Prevention Of Mother-to-child Transmission Services Research Articles

Evaluating the effect of a community score card among pregnant and breastfeeding women living with HIV in two districts in Malawi.

Malawi faces challenges with retaining women in prevention of mother-to-child HIV transmission (PMTCT) services. We evaluated Cooperative for Assistance and Relief Everywhere, Inc. (CARE's) community score card (CSC) in 11 purposively selected health facilities, assessing the effect on: (1) retention in PMTCT services, (2) uptake of early infant diagnosis (EID), (3) collective efficacy among clients, and (4) self-efficacy among health care workers (HCWs) in delivering quality services. The CSC is a participatory community approach. In this study, HCWs and PMTCT clients identified issues impacting PMTCT service quality and uptake and implemented actions for improvement. A mixed-methods, pre- and post-intervention design was used to evaluate the intervention. We abstracted routine clinical data on retention in PMTCT services for HIV-positive clients attending their first antenatal care visit and EID uptake for their infants for 8-month periods before and after implementation. To assess collective efficacy and self-efficacy, we administered questionnaires and conducted focus group discussions (FGDs) pre- and post-intervention with PMTCT clients recruited from CSC participants, and HCWs providing HIV care from facilities. Retention of HIV-positive women in PMTCT services at three and six months and EID uptake was not significantly different pre- and post-implementation. For the clients, the collective efficacy scale average improved significantly post-intervention, (p = 0.003). HCW self-efficacy scale average did not improve. Results from the FGDs highlighted a strengthened relationship between HCWs and PMTCT clients, with clients reporting increased satisfaction with services. However, the data indicated continued challenges with stigma and fear of disclosure. While CSC may foster mutual trust and respect between HCWs and PMTCT clients, we did not find it improved PMTCT retention or EID uptake within the short duration of the study period. More research is needed on ways to improve service quality and decrease stigmatized behaviors, such as HIV testing and treatment services, as well as the longer-term impacts of interventions like the CSC on clinical outcomes.

Contextualising men’s role and participation in PMTCT programmes in Malawi and Zambia: A hegemonic masculinity perspective

ABSTRACT This study sought to explore and contextualise the man’s role in antenatal services, and the barriers and strategies for engaging men in prevention of mother-to-child HIV transmission (PMTCT). We conducted 143 interviews with pregnant and breastfeeding women, male partners, health workers and policy makers in Malawi and Zambia. We employed thematic and critical discourse analysis using the hegemonic masculinity perspective. We found that men’s roles in PMTCT reflected hegemonic masculinities. As breadwinners, men supported their partners with material and financial resources. As decision makers, men were involved in decision making on the health of their partners. As social protectors, men supported their partners in accessing and adhering to antenatal care, HIV treatment and care. Barriers and challenges to male involvement in antenatal care were often the result of conflict between the clinic operating hours and men’s working hours, the perception of antenatal care services as female spaces, and men’s fear of HIV testing. Proposed strategies to increase male engagement in PMTCT included sensitising men about HIV and pregnancy; engaging leaders and employers, providing services outside working hours, and providing incentives. We conclude that men’s role and participation in PMTCT services are an extension and adaptation of hegemonic masculinities.

Known HIV status among adolescent women attending antenatal care services in Eswatini, Ethiopia and Mozambique

BackgroundAntenatal care (ANC) clinics remain important entry points to HIV care for pregnant women living with HIV—including adolescents. Prior knowledge of their HIV status at ANC enrollment is crucial to providing services for prevention of mother-to-child transmission (PMTCT) of HIV. We examined known HIV status of pregnant adolescents and women in other age groups at ANC enrollment.MethodsA descriptive study of routinely reported PMTCT data from 419 facilities in Eswatini, Ethiopia, and Mozambique, from January through December 2018 was conducted. We assessed knowledge of HIV status by country for three age groups: adolescents aged 15–19 years, young women aged 20–24 years, and older women aged 25–49 years. We report HIV prevalence and proportions of known and newly diagnosed HIV infections in women, by age group and country. The data were summarized by frequencies and proportions, including their 95% confidence intervals.ResultsAmong the facilities examined, 52 (12.4%) were in Eswatini, 63 (15.0%) in Ethiopia, and 304 (72.6%) in Mozambique. Across three countries, 488,121 women attended a first ANC visit and 23,917 (4.9%) were HIV-positive. Adolescents constituted 22% of all ANC attendees, whereas young and older women represented 33% and 45%, respectively. HIV prevalence was lowest among adolescents than in other age groups in Eswatini (adolescents 11.9%, young 24.2% and older 47.3%), but comparable to young women in Ethiopia (adolescents 1.6%, young 1.6% and older 2.2%) and Mozambique (adolescents 2.5%, young 2.5% and older 5.8%), However, in each of the three countries, lower proportions of adolescents knew their HIV-positive status before ANC enrollment compared to other age groups: in Eswatini (adolescents 51.3%, young 59.9% and older 79.2%), in Ethiopia (adolescents 42.9%, young 63.7% and older 75.2%), and in Mozambique (adolescents 16.4%, young 33.2% and older 45.6%).ConclusionOverall, adolescents made up nearly one-quarter of the women examined and had the least knowledge of their HIV status at ANC enrollment. Their HIV prevalence and known HIV-positive status varied widely across the countries examined. Adolescent-friendly sexual and reproductive health, and PMTCT services, before pregnancy, are needed to improve knowledge of HIV status and support pregnant adolescents and their infants.Plain English summaryAntenatal care (ANC) clinics are important for HIV testing of pregnant adolescents, who may not know their HIV-positive status at the first ANC visit. We describe data on pregnant adolescents and women in other age groups in ANC services to examine their prior HIV status at ANC enrollment across three African countries.We examined data from 419 PMTCT sites in Eswatini, Ethiopia, and Mozambique from January-December 2018, to evaluate HIV testing results for adolescents, young and older women aged 15–19, 20–24 and 25–49 years, respectively. We report the number of women living with HIV and the proportions of known and newly identified women living with HIV, by age-group and country.Across three countries, 488,121 women attended ANC and 23,917 (4.9%) were living with HIV. Adolescents constituted 22% of all ANC attendees, whereas young and older women represented 33% and 45%, respectively. HIV prevalence in each country compared to other age groups was lowest and varied among adolescents from 11.9% in Eswatini, to 1.6% in Ethiopia and to 2.5% in Mozambique. Also, fewer adolescents knew their HIV-positive status before ANC enrollment compared to young and older women from 51.3% in Eswatini, 42.9% in Ethiopia to only 16.4% in Mozambique.Pregnant adolescents made up nearly one-quarter of all ANC attendees; a majority of them had no previously known HIV-positive status. Adolescent-friendly, sexual and reproductive health services, before pregnancy and in PMTCT services, are needed to support pregnant adolescents and their infants.

Integrated early childhood development services improve mothers\u2019 experiences with prevention of mother to child transmission (PMTCT) programs in Malawi: a qualitative study

BackgroundHIV-positive mothers who face the dual burden of HIV-positive status and motherhood, may benefit from holistic services that include early childhood development (ECD). We evaluated the acceptability and impact of integrated ECD-PMTCT interventions for mothers and their children.MethodsWe implemented an integrated ECD-PMTCT intervention in 4 health facilities in Malawi for HIV-positive mothers and their infants. WHO/UNICEF Care for Child Development (CCD) education and counseling sessions were offered during routine PMTCT visits between infant age 1.5–24 months. From June–July 2019, we conducted in-depth interviews with 29 mothers enrolled in the intervention for ≥6 months across 4 health facilities. The interview guide focused on perceived impact of the intervention on mothers’ ECD and PMTCT practices, including barriers and facilitators, and unmet needs related to the program. Data were coded and analyzed using constant comparison methods in Atlas ti.8.ResultsThe vast majority of mothers believed the ECD-PMTCT intervention improved their overall experience with the PMTCT services, strengthened their relationship with providers, and excited and motivated them to attend PMTCT services during the postpartum period. Unlike prior experience, mothers felt more welcome at the health facility, and looked forward to the next visit in order to interact with other mothers and learn new ECD skills. Mothers formed new social support networks with other mothers engaged in ECD sessions, and they provided emotional and financial support to one another, including encouragement regarding ART adherence. Mothers believed their infants reached developmental milestones faster compared to non-intervention children they observed at the same age, and they experienced improved engagement in caregiving activities among male caregivers. Nearly half of women requested additional support with depression or anxiety, coping mechanisms to deal with the stresses of life, or support in building positive dynamics with their male partner.ConclusionThe integrated ECD-PMTCT intervention improved mother’s experiences with PMTCT programs and health care providers, increased ECD practices such as responsive and stimulating parenting, and created social support networks for women with other PMTCT clients.

Role of temporal discounting in a conditional cash transfer (CCT) intervention to improve engagement in the prevention of mother-to-child transmission (PMTCT) cascade

BackgroundTemporal discounting, the tendency of individuals to discount future costs and benefits relative to the present, is often associated with greater engagement in risky behaviors. Incentives such as conditional cash transfers (CCTs) have the potential to counter the effects of high discount rates on health behaviors.MethodsWith data from a randomized trial of a CCT intervention among 434 HIV-positive pregnant women in the Democratic Republic of Congo, we used binomial models to assess interactions between discount rates (measured using a delay-discounting task) and the intervention. The analysis focused on two outcomes: 1) retention in HIV care, and 2) uptake of prevention of mother-to-child transmission (PMTCT) services.ResultsThe effect of high discount rates on retention was small, and we did not observe evidence of interaction between high discount rates and CCT on retention. However, our findings suggest that CCT may mitigate the negative effect of high discount rates on uptake of PMTCT services (interaction contrast (IC): 0.18, 95% CI: − 0.09, 0.44).ConclusionsOur findings provide evidence to support the continued use of small, frequent incentives, to motivate improved uptake of PMTCT services, especially among women exhibiting high rates of temporal discounting.Trial registrationClinicaltrials.gov number NCT01838005, April 23, 2013.

Involvement of Male Partners of Pregnant Women in the Prevention of Mother-to-Child Transmission (PMTCT) of HIV in Haiti: A Mixed-Methods Study.

This mixed-methods study aimed to determine the level of male involvement in the prevention of mother-to-child transmission (PMTCT) services in Haiti and identify barriers and associated factors. From May to June 2018, a questionnaire was used to measure the level of male involvement. Semistructured interviews with pregnant women were also conducted. Multivariate linear regression and qualitative content analyses were performed to explore factors associated and barriers to male partners’ involvement in PMTCT services. One hundred and two pregnant women living with HIV completed the questionnaire. About 47% of male partners had a high level of involvement. Specifically, 90% financially supported their spouse, and 82% knew her appointment date at the antenatal clinic (ANC). Only 25% of male partners accompanied their spouse to the ANC, and 19% routinely used a condom during sexual intercourse. Factors associated with male involvement in PMTCT were being married and sharing HIV status with the male partner. Male partners with a positive HIV status were more likely to be involved in PMTCT. Qualitative findings revealed that barriers to male involvement included the conflict between opening hours of the ANC and the male partner’s schedule, waiting time at the ANC, and the perception of antenatal care as being women’s business. Overall male partners’ involvement in PMTCT services is moderate. Gender relations, sociocultural beliefs, and care organization are likely to hinder this involvement. Developing and implementing contextually and culturally accepted strategies for male partners of pregnant women could contribute to strengthening their involvement in the PMTCT program.

Prevention of Mother to Child Transmission in HIV Antenatal and Postnatal Screening in Khulna Medical College

Introduction: Prevention of Mother to Child Transmission (PMTCT) program, offers a range of services for women of reproductive age living with or at risk of HIV to maintain health and stop their infants from acquiring HIV. PMTCT services should be commenced before conception and throughout pregnancy, labor and breast feeding. Around 1.4 million HIV infections among children were prevented between 2010 and 2018 by PMTCT program. UNFPO started antenatal screening program in collaboration with AIDS/STD program in Bangladesh from 2013, in 12 centers (BSMMU, 4 Medical College Hospitals, 3 Sadar Hospitals, 3 Health Complexes and Memon Maternity Hospital, Chittagong).
 Materials and Methods: Observational study of Antenatal and postnatal cases in HIV screening in KMCH during the period of Nov’2017 to March’2020.
 Results: From November 2017 to March 2020, total 18,911 patients screened, 11 patients were found HIV positive. 2 patients dropped out. Among 9 patients, 6 patients were detected in antenatal and 3 in postnatal period. 6 patients had vaginal delivery, 2 elective caesarean section and 1 patient had abortion. Screening was done by Alere Determine HIV- ½ Ag/Ab Combotest and diagnosis was confirmed by Uni-Gold HIV Rapid Test and First Response HIV 1-2-0 Card test.
 Conclusion: Following confirmation, ARV started with proper counseling. All babies were breast fed. The neonates were screened by PCR at their age of 45 days and found negative. WHO guideline was strictly maintained during labor conduction and cesarean sections. PMTCT program should be expanded in all institutions to detect cases, reduce transmission, contraception counselling to reduce confirmed cases.
 Medicine Today 2021 Vol.33(1): 7-11

Burden of HIV-Related Stigma and Post-Partum Depression: A Cross-Sectional Study of Patients Attending Prevention of Mother-to-Child Transmission Clinic at Kenyatta National Hospital in Nairobi.

Background: We look at how various HIV-related stigma subtypes, especially internalizing types, interact with postpartum depression (PPD) among women living with HIV. Additionally, we identify key psychosocial risk factors that influence stigma and PPD among women attending Prevention of Mother-to-Child Transmission (PMTCT) clinics.Methods: In this cross-sectional design, 123 women living with HIV were recruited. Participants ages between 18 and 50, who were at least 8 weeks postpartum seeking PMTCT services at Kenyatta National Hospital (KNH), between June and September 2014 participated in the study. HIV/AIDS Stigma Instrument—PLWHA (HASI–P) was used to assesses stigma and Postpartum depression was assessed by Edinburgh Postnatal Depression Scale (EPDS). Bivariate and multivariate regression models were used to determine the individual characteristics associated with the HIV-related stigma Scale. Post survey a few in-depth-interviews were conducted to explore individuals' stigma and depression experiences.Results: The mean age was 31.2 years (SD = 5.2). Fifty-nine (48%) women screened positive for significant depressive symptoms. Post-partum depression was a significant predictor of internalized stigma, enacted, and total stigma (P < 0.05). Older age was associated with less internalized stigma. Living with a partner was associated with more internalized stigma. Having an income above 100 USD per month was protective against stigma. Having good family social support was protective against internalized stigma. A higher educational level was protective against enacted stigma. Being treated for STIs was a risk factor for both enacted and overall stigma.Conclusions: HIV-related stigma needs to be addressed through integrated mental health care programs in PMTCT. Postpartum depression requires comprehensive management to improve short- and long-term outcomes of women living with HIV.

An Assessment of Prevention of Mother to Child Transmission (PMTCT) of HIV Services in Gombe State, Nigeria

Transmission of HIV from mother to child continues to be the major source of HIV infection among children under the age of fifteen. Therefore, targeting pregnant women attending antenatal clinics provides a unique opportunity for the implementation of prevention of mother-to-child transmission (PMTCT) intervention program against HIV infection of new-born babies. This study was aimed at assessing the Mother to Child Transmission of HIV intervention and the follow up of exposed infant HIV testing in nine selected health facilities in Gombe state between January 2016 and December 2016. The methodology used was a non-experimental descriptive study that combined hospital record review and structured questionnaire to collect relevant data. A cross-sectional retrospective evaluation of women enrolled in Prevention of Mother to Child Transmission of HIV programme at facilities supported by an indigenous partner (Centre for Integrated Health Program - CIHP), was carried out. In addition, structured questionnaires were served on 498 ANC attendees and service providers, selected by consecutive sampling method. Data entry and analysis were done using SPSS version 21. The study showed that there was adequate coverage with PMTCT services in the study area as all the respondents affirmed to accessing all expected services in all the facilities. Pregnancy was found to be an automatic indicator (469, 94.2%) for HIV test and therefore ANC served as a critical window for the provision of PMTCT services. Mother-to-child transmission remained a major route of HIV transmission in children with 12 (2.4%) cases of HIV in infants at 6weeks DNA PCR test and 5 (1.0%) cases of HIV-positive in children after the Rapid test at 18 months. Hence, it is recommended that there should be a scale-up of the programme, pre-natal sensitization of women, baby positioning and attachment for safe and effective breastfeeding, ensuring prompt (within 28 days) availability of DNA/PCR test results and adopting consensus method for the assessment of PMTCT.

A model for enhancing prevention of mother to child HIV transmission in a low resource setting

BackgroundThe prevention of mother-to-child transmission (PMTCT) programmes plays a significant role in the reduction of human immunodeficiency virus (HIV) infections in the under-five age group and maternal mortalities. A phenomenological study on the experiences of HIV-positive women who utilised the PMTCT services identified challenges affecting the use of those services. An enabling environment is required for the effectiveness of the PMTCT programme. PurposeThe purpose of this paper is to develop and describe a model for enhancing prevention of mother-to-child HIV transmission in a low-resource setting. MethodThe model was developed in three sequential phases: empirical foundation, development of the model and description of the model. The model was developed using Walker and Avant’s steps of theory development. Chinn and Kramer’s criteria were used to evaluate the model and the modified version of the Delphi technique was utilised for peer review and further refinement of the model. This emanated from findings of a doctoral thesis on the experiences of HIV-positive PMTCT clients at a central hospital in Zimbabwe. The procedure involved the use of systems theory, central concept identification, a literature review, the definition of key terms and the identification of the elements of the model, after which the model was developed, described, and evaluated. ResultsThe elements of the model encompass the context, input, process and outcome. ConclusionThe model will act as a reference framework for midwives and programme planners with a view of enhancing utilisation and the quality of PMTCT services.

Prevention of HIV Transmission from Mother to Child: Challenges to the Successful Program Implementation and Practice in Indonesia.

Introduction:The level of human immunodeficiency virus (HIV) transmission from mother to child in Indonesia ranks first worldwide. Newborn babies in Indonesia are at greater risk of experiencing the burden of HIV infection than babies born in other countries.Objectives:To explore the full extent of Prevention of Mother to Child Transmission (PMTCT) in South Sulawesi Province in 2020 and to discuss program and policy implications for PMTCT.Methods:This is a health system analysis study with a qualitative approach using focus group discussion, in-depth interviews, and observations in primary health centers and hospitals.Results:There is no local policy and guidelines for PMTCT programs and services; the coverage of HIV testing in pregnant women has not achieved 100% according to the target. There are limitations to human resources in public and private services to conduct the program. The assistance’s activities to ensure antiretroviral (ARV) adherence are limited, and HIV-positive women faced stigma and discrimination, not only from the community but also from health workers.Recommendations:Some recommendations are to improve the HIV test coverage to 100% in pregnant women as well as the coverage and quality of ARV treatment.

976. A Descriptive Retrospective Data Analysis of Maternal Sociodemographic Factors and Access of Healthcare Resources within the African Cohort Study, an Integrated Multicountry Preventative Mother to Child Transmission Program

BackgroundGlobal reduction in new infant HIV infections is largely due to the expansion of prevention of mother-to-child transmission (PMTCT) programs. Identification of gaps in healthcare services is paramount in targeting interventions that identify high-risk populations and healthcare barriers that could lead to increased risk of mother to child transmission (MTCT) of HIV.MethodsHIV infected women from 5 regions of Africa enrolled in the African Cohort Study (AFRICOS) were followed prospectively with assessments performed every 6 months. Sociodemographic factors, pregnancy outcomes, and access of PMTCT resources were reviewed for retrospectively reported pregnancies and those followed prospectively from study enrollment. Statistical analysis compared the impact of clinical factors on infant mortality and preterm delivery.ResultsThe study reported 5591 pregnancies from January 2013 to June 2019 of which 5363 were retrospectively reported prior to study enrollment and 228 occurred after enrollment. Pregnancies followed prospectively had higher rates of linkage to PMTCT services prenatally (92.5% vs 6.8%, P< 0.001), intrapartum (64.5% vs 3.5%, P< 0.001), and post-partum (64.5% vs 2.9%, P< 0.001). This group had higher rates of delivery by a skilled birth attendant (93.4% vs 66.7%, P< 0.001) and antiretroviral therapy (ART) prescribed antepartum (96.1% vs 5.5%, P< 0.001) and post-partum (74.6% vs 3.6%, P< 0.001). Both groups had similar rates of prescriptions for intrapartum ART (98.7% vs 97.9%). The majority of women reported ART adherence (96.5%, P< 0.001) which was associated with a decrease in both preterm delivery and infant mortality (adjusted OR 0.24, 95% CI 0.15-0.39). A significant proportion of women followed prospectively reported their infants received ART with good adherence (51.8% vs 0.3% and 93.4% vs 6.3%, respectively P< 0.001).ConclusionParticipation in AFRICOS increased linkage to PMTCT programs which resulted in increased likelihood of skilled delivery and appropriate ART use for women and their infants. It highlights that linkage to care continues to be a crucial factor in limiting MTCT of HIV especially in resource-limited settings. Limitations in this study exist due to the low number of prospectively followed pregnancies.Disclosures All Authors: No reported disclosures

Exploring the meanings of male partner involvement in the prevention of MTCT of HIV in Zimbabwe

Male partner involvement (MPI) in the prevention of mother-to-child transmission (PMTCT) of human immunodeficiency virus (HIV) is considered as one of the priority interventions in reducing paediatric HIV. However, there is neither a standard definition nor measurement for MPI in PMTCT. The study explored meanings of MPI in PMTCT programmes in Zimbabwe. Eight focus group discussions (FGDs) were conducted with men and women aged 18 years and above. Seven key informants (KII) from health institutions and organisations providing PMTCT services were interviewed. Eight in-depth interviews (IDIs) were conducted with pregnant women at two public health facilities. Thematic analysis was used for data analysis. Five major themes were identified which facilitated our understanding of MPI. Male partner involvement was referred to as participation of male partners in HIV couple counselling and testing. Acceptance of condom use during pregnancy and breastfeeding was deemed vital as this prevents HIV transmission. Male partners were expected to have knowledge of administering antiretroviral drugs to an HIV-exposed child. Provision of financial support was another form of male involvement commonly expected during antenatal and postnatal periods. Faithfulness in marriage was a major theme that was highlighted, especially by respondents in marital relationships. Male partner presence in PMTCT community educational sessions was also considered. However, the provision of male-oriented educational programmes was identified as poor. The study suggested a definition for MPI in PMTCT in Zimbabwe. The merit of this definition was that it took a holistic approach to include activities beyond antenatal activities and HIV testing. Future research should explore how public health institutions could create male-oriented health services within PMTCT programmes, as this has the potential of increasing men’s involvement in PMTCT of HIV.Contribution: This article contributed to the knowledge on how world views, which is shaped by culture and religion, influenced the formation of meanings on MPI PMTCT programmes.

Calculating the Number of Pregnant Women Receiving Standardized Services for PMTCT of HIV in Liangshan Prefecture, Based on the Equivalent Method

ObjectiveTo calculate the number of pregnant women who receive standardized prevention of mother-to-child transmission (PMTCT) services for HIV annually. MethodsHIV-positive pregnant women in six counties of Liangshan Prefecture in 2017 were selected as study subjects. The entire process, from when the subjects first received the PMTCT of HIV services to the end, was divided into four stages, which were further divided into 25 phases. The equivalent coefficient was used to indicate the weight of workload in each phase. Seven experts were invited to score the equivalent coefficient; the number of pregnant women who received standardized services to prevent the transmission of HIV was calculated. ResultsA total of 663 HIV-positive pregnant women were registered in six Liangshan Prefecture counties in 2017. This figure was converted into 7,780 person-months devoted to HIV-positive pregnant women, with 260 person-months (3.34%) spent on the first antenatal care, 1,510 person-months (19.41%) during pregnancy, 378 person-months (4.86%) on delivery, and 5,632 person-months (72.39%) on post-partum period. The equivalent coefficient calculation showed that 314 HIV-positive pregnant women received standardized PMTCT services. ConclusionThe number of pregnant women receiving standardized services for the PMTCT of HIV can be calculated accurately using the equivalent method to identify the gap between the level of PMTCT of HIV intervention services needed and the actual workload.

Prevention of Mother-to-Child HIV Transmission Service Utilization among Pregnant Women in Northeast Ethiopia: A Cross-Sectional Survey.

Background Targeting pregnant women attending antenatal care clinics provides a unique opportunity for implementing the Prevention of Mother-to-Child Transmission (PMTCT) programs against human immunodeficiency virus (HIV) infection of newborn babies. The objective of this study was to assess the PMTCT service utilization rate and to characterize its reasons among pregnant women attending antenatal care clinics at selected public health facilities in Debre Berhan Town, Northern Ethiopia. Methods A facility-based cross-sectional survey was conducted among 355 pregnant women from May 1 to June 15, 2019. The participants were selected by systematic random sampling technique, and data were collected using a pretested interviewer-administered structured questionnaire. Descriptive statistics like frequency, mean, and standard deviation were reported using text, table, and graphs. Results The mean ages of the respondents were 24 (±5.6) years, and the majority of the respondents (287 (80.8%)) were urban residents. In this study, prevention of mother-to-child HIV transmission service utilization rate was 86.8%. The most frequently mentioned reasons for not utilization of services were fear of stigma and discrimination (42.6%), fear of rejection by partner (19.1%), fear of positive test results (17.0%), lack of awareness (12.7%), and wastage of time (8.5%). Hence, continuous health education and comprehensive counseling are necessary to increase the awareness and reduce stigma, fear of the positive result, and partner rejection.

Adherence to Antiretroviral Treatment for Prevention of Mother-to-Child Transmission of HIV in Eastern Ethiopia: A Cross-Sectional Study.

IntroductionEven though PMTCT (prevention of mother-to-child transmission) is the most effective option to prevent vertical transmission of HIV, achieving optimal adherence has been a universal challenge to PMTCT, including Ethiopia.ObjectiveTo assess levels of adherence and associated factors among pregnant and lactating mothers on PMTCT at public health facilities in Harar town, Harari region, Eastern Ethiopia.MethodsA facility-based cross-sectional study was conducted from April 01 to April 30, 2019, at the selected public health facilities of Harar town, Harari regional state, Eastern Ethiopia. Adherence was measured using a multi-method tool that includes pill counting and self-reporting method. Binary logistic regression analysis was used to determine factors associated with PMTCT adherence. The results were adjusted for possible confounding variables and P-value <0.05 or CI not including 1 was considered statistically significant.ResultsOf the 190 included patients, 83.2% of them had good adherence to PMTCT. Forgetfulness (79%) and being busy (71%) were among the main reasons for non-adherence to PMTCT. In multivariate logistic regression, participants who have received counseling on side effects were 3.4 times more likely to have good adherence [AOR=3.4, 95% CI: 2.1–9.2]; those with previously known HIV status were 2.1 times more likely to have good adherence to PMTCT [AOR=2.1, 95% CI: 1.6–7.1] and women who were knowledgeable on PMTCT were 5.2 times more likely to have good adherence [AOR=5.2, 95% CI: 1.6–6.28].ConclusionIn this study, the overall level of adherence to PMTCT care and support was 83.2%. Counseling on side effects, knowledge about PMTCT, and pregnancy status during initiation of ART were the factors that determine adherence of pregnant and lactating women towards PMTCT service. Thus, it is recommended to raise awareness about PMTCT among all reproductive-age women by stressing the benefit of the early initiation of ART and by providing information on the possible side effect of the drugs.

Determinants of uptake of PMTCT services by HIV positive mothers accessing care in Akure, Ondo State, Nigeria

BACKGROUND: Mother-to-child transmission (MTCT) of HIV remains a major public health challenge which account for substantial proportion of new HIV infections among children. Global interventional programme such as Prevention of mother to child transmission (PMTCT) of HIV has been initiated to protect children from the scourge of HIV pandemics. However, it is faced by multiple challenges in Africa. This study assessed the influencers of PMTCT services uptake among HIV-positive mothers in Akure.METHODS: A cross-sectional descriptive survey was employed using quantitative and qualitative design among 300 HIV positive pregnant and lactating mothers. Information on knowledge, awareness, and factors influencing uptake of PMTCT were collected using semi structured questionnaire. Data was analysed using SPSS v.20.RESULT: The average age of the respondents was 31.07 ±5.0 years with 77% being married. Majority (83%) were aware of PMTCT. The uptake level of PMTCT services was 89%. Knowledge on PMTCT (χ2 = 9.3, P value 0.002), Partner Support (χ2= 5.09, p=0.024), Religion (Christianity) (χ2=7.264, p=0.007), Occupation (unskilled) (χ2=12.6, p=0.002) were factors found to be significantly associated with the uptake of PMTCT services among HIV positive mothers.CONCLUSION: The uptake of PMTCT services among HIV positive mothers was high in Akure. Knowledge of the respondent on PMTCT, Partner Support, Religion and occupation were factors that influenced level of uptake of PMTCT service. Health workers should intensify quality counselling and health talks by taking time to explain extensively in English and their mother tongues

Clients' Satisfaction with Services for Prevention of Mother-to-Child Transmission of HIV in Public Health Facilities in Diredawa City, Eastern Ethiopia.

BackgroundEthiopia has a very high burden of HIV infection among children, contracted from their mothers, and nearly two-thirds of pregnant women do not receive prevention of mother-to-child transmission (PMTCT) services. Ensuring clients’ satisfaction with PMTCT services is one of the bases to scale up service utilization and mitigate MTCT of HIV. However, in Ethiopia, particularly in the study area, evidence related to clients’ satisfaction with PMTCT services is scanty.MethodsA facility-based cross-sectional study was conducted among women attending antenatal care in Diredawa city. Systematic random sampling was used to select 517 study participants. Interviewer-administered structured and pretested questionnaires were used to collect data. Statistical significance was regarded as P≤0.05 with a 95% CI.ResultsClient satisfaction with PMTCT services was 82.2% (95% CI 66.4%–94.3). Receiving the service from a hospital (AOR 2.34; 95% CI 1.5, 3.98), no formal education (AOR 2.53, 95% CI 1.52–4.2), primary education (AOR 2.17 95% CI 1.17–4.04), receiving pre- and post-HIV test counseling from the same provider (AOR 4.93, 95% CI 2.98–7.17), gestational age above first trimester (AOR 1.74, 95% CI 1.12–2.71), and waiting time ≤15 minutes (AOR 2.31, 95% CI 1.28–4.16) were positively associated with client satisfaction with PMTCT services.ConclusionClient satisfaction with PMTCT services is relatively high. Receiving the service from a hospital, no formal education or only primary education, gestational age above first trimester, getting pre- and post-HIV test counseling from the same provider, and waiting time ≤15 minutes to receive services were factors associated with client satisfaction. A greater number of skilled PMTCT-service providers would improve service quality and hasten its delivery. Furthermore, providing mentoring and supportive supervision of health centers with PMTCT programs and keeping the same provider in posttest counseling is also mandatory.

Perception and Barriers to Prevention of Mother to Child Transmission (PMTCT) of HIV among Pregnant Women Attending Antenatal Clinic in Urban Maternity, Bauchi State, Nigeria

Globally HIV pandemic remains an issue of major concern to the government, health practitioners, policymakers, and researchers. HIV can be transmitted from mother to child either during pregnancy, labor, delivery, or breastfeeding; presently developing countries including Nigeria accord importance to the prevention of mother to child transmission. Despite this effort and commitment to the provision of access to prevention of mother to child transmission of HIV (PMTCT) drugs services in Nigeria, statistics have shown that annual HIV positive births are recorded in larger figures in Nigeria. On this basis, this study aimed to examine the perception of and barriers to prevention of HIV mother to child transmission (PMTCT) among antenatal mothers in urban maternities in Bauchi state, investigating the level of PMTCT services perception, establishing the extent to which PMTCT services are used, and barriers to the use of PMTCT services in the state. The study used a narrative approach and description applying percentages and frequencies using five-point Likert scales to get responses from the respondents. Data were collected and analyzed and the findings reveal a positive perception of prevention of mother to child transmission of HIV and that positive women are ready to take ARV drugs to end the pandemic. It also showed that 90% of the respondents had good knowledge of HIV transmission mechanisms. The PMTCT program revealed good knowledge of MTCT prevention. We recommend that regular assessment of the PMTCT program should be conducted for program sustainability and scale-up. HIV positive mothers should continue to receive ARV in pregnancy and the postpartum period, reinforce joint action of all stakeholders to reach those women who are positive to achieve the PMTCT national target and religious leaders should preach to their followers to voluntarily have HIV testing to know their status.

Knowledge of HIV Status Among Mothers Accompanying Their Infants for Immunization in Machakos, Kenya, 2014

BACKGROUNDElimination of mother-to-child transmission of HIV is achievable through prevention of mother-to-child transmission (PMTCT) interventions. For HIV-positive mothers to access PMTCT services, they must be identified through HIV testing and counseling. We sought to measure the proportion of mothers with unknown HIV status and to determine associated factors.&#x0D; METHODSWe recruited into a cross-sectional study 400 mothers accompanying their infants for routine immunization at mother-child health clinic (MCH) at Machakos Hospital, Kenya, collected information on HIV testing from their antenatal records, and offered opt-out HIV testing to those with unknown HIV status.&#x0D; RESULTSOverall, 304 (76.0%) mothers had unknown status at MCH, of whom 25 (8.6%) tested HIV-positive. HIV positivity was three times higher among mothers who never tested during pregnancy/delivery versus those whose last negative HIV test was &gt;3 months prior to study enrolment (18% versus 6%). Women living more than three kilometers away from the health facility had 2.7-fold greater odds of having unknown status compared to those who lived less than three kilometers (adjusted odds ratio [AOR] 2.7, 95% CI 1.3–5.6). Married women had 3.2-fold greater odds of having unknown status as compared to those who were single (AOR 3.2, 95% CI 1.4–7.0). Those with education had a tenfold reduction in odds of having unknown status compared to those with none (AOR 0.1, 95% CI 0.0–0.2).&#x0D; CONCLUSIONInterventions are needed to improve women’s ANC attendance, uptake of HIV testing, and disclosure of HIV status during pregnancy to achieve the elimination of MTCT.