The Role of Maternal, Health System, and Psychosocial Factors in Prevention of Mother-to-Child Transmission Failure in the Era of Programmatic Scale Up in Western Kenya: A Case Control Study

Onono, Maricianah; Owuor, Kevin; Turan, Janet M.; Bukusi, Elizabeth A.; Gray, Glenda; Cohen, Craig R.

doi:10.1089/apc.2014.0181

Cited by 16 publications

(13 citation statements)

References 32 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Another significant finding of this study was the association between poor adherence to ART and MTCT of HIV. This finding is consistent with related study done in Kenya [ 27 ], which might be explained by reduction in viral load caused by good ART adherence.…”

Section: Discussionsupporting

confidence: 93%

Determinants of HIV infection among children born to mothers on prevention of mother to child transmission program of HIV in Addis Ababa, Ethiopia: a case control study

2018

View full text Add to dashboard Cite

BackgroundDespite wide spread use of Antiretroviral Therapy (ART) by pregnant women living with Human Immunodeficiency Virus (HIV), the transmission rate is still higher by 18% after breastfeeding ends. The aim of this study was to identify factors affecting mother-to-child HIV transmission.MethodsUnmatched case–control study was conducted in Addis Ababa, from April to May, 2017. A case was HIV positive mother who had been on PMTCT program with her child confirmed HIV positive at or before 24 months and control was HIV positive mother who had been on PMTCT program with her child tested definitive HIV negative at 24 months. Accordingly, 44 cases were identified and for each case four controls with the nearest date of birth to the cases were selected from same health facilities. Primary data collected from the mothers were supplemented by record reviews and entered to Epidata version 3.1 and analyzed using SPSS version 22. Multivariate logistic regression was fitted to identify factors independently associated with mother-to-child HIV transmission.ResultsLack of participation in mother-to-mother support program (AOR: 5.1; 95% CI: 1.4, 18.1), low partner involvement (AOR: 6.9; 95% CI: 1.4, 13.4), poor ART adherence (AOR:3.1; 95% CI: 1.3, 7.5), positive syphilis test results (AOR: 3.2; 95% CI: 1.2, 8.6), maternal malnutrition (AOR: 3.1; 95% CI: 1.4, 6.8), unplanned pregnancy (AOR: 10.3; 95% CI: 3.9, 27.2), home delivery (AOR: 5.3; 95% CI: 1.4, 19.4) and mixed feeding of the child during first six months of life (AOR: 12.5; 95% CI: 2.9, 52.7) were significantly associated with MTCT of HIV.ConclusionsMother-to-mother support, male partner involvement in PMTCT of HIV, strengthening antenatal care, counseling mothers on appropriate infant feeding options are important to reduce mother –to- child transmission of HIV.Electronic supplementary materialThe online version of this article (10.1186/s12879-018-3217-3) contains supplementary material, which is available to authorized users.

show abstract

Section: Discussionsupporting

confidence: 93%

Determinants of HIV infection among children born to mothers on prevention of mother to child transmission program of HIV in Addis Ababa, Ethiopia: a case control study

2018

View full text Add to dashboard Cite

show abstract

“…This was a qualitative investigation conducted as part of a mixed method case control study that sought to identify factors associated with PMTCT failure in an area of Kenya with widely available free PMTCT health services [ 15 ]. The flexibility of individual in-depth interviews as qualitative methodologies enabled us to evoke meaningful and culturally salient responses pertaining to PMTCT service utilization and uptake [ 16 ].…”

Section: Methodsmentioning

confidence: 99%

?You Know You Are Sick, Why Do You Carry A Pregnancy Again?? Applying the Socio-Ecological Model to Understand Barriers to PMTCT Service Utilization in Western Kenya

et al. 2015

Self Cite

View full text Add to dashboard Cite

Objective Throughout most of sub-Saharan Africa (SSA), prevention of mother-to-child transmission (PMTCT) services are readily available. However, PMTCT programs in SSA have had suboptimal performance compared to other regions of the world. The main objective of this study is to explore the socio-ecological and individual factors influencing the utilization of PMTCT services among HIV-positive pregnant women in western Kenya using a social ecological model as our analytical lens. Methods Data were collected using in-depth interviews with 33 HIV-infected women attending government health facilities in rural western Kenya. Women with HIV-infected infants aged between 6 weeks to 6 months with a definitive diagnosis of HIV in the infant, as well as those with an HIV-negative test result in the infant were interviewed between November 2012 and June 2013. Coding and analysis of the transcripts followed grounded theory tenets. Coding reports were discussed in a series of meetings held among the authors. We then employed constant comparative analysis to discover dominant individual, family, society and structural determinants of PMTCT use. Results Barriers to women’s utilization of PMTCT services fell within the broad constructs of the socio-ecological model of individual, family, society and structural determinants. Several themes cut across the different steps of PMTCT cascade and relate to different constructs of the socio-ecological model. These themes include: self-motivation, confidence and resilience, family support, absence or reduced stigma, right provider attitude and quality of health services provided. We also found out that these factors ensured enhanced maternal health and HIV negative children. Conclusion The findings of this study suggest that a woman’s social environment is an important determinant of MTCT. PMTCT Interventions must comprehensively address multiple factors across the different ecological levels. More research is however required for the development of multi-component interventions that combine strategies at different ecological levels.

show abstract

“…Recent studies suggest that HIV-positive individuals need to take at least 80% of prescribed cART doses to adequately suppress HIV (Gordon, Gharibian, Chong, & Chun, 2015; Kobin & Sheth, 2011). Suboptimal adherence to cART among HIV-positive pregnant and breastfeeding women not only increases the risk of MTCT, but also increases the likelihood of maternal HIV-related disease progression and drug resistance for both the mother and the infant (Nachega et al, 2007; Ngoma et al, 2015; Onono et al, 2015). Achieving high PMTCT adherence remains a challenge in many settings globally, including sub-Saharan Africa (Nachega et al, 2012).…”

Section: Introductionmentioning

confidence: 99%

Intimate partner violence and HIV-positive women's non-adherence to antiretroviral medication for the purpose of prevention of mother-to-child transmission in Lusaka, Zambia

Hampanda

2016

Social Science & Medicine

View full text Add to dashboard Cite

Background Prevention of mother-to-child transmission (PMTCT) depends critically on HIV-positive women’s adherence to antiretroviral drugs during and after pregnancy. Adherence among pregnant and breastfeeding women remains a challenge across sub-Saharan Africa. Power dynamics within couples, such as intimate partner violence, has largely been neglected in research regarding PMTCT adherence. Objective This study aims to determine if there is a relationship between intimate partner violence and non-adherence to PMTCT. Methods In 2014, using a verbally administered cross-sectional survey at a large public health clinic in Lusaka, Zambia, 320 HIV-positive postpartum women, who were currently married or living with a man, provided information on their drug adherence during and after pregnancy, as well as relationship dynamics. Adherence was defined as the woman reporting she took or gave to the infant at least 80% of prescribed medication doses. Results Experiencing intimate partner violence was associated with decreased odds of adherence to PMTCT during and after pregnancy. Different forms of violence affected PMTCT adherence differentially. Physical violence had a less pronounced effect on non-adherence than emotional and sexual violence. A dose-response relationship between intimate partner violence and non-adherence was also observed. Conclusions Intimate partner violence is associated with non-adherence to PMTCT during and after pregnancy, which deserves increased attention in the effort to eliminate mother-to-child transmission.

show abstract

The Role of Maternal, Health System, and Psychosocial Factors in Prevention of Mother-to-Child Transmission Failure in the Era of Programmatic Scale Up in Western Kenya: A Case Control Study

Cited by 16 publications

References 32 publications

Determinants of HIV infection among children born to mothers on prevention of mother to child transmission program of HIV in Addis Ababa, Ethiopia: a case control study

Determinants of HIV infection among children born to mothers on prevention of mother to child transmission program of HIV in Addis Ababa, Ethiopia: a case control study

?You Know You Are Sick, Why Do You Carry A Pregnancy Again?? Applying the Socio-Ecological Model to Understand Barriers to PMTCT Service Utilization in Western Kenya

Intimate partner violence and HIV-positive women's non-adherence to antiretroviral medication for the purpose of prevention of mother-to-child transmission in Lusaka, Zambia

Contact Info

Product

Resources

About