Factors Influencing Teen Mothers' Enrollment and Participation in Prevention of Mother-to-Child HIV Transmission Services in Limpopo Province, South Africa

Varga, Christine; Brookes, Heather

doi:10.1177/1049732308318449

Cited by 60 publications

(77 citation statements)

References 19 publications

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“…Other studies have reported that negative interactions between healthcare staff and pregnant women, negative staff attitudes and poor access to ART services can serve as barriers to the uptake of and adherence to PMTCT services by pregnant women. [6,10,40,42,44,45] …”

Section: Discussionmentioning

confidence: 99%

Factors associated with the lack of antiretroviral therapy initiation among eligible HIV-positive pregnant women in Swaziland

et al. 2017

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Background. Antiretroviral therapy (ART) initiation is critical for the prevention of mother-to-child transmission (PMTCT) of HIV. Objectives. To quantify factors that were barriers or facilitators to the initiation of ART in pregnant HIV-infected women in Swaziland. Methods. We conducted a cross-sectional survey in HIV-infected women with at least one antenatal care (ANC) visit, who had delivered in maternity wards between April and August 2013 in Swaziland. Variables collected included intrapersonal, interpersonal and organisational factors. Logistic regression models were used to calculate univariate and adjusted multivariate measures of association between ART initiation and the independent variables. Results. Among the 163 pregnant women who were eligible for ART, 110 (67.5%) were initiated on ART by the time of delivery. The most commonly cited reason for not initiating ART (n=53) was women not being ready to initiate life-long treatment (24.5%). On multivariate logistic regression, favourable perceptions of the benefits of ART (adjusted odds ratio (AOR) 3.04; 95% CI 1.55 -5.96) and presence of partner support (AOR 4.75; 95% CI 2.11 -10.67) remained significantly and independently associated with ART initiation. Conclusion. ART initiation among ART-eligible pregnant women in Swaziland was independently associated with the presence of partner support and favourable perceptions of the benefits of ART. Stronger counselling and education for pregnant women and male involvement strategies need to be implemented as universal life-long ART for all HIV-infected pregnant women is implemented. Factors associated with the lack of antiretroviral therapy initiation among eligible HIV-positive pregnant women in Swaziland Prior to 2013, antiretroviral therapy (ART) was recommended by the World Health Organization (WHO) for HIV-infected pregnant women with CD4 cell counts of <350 cells/µL or those who were at WHO clinical stage III or IV Women who did not meet these criteria,were advised to use one of two options. Option A: antepartum zidovudine, with single-dose nevirapine during labour, and a 7-day zidovudine/lamivudine 'tail' alongside daily infant nevirapine during breastfeeding. Option B: ART during pregnancy and through cessation of breastfeeding to prevent mother-to-child HIV transmission (PMTCT.) [1] Many countries, including Swaziland, chose to implement option A; a CD4 cell count was performed on all women identified to have HIV infection to determine those who should be initiated on life-long ART for both maternal health and PMTCT. In Swaziland, 88% of facilities that provide antenatal care (ANC) services also provide PMTCT services.[2] In 2009, 73% of women attending ANC facilities were tested for HIV, and 88% of HIV-infected pregnant women received a complete course of PMTCT prophylaxis in 2009. [3] However, a review of the data in the Early Infant Diagnosis (EID) database in Swaziland at the time of the introduction of option A guidelines, showed that ~50% of HIV-infected women who were eligible for ART actu...

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Section: Discussionmentioning

confidence: 99%

Factors associated with the lack of antiretroviral therapy initiation among eligible HIV-positive pregnant women in Swaziland

et al. 2017

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“…This may then manifest as a negative attitude, lack of compassion or even abuse towards those they see as subordinate to themselves. 15,[26][27] Poor knowledge about HIV and ARVs has been shown to result in a delay in HIV testing of infants. 9,15 Caregivers appear to have poor knowledge, despite undergoing counselling and attending talks at their local clinics.…”

Section: Discussionmentioning

confidence: 99%

“…15,[26][27] Poor knowledge about HIV and ARVs has been shown to result in a delay in HIV testing of infants. 9,15 Caregivers appear to have poor knowledge, despite undergoing counselling and attending talks at their local clinics. This raises concerns about the quality of counselling and the effectiveness of communication.…”

Section: Discussionmentioning

confidence: 99%

“…Poor communication about the diagnosis and treatment, negative attitudes, blaming patients for their health problems and not maintaining confidentiality were all issues raised by patients. [14][15][16] Poor patient experience makes it more likely that patients will seek help from traditional medicine and delay starting ART. 17 Stigma has also been associated with reduced utilisation of health services.…”

Section: Introductionmentioning

confidence: 99%

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How children access antiretroviral treatment at Kgapane District Hospital, Limpopo, South Africa

Railton

Mash

2012

South African Family Practice

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Background: At Kgapane Hospital, Limpopo Province, only 20% of eligible children initiated antiretroviral treatment (ART) in 2007. The aim of this study was to improve the ART programme by assessing how children were accessing ART, and to explore the factors that facilitate or obstruct this access.Method: Mixed methods were used in a descriptive study of human immunodeficiency virus (HIV)-infected children admitted to the hospital over a seven-month period and their caregivers. Children's subsequent attendance for ART was tracked and caregivers were interviewed about factors influencing access and attendance.Results: Of 132 children initially admitted, 14 (10.6%) subsequently died and 13 (9.8%) relocated. Sixty of the remaining 105 (57.1%) returned within one month to the antiretroviral clinic, three (2.9%) attended later and 42 (40.0%) did not return at all. Quantitative data associated with poor attendance were younger age, higher CD4 count, maternal caregiver, no income and participation in the prevention of mother-to-child transmission program. Qualitative factors included a lack of money for transport, poor social support, and mothers who struggled to accept their diagnosis, had poor understanding of HIV and strong traditional beliefs. Primary care providers delayed HIV testing and referral, displayed poor attitudes, and were insufficient in number. Quantitative factors significantly associated with good attendance were prior knowledge of the child/mother's HIV status, mother's ART treatment and referral to the dietician. Conclusion:There are serious deficiencies in the prevention, diagnosis and treatment of HIV in children. Factors were identified to improve health services and these highlight the need for broader strategies aimed at addressing poverty, stigma and education.Peer reviewed.

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“…Varga et al [97] examined impediments to willingness to be tested for HIV of 15 to 19-year-old mothers in rural and urban Limpopo Province, South Africa. The study found that the relationship and communication between the pregnant women and the HCT counselor was a significant factor influencing the rate of acceptance of HIV testing, as were the counselors' profiles, which impacted the interaction between pregnant women and clinic staff.…”

Section: Health Care Provider Related Factorsmentioning

confidence: 99%

Women’s willingness to be tested for human immunodeficiency virus during pregnancy: A review

Ben-Natan

Hazanov

2015

WJV

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not receive prevention services. HIV testing of pregnant women is considered to be one of the key strategies for preventing mother-to-child-transmission of HIV, but HIV testing rates among pregnant women in various countries remain suboptimal. Understanding the factors relating to women's willingness to be tested for HIV during pregnancy is critical for developing strategies to increase HIV testing rates among pregnant women. Extensive research points to various factors relating to women's willingness to be tested for HIV during pregnancy, and various recommendations aimed at improving testing rates among pregnant women have been suggested based on the research. In light of the goals set by the United Nations to reduce the rate of infants infected with HIV, it is necessary to summarize what is currently known regarding factors related to women's willingness to be tested for HIV during pregnancy. The purpose of this review is therefore to examine factors related to women's willingness to be tested for HIV during pregnancy, and to summarize recommendations for practice and further research. Core tip: The willingness of women to be tested for human immunodeficiency virus (HIV) during pregnancy is a complex phenomenon. There is frequent inconsistence in research results; however, studies have shown that certain major factors are steadily identified over time as associated with the phenomenon. Numerous factors related to pregnant women's willingness to be tested suggest multiple possible interventions to maximize HIV testing efficiency and increase testing rates. There is a need in further research of the phenomenon, as the majority of the research literature focuses on sub-Saharan Africa.Women's willingness to be tested for human immunodeficiency virus during pregnancy: A review Ben-Natan M, Hazanov Y. Women's willingness to be tested for human immunodeficiency virus during pregnancy: A review.

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Factors Influencing Teen Mothers' Enrollment and Participation in Prevention of Mother-to-Child HIV Transmission Services in Limpopo Province, South Africa

Cited by 60 publications

References 19 publications

Factors associated with the lack of antiretroviral therapy initiation among eligible HIV-positive pregnant women in Swaziland

Factors associated with the lack of antiretroviral therapy initiation among eligible HIV-positive pregnant women in Swaziland

How children access antiretroviral treatment at Kgapane District Hospital, Limpopo, South Africa

Women’s willingness to be tested for human immunodeficiency virus during pregnancy: A review

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