Patient and provider perspectives on improving the linkage of HIV-positive pregnant women to long-term HIV care and treatment in eastern Uganda

Saleem, Haneefa; Kyeyagalire, R; Lunsford, Sarah Smith

doi:10.2989/16085906.2014.892015

Cited by 7 publications

(14 citation statements)

References 14 publications

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“…Many studies and reviews have assessed the effectiveness of the integration of HIV and SRH services, discussing issues around coverage, service uptake and time-to-treatment initiation [7–14], access to quality services [15], providers’ experiences and willingness to deliver joint services [16–23], cost-effectiveness [24, 25], and health systems barriers to integration [2, 3, 26, 27]. …”

Section: Introductionmentioning

confidence: 99%

“…Less information exists on patients’ experiences with integrated care, primarily among pregnant women [26, 34, 37]. A study on improving the linkage of HIV-positive pregnant women to long-term HIV care and treatment in eastern Uganda reports that facilitating factors for linked care include (among others) support from expert clients, escorted referrals, and coordination between ANC and HIV service; while reported barriers for women included shortages in HIV testing kits and fear of social, physical and medical consequences [26].…”

Section: Introductionmentioning

confidence: 99%

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Perceptions and Experiences of Integrated Service Delivery Among Women Living with HIV Attending Reproductive Health Services in Kenya: A Mixed Methods Study

et al. 2016

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This is one of the few studies that explores preferences of and experiences with integrated sexual and reproductive health (SRH)-HIV care among users of mainstream family planning and postnatal care services who are women living with HIV (WLWH). This paper reports on the quantitative data from 179 clients attending public sector clinics and from 30 qualitative in-depth interviews with WLHIV in Kenya. Quantitative data show that integration is happening for the vast majority of these clients at their last HIV visit. However, qualitative data show that very often the care received by WLWH is fragmented as providers do not offer multiple same-day appointments for FP and ARV refills. Our study has shown factors that could either prevent or enable receipt of integrated SRH and HIV care for WLWH. To address these factors, management systems need to be able to support providers to make flexible decisions and facilitate better coordination and communication across clinics within facilities.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Perceptions and Experiences of Integrated Service Delivery Among Women Living with HIV Attending Reproductive Health Services in Kenya: A Mixed Methods Study

et al. 2016

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“…Women in two studies reported fear of physical violence from partners if they found out about their HIV status [24,41], while having adequate support from a partner or family member was reported as an enabler of transition [5,21]. Women transitioning from ANC to ART clinics to start treatment reported fear of medication side effects and the burden of being on treatment as additional barriers [22,24,41].…”

Section: Fearmentioning

confidence: 99%

Approaches to transitioning women into and out of prevention of mother‐to‐child transmission of HIV services for continued ART: a systematic review

Phillips

Teasdale

Geller

et al. 2020

J. Intern. AIDS Soc.

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Introduction Women living with HIV are required to transition into the prevention of mother‐to‐child transmission of HIV (PMTCT) services when they become pregnant and back to ART services after delivery. Transition can be a vulnerable time when many women are lost from HIV care yet there is little guidance on the optimal transition approaches to ensure continuity of care. We reviewed the available evidence on existing approaches to transitioning women into and out of PMTCT, outcomes following transition and factors influencing successful transition. Methods We searched PubMed and SCOPUS, as well as abstracts from international HIV‐focused meetings, from January 2006 to July 2020. Studies were included that examined three points of transition: pregnant women already on ART into PMTCT (transition 1), pregnant women living with HIV not yet on ART into treatment services (transition 2) and postpartum women from PMTCT into general ART services after delivery (transition 3). Results were grouped and reported as descriptions of transition approach, comparison of outcomes following transition and factors influencing successful transition. Results & discussion Out of 1809 abstracts located, 36 studies (39 papers) were included in this review. Three studies included transition 1, 26 transition 2 and 17 transition 3. Approaches to transition were described in 26 studies and could be grouped into the provision of information at the point of transition (n = 8), strengthened communication or linkage of data between services (n = 4), use of transition navigators (n = 12), and combination approaches (n = 4). Few studies were designed to directly assess transition and only nine compared outcomes between transition approaches, with substantial heterogeneity in study design, setting and outcomes. Four themes were identified in 25 studies reporting on factors influencing successful transition: fear, knowledge and preparedness, clinic characteristics and the transition requirements and process. Conclusions This review highlights that, despite the need for women to transition into and out of PMTCT services for continued ART in many settings, there is very limited evidence on optimal transition approaches. Ongoing operational research is required to identify sustainable and acceptable transition approaches and service delivery models that support continuity of HIV care during and after pregnancy.

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“…Despite the need for strong linkages and collaborations between the multi-dimensional aspects of care, most programs have struggled to maintain linkage and cross-referral systems. 20,21…”

Section: Barriers To Testing and Care For Heimentioning

confidence: 99%

Beyond Early Infant Diagnosis: Changing the Approach to HIV-Exposed Infants

Modi

Broyles

Montandon

et al. 2018

JAIDS Journal of Acquired Immune Deficiency Syndromes

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Despite dramatic global progress with implementing prevention of mother-to-child HIV transmission (PMTCT) programs, there were 160,000 new pediatric HIV infections in 2016. More than 50% of infant HIV infections now occur in the postpartum period, reflecting the relatively high coverage of interventions in the antenatal period and the need for greater attention to the breastfeeding mother and her HIV-exposed infant (HEI). Early diagnosis and treatment are critical to prevent morbidity and mortality in HIV-infected children; however, early infant HIV testing rates remain low in most high HIV-burden countries. Furthermore, systematic retention and follow-up of HEI in the postpartum period and ascertainment of final HIV status remain major program gaps. Despite multiple calls to action to improve infant HIV testing rates, progress has been marginal due to a lack of focus on the critical health care needs of HEI coupled with health system barriers that result in fragmented services for HIV-infected mothers and their families. In this paper, we describe the available evidence on the health outcomes of HEI, define a comprehensive care package for HEI that extends beyond early HIV testing, and describe successful examples of integrated services for HEI.

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Patient and provider perspectives on improving the linkage of HIV-positive pregnant women to long-term HIV care and treatment in eastern Uganda

Cited by 7 publications

References 14 publications

Perceptions and Experiences of Integrated Service Delivery Among Women Living with HIV Attending Reproductive Health Services in Kenya: A Mixed Methods Study

Perceptions and Experiences of Integrated Service Delivery Among Women Living with HIV Attending Reproductive Health Services in Kenya: A Mixed Methods Study

Approaches to transitioning women into and out of prevention of mother‐to‐child transmission of HIV services for continued ART: a systematic review

Beyond Early Infant Diagnosis: Changing the Approach to HIV-Exposed Infants

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