Looking back, moving forward: Implementing PMTCT programs in resource-constrained settings, Horizons studies 1999 to 2007

Baek, Carolyn; Rutenberg, Naomi

doi:10.31899/hiv10.1010

Cited by 2 publications

(2 citation statements)

References 14 publications

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“…Strengthening of psychosocial support to HIV patients has been one of the key areas of intervention in reducing LTFU. In South Africa and Malawi, peer-led psychosocial support has been used to reduce LTFU especially amongst pregnant women [19]. Peer-led psychosocial support could greatly improve both adherence and retention and will be a great strategy to try out in adult care in Cameroon.…”

Section: Discussionmentioning

confidence: 99%

Predictors of Loss to Follow-up in Patients on Antiretroviral Treatment in Centre Hospitalier Essos, Cameroon

Nyenty¹,

Bita²,

Ngongheh³

et al. 2021

Clin J HIV AIDS

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Background: HIV remains one of the major public health issues in Cameroon. Progress has been made in attaining the 90-90-90 according to the UNAIDS target, the Loss to follow-up (LTFU) remains a significant challenge to attain the second and third 90. There is a gap of information concerning assessing predictors and determinants of LTFU in the Cameroonian setting taking into consideration psychosocial, economic, cultural, financial, and treatment-related factors. This study seeks to assess and evaluate the determinants and predictors of LTFU among patients enrolled for treatment in the Centre Hospitalier Essos (CHE), Cameroon. Methods:We carried out a retrospective case-control study among 200 patients from which, 100 cases of patients LTFU and 100 controls of regular patients from the treatment centre. Simple random sampling was used to select 100 participants from the case list and matched with 100 participants from the control list. We compared several demographic, social, disease-related, and treatment-related characteristics of the two groups to determine which properties are significantly associated with LTFU. Data analysis was done using the SPSS software. Bivariate and multivariate analysis was done with p value < 0.05, odds ratio 95% CI.Results: Out of 200 participants, the mean age was 38 ± 9years. A total of 74 (37%) participants' HIV status was known by a family member. About 50% (54) of those who were married had an HIV-positive partner and of these, 86% (46) were on treatment. On multivariate analysis, distance to health facility; occurrence of opportunistic infections; patient receiving treatment for other conditions; duration of psychological follow-up and number of adherence counselling sessions were found to be independently associated with loss to follow-up. Conclusion:With LTFU, there is a consequent increased risk of HIV transmission and also increased morbidity and mortality. Reinforcement of adherence counseling sessions, intensification of patient tracking especially for patients with comorbidities, transfer of patients in suburbs to health facilities closer to their areas of residence will be important to curb LTFU rates and improve on retention of patients LTFU.

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Section: Discussionmentioning

confidence: 99%

Predictors of Loss to Follow-up in Patients on Antiretroviral Treatment in Centre Hospitalier Essos, Cameroon

Nyenty¹,

Bita²,

Ngongheh³

et al. 2021

Clin J HIV AIDS

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“…Previous research suggests that support groups and local volunteers can play important roles in increasing adherence to PMTCT and HAART by bridging the social worlds of the clinic staff and rural communities (Chandisarewa et al 2008;Jamisse et al 2008;Teasdale et al 2008;Agadjanian and Hayford 2009;Baek and Rutenberg 2010). In the clinics studied here, local seropositive women work as volunteers (activistas in Portuguese) to promote peer-to-peer transfer of information by reaching out to recently diagnosed women and by leading support groups.…”

Section: Discussionmentioning

confidence: 99%

Providers' Views Concerning Family Planning Service Delivery to HIV‐positive Women in Mozambique

Hayford

Agadjanian

2010

Studies in Family Planning

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This study explores challenges and obstacles in providing effective family planning services to HIV-positive women as described by staff of maternal and child health (MCH) clinics. It draws upon data from a survey of service providers carried out from late 2008 to early 2009 in 52 MCH clinics in southern Mozambique, some with and some without HIV services. In all clinics, surveyed providers reported that practical, financial, and social barriers made it difficult for HIVpositive clients to follow protocols to prevent mother-to-child transmission of the virus. Likewise, staff were skeptical of their seropositive clients' ability to adhere to recommendations to cease childbearing and to use condoms consistently. Providers' recommendations to HIV-positive clients and their assessment of barriers to adherence did not depend on availability of HIV services. Although integration of HIV and reproductive health services is advancing in Mozambique, service providers do not feel that they can influence the behaviors of HIV-positive women effectively.The large-scale rollout of antiretroviral therapies is transforming HIV/AIDS from an untreatable and lethal disease to a chronic condition. As a result, increasing effort has been directed toward improving the quality of life of people living with HIV, and in particular toward managing their reproductive health and parenthood. In sub-Saharan Africa, HIV testing and treatment services have grown rapidly in the first decade of the twenty-first century. Voluntary counseling and testing (VCT) programs have become more widely available, allowing an increasing number of women to learn their HIV status. Recently developed regimens for the prevention of mother-to-child transmission (PMTCT) lower the likelihood of vertical transmission, and highly active antiretroviral therapy (HAART) can stall the progression of HIV infection to AIDS.In theory, these technologies make pregnancy and childbirth for seropositive women possible with minimal risk of mother-to-child transmission, but in practice considerable logistical, financial, and cultural barriers inhibit their full implementation. The recent introduction of rapid and readily available HIV testing, regimens for the prevention of vertical transmission, and official policies for the treatment of seropositive women have created new requirements for specialized care. Prevention and treatment protocols are developed at the national and even international level, but are implemented by local clinic staff. These "street-level bureaucrats" (Lipsky 1980) make decisions about how to allocate limited resources and how to translate official recommendations into locally comprehensible advice-decisions that are shaped by their social position and cultural outlook as well as sarah.hayford@asu.edu.

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Looking back, moving forward: Implementing PMTCT programs in resource-constrained settings, Horizons studies 1999 to 2007

Cited by 2 publications

References 14 publications

Predictors of Loss to Follow-up in Patients on Antiretroviral Treatment in Centre Hospitalier Essos, Cameroon

Predictors of Loss to Follow-up in Patients on Antiretroviral Treatment in Centre Hospitalier Essos, Cameroon

Providers' Views Concerning Family Planning Service Delivery to HIV‐positive Women in Mozambique

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