Abstract
Background
In Malawi, loss to follow-up (LTFU) of HIV-positive pregnant and postpartum women on Option B+ regimen greatly contributes to sub-optimal retention, estimated 74% at 12 months postpartum. This threatens Malawi’s efforts to eliminate mother-to-child transmission of HIV. We investigated factors associated with LTFU among Mother-Infant Pairs.
Methods
We conducted a qualitative study, nested within the “Promoting Retention Among Infants and Mothers Effectively (PRIME)” study, a 3-arm cluster randomized trial assessing the effectiveness of strategies for improving retention of mother-infant pairs in HIV care in Salima and Mangochi districts, Malawi. From July to December 2016, we traced 19 LTFU women and conducted in-depth interviews with them and also with 30 healthcare workers from health facilities where the LTFU women were receiving care. Recorded interviews were transcribed and translated and, then, analysed using deductive content analysis.
Results
The following reasons were reported contributing to LTFU: lack of support from husbands or family members; long distance to health facilities; food insecurity; community-level stigma; ART side effects; perceived good health after taking ART and adoption of other alternative HIV treatment options.
Conclusion
Our study has found multiple factors at personal, family, community and health system level which contribute to poor retention of mother-infant pairs in HIV care.
Key words
PRIME, PMTCT, EMTCT, loss to follow up, mother-infant pairs, Option B+
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