Experiences of Fetal or Infant Loss Among Tanzanian Women in HIV Care

Kisigo, Godfrey; Manavalan, Preeti; Cichowitz, Cody; Knettel, Brandon A.; Mmbaga, Blandina T.; Watt, Melissa H.

doi:10.1080/15325024.2019.1600850

Cited by 1 publication

(2 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…These findings contribute to prior studies highlighting the multiple, complex barriers that can impede care engagement among pregnant and postpartum women, including individual, social, and health systems factors [ 6 , 8 , 22 ]. A variety of interventions have demonstrated preliminary effectiveness in addressing these challenges and improving care retention, including task-shifted support from community health workers, engaging male partners in HIV testing and counseling, provision of ART in community-based adherence clubs, and mobile reminders for medication adherence and clinic appointments [ 23 – 25 ]. While our findings echo many of the care engagement challenges faced in the general population of PLWH, women who initiate HIV care during pregnancy face unique challenges as they traverse the antenatal continuum.…”

Section: Discussionmentioning

confidence: 99%

“…Pregnant women commonly cite the desire to avoid mother-to-child transmission as a primary driver of care engagement; thus, they may be prone to dropping out of care after the birth of the child. These types of care challenges may be even more pronounced among women who experience a major life transition during pregnancy or the postpartum period, such as a miscarriage, stillbirth, or death of a young child [23].…”

Section: Plos Onementioning

confidence: 99%

See 1 more Smart Citation

“At home, no one knows”: A qualitative study of retention challenges among women living with HIV in Tanzania

et al. 2020

Self Cite

View full text Add to dashboard Cite

Introduction Despite the broad success of Prevention of Mother-to-Child Transmission of HIV (PMTCT) programs, HIV care engagement during the pregnancy and postpartum periods is suboptimal. This study explored the perspectives of women who experienced challenges engaging in PMTCT care, in order to better understand factors that contribute to poor retention and to identify opportunities to improve PMTCT services. Methods We conducted in-depth interviews with 12 postpartum women to discuss their experiences with PMTCT care. We used data from a larger longitudinal cohort study conducted in five PMTCT clinics in Moshi, Tanzania to identify women with indicators of poor care engagement (i.e., medication non-adherence, inconsistent clinic attendance, or high viral load). Women who met one of these criteria were contacted by telephone and invited to complete an interview. Data were analyzed using applied thematic analysis. Results We observed a common pathway that fear of stigma contributed to a lack of HIV disclosure and reduced social support for seeking HIV care. Women commonly distrusted the results of their initial HIV test and reported medication side effects after care initiation. Women also reported barriers in the health system, including difficult-to-navigate clinic transfer policies and a lack of privacy and confidentiality in service provision. When asked how care might be improved, women felt that improved counseling and follow-up, affirming patientprovider interactions, and peer treatment supporters would have a positive effect on care engagement.

show abstract