Do Obstetricians’ Knowledge and Approaches to HIV and Pregnancy Reflect the State-of-the-Art Literature in the Era of Contemporary ARTs, U=U, and PrEP? Günümüz ART, U=U ve PrEP Döneminde Obstetrisyenlerin HIV ve Gebeliğe Yönelik Bilgi ve Yaklaşımları Güncel Literatürü Yansıtıyor mu?

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ÇELİK EKİNCİ S., YENİLMEZ E., Yetginakın T., Şenyuva A., Küçükbirer A., Denizoğlu B., ...Daha Fazla

Mediterranean Journal of Infection, Microbes and Antimicrobials, cilt.14, sa.1, 2025 (ESCI, Scopus, TRDizin)

Özet

Introduction: Obstetricians are very important intermediaries for reaching and engaging with women living with Human Immunodeficiency Virus (HIV) or women at risk for acquiring HIV. Thus, they should acquire up-to-date HIV knowledge for them to make clinical decisions in prepregnancy counseling and follow-up of HIV-positive pregnant women. Materials and Methods: This study assessed obstetricians’ knowledge about HIV and pregnancy and their behaviors regarding the follow-up of HIV-positive pregnant women using a 54-item face-to-face and online questionnaire administered to physicians working in Türkiye between February and May 2023. This cross-sectional study questionnaire consists of four sections including following up of HIV+ pregnancies, knowledge of HIV, undetectable=untransmittable (U=U) pre-exposure prophylaxis (PrEP), and patient management or treatment approaches. Results: A total of 133 obstetricians and gynecologists, comprising 15 (11.3%) academic members, 43 (32.3%) specialists, and 75 (56.4%) residents, participated in this study. A significant proportion of respondents felt that they knew nothing (2.2%) or little (34.6%) about HIV/Acquired Immunodeficiency Syndrome. A substantial proportion of respondents with <5 years of experience (40.5%, p=0.001) stated they had never attended a scientific meeting on HIV and had never read a guideline or article, whereas 34.6% had never followed up an HIV-positive pregnancy, and 43.6% reported having followed up only one to five HIV-positive pregnancies. Of the participants, 49.6% believed that HIV is an infection that will continue to progress and lead to death despite treatment, 74.4% reported they had never heard of the term U=U, and only 18.8% stated they had some knowledge on PrEP. Knowledge regarding the use of semen preparation techniques and indications for cesarean section and intravenous zidovudine in pregnant women with HIV was reportedly lacking. Conclusion: The knowledge level on HIV, the disease course, the efficacy of antiretroviral drugs, and the use of these drugs in pregnancy among obstetricians participating in our study is insufficient. Considering that the incidence and prevalence of HIV will continue to increase significantly in the coming years and that a significant proportion of this increase will be young women of childbearing age, obstetricians and gynecologists must keep themselves up-to-date on HIV and pregnancy.