Awareness, attitudes and perceptions regarding HIV and PMTCT amongst pregnant women in Guinea-Bissau– a qualitative study

Vieira, Noel; Rasmussen, Dlama Nggida; Oliveira, Isabel; Gomes, Aureliano; Aaby, Péter; Wejse, Christian; Sodemann, Morten; Reynolds, Lucy; Unger, Holger W.

doi:10.1186/s12905-017-0427-6

Cited by 23 publications

(57 citation statements)

References 50 publications

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“…This is in line with findings of other study done in Ethiopia revealed that health workers are not happy to handle deliveries for women who are known HIV positive due to fear of accidental infection [22]. Other studies have also had similar findings [17,23,[28][29][30][31].…”

Section: Discussionsupporting

confidence: 90%

“…Frequently mentioned individual and family related factors identified in this study were fear of divorce, lack of family support, lack of partner support and lack of time. Like our research, other studies found that non-disclosure of HIV status, fear of divorce, fear of HIV stigma, and lack of partners support were some of the most common barriers to PMTCT service utilization [16,[19][20][21][22][23][24][25][26]. Another study in Sudan [27], and in Malawi [28] also revealed that women are not likely to disclose their HIV status due to stigma.…”

Section: Discussionsupporting

confidence: 72%

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Factors influencing prevention of mother to child HIV transmission service utilization among HIV positive women in Amhara National Regional State, Ethiopia: A thematic content analysis

et al. 2019

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Introduction:Mother to child transmission (MTCT) of HIV is the major source of HIV infection among children under the age of 15 years. Prevention of mother to child transmission (PMTCT) service has been an important strategy in preventing HIV infections in infants.However, improving PMTCT service uptake and continuum of care still remains a significant impediment in the Amhara Region of Ethiopia. The aim of this study was to explore factors that may hinder and promote PMTCT service utilization among HIV positive women.Methods: Phenomenological study design was used. Three focus group discussions (FGDs) with HIV positive women and five in-depth interviews with health care workers were conducted from the selected health institutions. Data analysis was conducted using thematic content analysis. ATLAS/ti version 7.5.16 software was used to assist in coding and analysis of the qualitative data. Results:The findings of the study revealed that there are a range of factors that influence HIV positive women on PMTCT service utilization. Stigma, discrimination, limited knowledge on HIV, lack of partner and family support, and not getting friendly service from health facility were factors that might hinder PMTCT service utilization. The experiences of HIV positive mothers revealed that continuous partner support, previous history of getting HIV free child, good health worker support, and advice by mother support group were factors that promote utilization of PMTCT service. Conclusions:Strengthening community awareness on HIV, engaging male involvement in PMTCT care and getting friendly service were the key determinants for the better PMTCT service utilization.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionsupporting

confidence: 72%

Factors influencing prevention of mother to child HIV transmission service utilization among HIV positive women in Amhara National Regional State, Ethiopia: A thematic content analysis

et al. 2019

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“…The low refusal rate in this study may support the high acceptability of opt-out testing observed in other countries [ 32 – 36 ]. However, qualitative research from Guinea-Bissau suggests that testing around the time of delivery may in some instances have been done without adequate informed consent, which may have contributed to the high testing rates observed in this study [ 37 ].…”

Section: Discussionmentioning

confidence: 99%

Political instability and supply-side barriers undermine the potential for high participation in HIV testing for the prevention of mother-to-child transmission in Guinea-Bissau: A retrospective cross-sectional study

et al. 2018

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BackgroundThe World Health Organization recommends HIV testing is included in routine screening tests for all pregnant women in order to prevent mother-to-child-transmission of HIV and reduce maternal morbidity and mortality.ObjectivesTo assess the proportion of women approached and tested for HIV at delivery and factors associated with non-testing at the maternity ward of the Simão Mendes National Hospital (HNSM) in Bissau, Guinea-Bissau.MethodsWe conducted a retrospective cross-sectional study among women presenting for delivery from June 2008 until May 2013. During the study period, national policy included opt-out HIV-testing at delivery. Modified Poisson regression models were used to examine the association of maternal characteristics with HIV testing. Time trends were determined using Pearson’s χ2 test.ResultsSeventy-seven percent (24,217/31,443) of women presenting for delivery were counselled regarding PMTCT, of whom 99.6% (24,107/24,217) proceeded with HIV testing. The provision of opt-out HIV testing at labour increased from 38.1% (1,514/3973) in 2008 to 95.7% (2,021/2,113) in 2013, p<0.001. There were four distinct periods (two or more consecutive calendar months) when less than 50% of women delivering at HNSM were tested. Periods of political instability were significantly associated with not testing for HIV (adjusted prevalence ratio [APR] 1.79; 95% CI 1.73–1.84), as was a lower educational status (APR 1.05; 95% CI 1.00–1.10), admission during evenings/nights (APR 1.05; 95% CI 1.01–1.09) and on Sundays (APR 1.14; 95% CI 1.07–1.22) and Mondays (APR 1.12; 95% CI 1.05–1.19).ConclusionsRapid scale-up of PMTCT HIV testing services and high testing coverage was possible in this resource-limited setting but suffered from regular interruptions, most likely because of test stock-outs. Establishing proper stock management systems and back-up plans for periods of political instability is required to ensure the maintenance of health system core functions and increase health system resilience.

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“…The main barriers to adherence were disbelief in ARV efficacy to prevent HIV transmission from mother to child, unsupportive partners, and fear of stigma and discrimination from community members [ 23 , 38 , 41 – 43 ]. Women’s doubts regarding ARV efficacy were commonly reported as a main challenge to adherence in PMTCT for asymptomatic participants, as documented in several studies in East Africa [ 19 , 33 , 44 ], as they do not experience a tangible benefit from treatment.…”

Section: Discussionmentioning

confidence: 99%

Understanding women's uptake and adherence in Option B+ for prevention of mother-to-child HIV transmission in Papua, Indonesia: A qualitative study

et al. 2018

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BackgroundDespite a more proactive approach to reducing new HIV infections in infants through lifelong treatment (Option B+ policy) for infected pregnant women, prevention of mother-to-child transmission of HIV (PMTCT) has not been fully effective in Papua, Indonesia. Mother-to-child transmission (MTCT) is the second greatest risk factor for HIV infection in the community, and an elimination target of <1% MTCT has not yet been achieved. The purpose of this study was to improve understanding of the implementation of Option B+ for PMTCT in Papua through investigation of facilitators and barriers to women’s uptake and adherence to antiretroviral therapy (ART) in the program. This information is vital for improving program outcomes and success of program scale up in similar settings in Papua.MethodsIn-depth interviews were conducted with 20 women and 20 PMTCT health workers at two main referral hospitals for PMTCT in Papua. Development of interview guides was informed by the socio-ecological framework. Qualitative data were managed with NVivo11 software and themes were analysed using template analysis. Factors influencing women’s uptake and adherence in Option B+ for PMTCT were identified through final analysis of key themes.ResultsFactors that motivated PMTCT uptake and adherence were good quality post-test HIV counselling, belief in the efficacy of antiretroviral (ARV) attained through personal or peer experiences, and a partner who did not prevent women from seeking PMTCT care. Key barriers for PMTCT participation included doubts about ARV efficacy, particularly for asymptomatic women, unsupportive partners who actively prevented women from seeking treatment, and women’s concerns about community stigma and discrimination.ConclusionsResults suggest that PMTCT program success is determined by facilitators and barriers from across the spectrum of the socio-ecological model. While roll out of Option B+ as current national policy for pregnant women in Papua has improved detection and enrolment of HIV-positive women, health facilities need to address various existing and potential issues to ensure long-term adherence of women beyond the current PMTCT program, including during pregnancy, childbirth and breastfeeding.

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Awareness, attitudes and perceptions regarding HIV and PMTCT amongst pregnant women in Guinea-Bissau– a qualitative study

Cited by 23 publications

References 50 publications

Factors influencing prevention of mother to child HIV transmission service utilization among HIV positive women in Amhara National Regional State, Ethiopia: A thematic content analysis

Factors influencing prevention of mother to child HIV transmission service utilization among HIV positive women in Amhara National Regional State, Ethiopia: A thematic content analysis

Political instability and supply-side barriers undermine the potential for high participation in HIV testing for the prevention of mother-to-child transmission in Guinea-Bissau: A retrospective cross-sectional study

Understanding women's uptake and adherence in Option B+ for prevention of mother-to-child HIV transmission in Papua, Indonesia: A qualitative study

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