HIV, pregnancy, and zidovudine: what do women know?

Abstract

AIDS is a major cause of death among women and children, representing the fourth leading cause of death among women ages 25 to 44 and the seventh leading cause of death among children ages 1 to 4 in the United States. In 1994, National Institutes of Health announced the findings of the AIDS Clinical Trials Group study (076) that found that the use of the antiretroviral drug zidovudine (AZT) reduced perinatal transmission of HIV by two thirds. These findings have direct implications for the growing number of women with HIV disease, their children and families, and the multiple systems that deliver ongoing services and care. In response to these findings, complex clinical, legal, and ethical issues have emerged that must be addressed to decrease the incidence of perinatal HIV transmission and to provide quality health care services. The purpose of this research was to assess what HIV-infected women presently know regarding AZT use in pregnancy to reduce prenatal transmission and to identify their views of the impact of this information on reproductive decision making. A one-page survey developed for this study was used to address these questions. A convenience sample of 204 HIV-infected women completed the survey. Data from 192 were usable. Of the sample, 121 (63.7%) women reported knowledge regarding the use of AZT in pregnancy. Only 73.5% of those who reported knowledge regarding AZT prophylaxis demonstrated accurate knowledge about the effects of its use. A relationship was found between knowledge about AZT use during pregnancy and women's decision to consider pregnancy, chi 2(2, N = 146) = 32.7, p = .0001, with women who reported that they were knowledgeable about AZT prophylaxis as more likely to consider pregnancy than those who reported that they were not knowledgeable.