Factors enhancing utilization of and adherence to prevention of mother-to-child transmission (PMTCT) service in an urban setting in Kenya.

Abstract

Despite expansive scale-up of prevention of mother-to-child transmission (PMTCT) of HIV services in Kenya over the last decade, Kenya remains one of the countries contributing to high numbers of children living with HIV globally and is among the 22 PMTCT global plan priority countries. Using structured and in-depth interviews this study examined enabling factors that enhance utilization of and adherence to PMTCT services in an urban setting in Kenya. HIV-positive birthmothers (N=55) whose infants were HIV-negative at the time of the study completed a structured interview and a subset (n=15) participated in in-depth interviews. The majority of the mothers (98%) delivered at a health facility and 91% exclusively breastfed. Further, 91% attended clinic appointments regularly and 69.1% strictly adhered to prescribed medication dosage and schedules. However, 18% had not disclosed their HIV status to anybody, 27% did not use condom during sex, 95% did not participate in AIDS support groups and 53% of their male partners were not involved in PMTCT. Four key themes facilitating PMTCT success emerged from the qualitative data: supportive counseling, striving for motherhood, assurance of confidentiality; and confirmation, affirmation and admiration. HIV/AIDS related stigma and gender imbalances create many missed opportunities for HIV-positive mothers to reach out for support from family and community, apply acquired knowledge and access more affordable care. To be successful, PMTCT programs should be aware of these factors and ensure that mothers are provided with culturally competent care.