were significant. No one was tested for Gonorrhoea and Chlamydia; 1250 (93.8%) were tested for Hepatitis B, 27 (1.9%) for Hepatitis C, 7 (0.5%) for HSV and, 74(5.3%) for Syphilis. Barriers to screening may include: Lack of consensus on mandated screening policy, HIV stigma, physician and patient prejudice and misconception of risk and, financial barriers as health insurance does not cover HIV screening. © 2020 Informa UK Limited, trading as Taylor & Francis Group.
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Keywords
Culture, Hiv, Middle east, Pregnancy, Prenatal care, Screening, Female, Hiv infections, Homosexuality, male, Humans, Lebanon, Longitudinal studies, Male, Physicians, Retrospective studies, Sexual and gender minorities, Tertiary care centers, Abortion, Adult, Article, Bacterium culture, Blood transfusion, Clinical assessment, Clinical practice, Controlled study, Cultural factor, Financial management, Health care policy, Health insurance, Hepatitis b, Hepatitis c, Human, Human immunodeficiency virus, Human immunodeficiency virus infection, Longitudinal study, Major clinical study, Needs assessment, Parity, Physician, Prejudice, Prenatal diagnosis, Religion, Retrospective study, Risk assessment, Risk factor, Screening test, Sexual health, Social stigma, Tertiary care center, Therapeutic misconception, University hospital, Vaginal delivery, Vertical transmission, Young adult, Epidemiology, Male homosexuality, Sexual and gender minority