Family Planning Priorities for Women Living with HIV and Attitudes Towards Mandatory Family Planning Use While Taking Dolutegravir
Bibliographic record
Abstract
Dolutegravir (DTG) is currently the first and second line antiretroviral therapy (ART) for women living with HIV (WLHIV). However, in 2018 Botswana Harvard AIDS Institute Partnership found that DTG exposure at conception corresponded with an increase in neural tube defects. Therefore, it is important that providers work with WLHIV to ensure they are aware of how to avoid unplanned pregnancies while on DTG. Telephone interviews were conducted with women living with HIV ages 21-59. The interviews were conducted in western Kenya, at clinical sites of the Academic Model Providing Access to Healthcare (AMPATH) program. Nineteen interview transcripts were coded using NVIVO 12. Domains included family planning use and shared decision making (SDM). Within these domains, three themes were used for this analysis: 1) tensions in ARV SDM and pregnancy, 2) decision making in family planning, and 3) decision making in family planning with DTG. The following three themes were discussed frequently: 1) When making decisions surrounding family planning, women preferred in person counseling and prioritized knowing the side effects of contraceptive methods; 2) WLHIV were often aware of the risk of HIV vertical transmission and valued preventing birth defects if told a medication may cause them; 3) When asked about using family planning while on DTG, WLHIV saw the benefit of preventing pregnancies. However, they did not believe family planning should be mandatory and preferred having a wide variety of contraceptive options. Understanding what factors influence women’s family planning choices may improve SDM between patients and providers. This is especially important when it comes to preventing pregnancies in women taking DTG. WLHIV often understood the importance of effective ARTs and wanted to prevent birth defects. Therefore, it is important to navigate SDM conversations such that WLHIV are given control of their own health decisions.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.008 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.004 | 0.002 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.000 | 0.002 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".