Preventing Maternal to Child Transmission of HIV by Following Loss to Follow-Up From the Clinic to the Community

Prevention of HIV transmission from mother to baby or Prevention of Mother to Child Transmission (PMTCT) is an effective and in achieving a broad objective in suppressing maternal and infant mortality related to the level of public health in a region.Public Health Center with VCT service in the city Pematangsiantar has not yet fully provide PMTCT to realize pregnant women for screening HIV/AIDS. Pregnant women with HIV/AIDS still have a loss to follow up, this is a threat to suppress the prevalence and incidence of HIV/AIDS. Obstetrics study Program which also integrates the promotion of HIV/AIDS and IMS into KIA service to be responsible in suppressing its spread. These research identified the behavior and perception of pregnant women's beliefs against HIV screening to determine the level of consciousness in conducted HIV screening. These research was a descriptive studied with cross sectional design. Pregnant women who were netted in the ANC Ministry were the populations in this study. Data analysis was conducted to see the behavior and perception of pregnant women's beliefs against HIV screening. Data processed with univariate analysis. Found 337 expectant mothers who perform ANC and as many as 194 people were not willing to do HIV screening. Found low-level, disagreement and low-action and low-confidence perception of HIV screening.It is necessary to conduct a strategy approach with personal counseling, peer-education and home visits in the net of pregnant women with HIV. Keywords: behavior; HIV; screening; perception ABSTRAK Pencegahan penularan HIV dari ibu ke bayinya atau Prevention of Mother to Child Transmission (PMTCT) adalah suatu cara yang efektif dan dalam mencapai tujuan yang luas dalam menekan angka kematian ibu dan bayi yang berkaitan dengan tingkat kesehatan masyarakat di suatu wilayah. Puskesmas dengan layanan VCT di kota Pematangsiantar belum sepenuhnya memberikan PMTCT untuk menyadarkan ibu hamil untuk screening HIV/AIDS. Ibu hamil dengan HIV/AIDS masih ada yang loss to follow up, hal ini menjadi ancaman dalam menekan prevalensi dan insiden HIV/AIDS. Program Studi Kebidanan Pematangsiantar yang turut mengintegrasikan Promosi HIV/AIDS dan IMS ke dalam pelayanan KIA ikut bertanggungjawab dalam menekan penyebarannya. Penelitian ini mengidentifikasi perilaku dan persepsi keyakinan ibu hamil terhadap screening HIV untuk mengetahui tingkat kesadarannya dalam melakukan screening HIV. Penelitian ini merupakan penelitian deskriptif dengan desain cross sectional. Ibu hamil yang terjaring dalam pelayanan ANCadalah populasi dalam penelitian ini. Analisis data dilakukan untuk melihat perilaku dan persepsi keyakinan ibu hamil terhadap screening HIV. Data diolah dengan analisis univariate. Ditemukan 337 ibu hamil yang melakukan ANC dan sebanyak 194 orang belum bersedia dilakukan screening HIV. Ditemukan pegetahuan yang rendah, sikap tidak setuju dan tindakan yang rendah serta persepsi keyakinan yang rendah terhadap screening HIV.Perlu melakukan strategi pendekatan dengan konseling pribadi, peer-edukasi dan kunjungan rumah dalam menjaring ibu hamil dengan HIV. Kata kunci: perilaku; HIV; screening; persepsi

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Loss to Follow-Up among HIV Positive Pregnant and Lactating Mothers on Lifelong Antiretroviral Therapy for PMTCT in Rural Uganda

Advances in Public Health ◽

10.1155/2018/7540587 ◽

2018 ◽

Vol 2018 ◽

pp. 1-9 ◽

Cited By ~ 3

Author(s):

Matilda Kweyamba ◽

Esther Buregyeya ◽

Joy Kusiima ◽

Vianney Kweyamba ◽

Aggrey David Mukose

Keyword(s):

Health Facilities ◽

Hiv Positive ◽

Peer Educators ◽

Mother To Child Transmission ◽

Child Transmission ◽

Loss To Follow Up ◽

Lactating Mothers ◽

Lost To Follow Up ◽

Mother To Child

Background. Mother-to-Child Transmission of HIV accounts for more than 90% of all pediatric HIV infections. However, Prevention of Mother-to-Child Transmission (PMTCT) of HIV through provision of lifelong ART to HIV positive mothers faces various challenges which affect its success. One of such challenges is the loss to follow-up (LTFU) of mothers. Methodology. We conducted a cross-sectional study utilizing both quantitative and qualitative data collection methods. We were able to trace 279 HIV positive, pregnant, and lactating mothers among mothers who were initiated on lifelong ART for PMTCT in public health facilities in Ntungamo district, Western Uganda. The proportion of those who were lost to follow-up was determined, and Log binomial regression with stepwise backward elimination method was employed to identify factors associated with LTFU. Focus group discussions (FDGs) of women on lifelong ART and key informant interviews (KIIs) of peer educators were also performed. Results. Out of the 279 mothers that were successfully traced and interviewed, 103 (37%) were identified as lost to follow-up. The prevalence of LTFU was higher among those whose transport costs were above $2.75, adj (adjusted) PR (Prevalence Ratio) 1.6 (95% CI; 1.02-2.55); those who waited beyond one hour before being attended to, adj PR 1.74 (95% CI; 1.02-2.96); and those who assumed that their infant was already infected, adj PR 1.76 (95% CI; 1.15-2.70). On interviews, LTFU in these mothers was attributed to fear of swallowing antiretroviral drugs, HIV related stigma and discrimination, inadequate facilitation of the peer educators, long patient waiting time, and transportation to the health facilities. Conclusion. More than one-third of mothers initiated on lifelong ART for PMTCT in Ntungamo district were lost to follow-up over a period of 25 months. Recommendations. Provision of regular and adequate pre-ART and ART adherence counseling and provision of routine health education would reduce LTFU.

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Loss to follow up of pregnant women with HIV and infant HIV outcomes in the prevention of maternal to child transmission of HIV programme in two high-burden provinces in Papua New Guinea: a retrospective clinical audit

BMJ Open ◽

10.1136/bmjopen-2020-038311 ◽

2020 ◽

Vol 10 (12) ◽

pp. e038311

Author(s):

Angela Kelly-Hanku ◽

Claire Elizabeth Nightingale ◽

Minh Duc Pham ◽

Agnes Mek ◽

Primrose Homiehombo ◽

...

Keyword(s):

Pregnant Women ◽

Papua New Guinea ◽

Hiv Positive ◽

Newly Diagnosed ◽

Mother To Child Transmission ◽

Child Transmission ◽

Loss To Follow Up ◽

Factors Associated ◽

Mother To Child

IntroductionDespite early adoption of the WHO guidelines to deliver lifelong antiretroviral (ARV) regimen to pregnant women on HIV diagnosis, the HIV prevention of mother to child transmission programme in Papua New Guinea remains suboptimal. An unacceptable number of babies are infected with HIV and mothers not retained in treatment. This study aimed to describe the characteristics of this programme and to investigate the factors associated with programme performance outcomes.MethodsWe conducted a retrospective analysis of clinical records of HIV-positive pregnant women at two hospitals providing prevention of mother to child transmission services. All women enrolled in the prevention of mother to child transmission programme during the study period (June 2012–June 2015) were eligible for inclusion. Using logistic regression, we examined the factors associated with maternal loss to follow-up (LTFU) before birth and before infant registration in a paediatric ARV programme.Results763 of women had records eligible for inclusion. Demographic and clinical differences existed between women at the two sites. Almost half (45.1%) of the women knew their HIV-positive status prior to the current pregnancy. Multivariate analysis showed that women more likely to be LTFU by the time of birth were younger (adjusted OR (AOR)=2.92, 95% CI 1.16 to 7.63), were newly diagnosed with HIV in the current/most recent pregnancy (AOR=3.50, 95% CI 1.62 to 7.59) and were in an HIV serodiscordant relationship (AOR=2.94, 95% CI 1.11 to 7.84). Factors associated with maternal LTFU before infant registration included being primipara at the time of enrolment (AOR=3.13, 95% CI 1.44 to 6.80) and being newly diagnosed in that current/most recent pregnancy (AOR=2.49, 95% CI 1.31 to 4.73). 6.6% (50 of 763) of exposed infants had a positive HIV DNA test.ConclusionsOur study highlighted predictors of LTFU among women. Understanding these correlates at different stages of the programme offers important insights for targets and timing of greater support for retention in care.

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