Implementing CenteringPregnancy Group Prenatal Care for Minority Women Living with HIV at an Urban University Hospital

• Published in: Journal of midwifery & women's health 2019-07, Vol.64 (4), p.451-461
• Main Authors: Potter, JoNell E., Duthely, Lunthita M., Diaz‐Mendez, Nelly, Smith, Lindsay, Messick, Barbara J., Echenique, Maria, Galli, Johnny, Yasin, Salih, Villar‐Loubet, Olga
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Antiretroviral drugs; Antiretroviral therapy; CenteringPregnancy; Childbirth & labor; Clinical outcomes; Computerized medical records; Curricula; Curriculum; Female; Florida - epidemiology; group prenatal care; Health records; HIV; HIV Infections - epidemiology; Hospitals, University; Hospitals, Urban; Human immunodeficiency virus; Humans; Immunology; Medical schools; Middle Aged; Midwives; Minority Groups; Patient Satisfaction; Patients; Perinatal; Pilot Projects; Pregnancy; Pregnancy Outcome; Prenatal care; Prenatal Care - organization & administration; Retrospective Studies; sexually transmitted infections; Social support; Sociodemographics; Womens health; Young Adult
• ISSN: 1526-9523; 1542-2011
• DOI: 10.1111/jmwh.12987

Introduction Pregnant women with HIV require sustained education and support throughout pregnancy to achieve healthy perinatal outcomes. To enhance prenatal care for women with HIV, the Prenatal Immunology Service at the University of Miami Miller School of Medicine adapted the Centering Healthcare Institute's CenteringPregnancy curriculum to include HIV content. Nurse‐midwives introduced the curriculum in a pilot project to learn if women would enroll in group prenatal care. A retrospective record review was conducted to evaluate perinatal outcomes among women with HIV who received prenatal care in a group setting. Methods Data were collected from the electronic health records of women with HIV who received either CenteringPregnancy‐HIV group prenatal care or traditional prenatal care between March 2015 and July 2016. Sociodemographic factors, HIV immune markers, and pregnancy and birth outcomes were reviewed. Univariate and bivariate statistics and multiple regression models assessed differences between women in CenteringPregnancy‐HIV group prenatal care compared with women with HIV in traditional care. Results Among women with HIV who received prenatal care during the pilot project, 128 met eligibility criteria for review. Perinatal outcomes were analyzed for 117 women who had a live birth; of these, 14 participated in CenteringPregnancy‐HIV group prenatal care, and 103 received traditional care. Demographic profiles were similar in both groups. No significant differences in perinatal outcomes were observed among women in CenteringPregnancy‐HIV group prenatal care compared with women with HIV in traditional prenatal care. Discussion Women with HIV can often feel stigmatized and isolated. Group prenatal care can foster patient engagement, self‐management, and social support to improve adherence to antiretroviral and other health regimens that promote healthy outcomes for both woman and newborn. Although results of this pilot study were not statistically significant, they show that CenteringPregnancy‐HIV group prenatal care may be an option for women with HIV, but the benefits need further exploration in larger studies.