Abstract
Background:Eswatini has adopted the PMTCT Option B+ approach as a strategy for the prevention of mother-to-child transmission of HIV.Objective:This study aimed to explore how pregnant Swazi women perceived and experienced PMTCT Option B+ and examined challenges they faced in disclosing their HIV status to their male partners.Methods:We interviewed 15 HIV-positive pregnant women selected using purposeful sampling from the PMTCT programme in Manzini Region, Eswatini. The data were analysed thematically.Results:The women had to deal with the pregnancy, the HIV-positive test results, the immediacy of the antiretroviral treatment (ART), and disclosure issues, all in one visit. They perceived the mandatory HIV testing and the same-day ART initiation as coercive. Regardless, they perceived PMTCT in a positive manner and as a gateway to early treatment for them. The drive to enroll in and remain in PMTCT was motivated by the belief in the efficacy of ART and the desire to protect their unborn babies from HIV infection. Their anticipation of rejection and violence from their partners led to their delaying disclosure and initiation of ART. Following disclosure, some of them were stigmatised, blamed for the infection, and abandoned by their partners.Conclusion:As Eswatini continues to roll out Option B+, there is a need to consider providing individualised counselling sessions to meet the individual needs of women.
Highlights
The uptake of the prevention of mother to child transmission (PMTCT) programme has significantly improved from 49% in 2010 to 82% in 2018 [1]
The sample consisted of 15 HIV-positive pregnant women, five of whom were pregnant for the first time
This study describes the experiences of HIV-positive pregnant Swazi women participating in PMTCT Option B+ in Eswatini and the challenges they experienced in disclosing their HIV-positive test results to their sex partners
Summary
The uptake of the prevention of mother to child transmission (PMTCT) programme has significantly improved from 49% in 2010 to 82% in 2018 [1]. To achieve the elimination of mother-to-child transmission (MTCT), HIVpositive women and their babies must be enrolled and retained in PMTCT programmes and must adhere to ART [2]. Eswatini is one of the countries that adopted the PMTCT Option B+ approach as a national strategy for the prevention of mother-to-child transmission of HIV in 2013. In a pilot study on the implementation of PMTCT option B+ in the first implementation regions in Eswatini, only half of the women initiated on ART had been retained at two years [8]. Eswatini has adopted the PMTCT Option B+ approach as a strategy for the prevention of mother-to-child transmission of HIV
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