scholarly journals Assessing Option B+ retention and infant follow-up in Lilongwe, Malawi

2017 ◽  
Vol 29 (2) ◽  
pp. 185-194 ◽  
Author(s):  
Blake M Hauser ◽  
William C Miller ◽  
Hannock Tweya ◽  
Colin Speight ◽  
Tiwonge Mtande ◽  
...  
Keyword(s):  
Unmet Need ◽  
Antenatal Clinic ◽  
Hiv Positive ◽  
Maternal Characteristics ◽  
Logistic Regression Models ◽  
Cart Initiation ◽  
Hiv Positive Women ◽  
Mother To Child ◽  
The Continuum

Malawi launched Option B+, a program for all pregnant or breastfeeding HIV-positive women to begin lifelong combination antiretroviral therapy (cART), in July 2011. This study characterises a portion of the continuum of care within an antenatal setting in Lilongwe. Women testing HIV-positive and having a cART initiation record at Bwaila Antenatal Clinic from July 2013 to January 2014 were included. Using logistic regression models, we analysed relationships between maternal characteristics and return for infant testing. Among 490 HIV-positive women with a cART initiation record, 360 (73%) were retained at three months. Of these, 203 (56%) were adherent. Records of infant testing were located for 204 women (42%). Women who were not retained were less likely to have an early infant diagnosis record (aOR = 0.20; 95% CI: 0.10, 0.41). Among the women retained, there was a non-significant association between maternal adherence and infant testing (OR = 1.35; 95% CI: 0.89, 2.06). Women lost at earlier continuum stages, who are at higher risk for mother-to-child-transmission, were less likely to bring infants for testing. Even with a test-and-treat program, many women did not remain in care or bring their infant for testing. Facilitating strategies to improve these measures remains an important unmet need.

UNMET NEED FOR CONTRACEPTION AMONG HIV-POSITIVE WOMEN IN LESOTHO AND IMPLICATIONS FOR MOTHER-TO-CHILD TRANSMISSION

2009 ◽  
Vol 41 (2) ◽  
pp. 269-278 ◽  
Author(s):  
TIMOTHY ADAIR
Keyword(s):  
Family Planning ◽  
Unmet Need ◽  
Hiv Positive ◽  
Mother To Child Transmission ◽  
Hiv Status ◽  
Child Transmission ◽  
Childbearing Age ◽  
Hiv Positive Women ◽  
Mother To Child ◽  
Unmet Need For Contraception

SummaryIn Lesotho, the risk of mother-to-child-transmission (MTCT) of HIV is substantial; women of childbearing age have a high HIV prevalence rate (26·4%), low knowledge of HIV status and a total fertility rate of 3·5 births per woman. An effective means of preventing MTCT is to reduce unwanted fertility. This paper examines the unmet need for contraception to limit and space births among HIV-positive women in Lesotho aged 15–49 years, using the 2004 Lesotho Demographic and Health Survey. HIV-positive women have their need for contraception unmet in almost one-third of cases, and multivariate analysis reveals this unmet need is most likely amongst the poor and amongst those not approving of family planning. Urgent action is needed to lower the level of unmet need and reduce MTCT. A constructive strategy is to improve access to family planning for all women in Lesotho, irrespective of HIV status, and, more specifically, integrate family planning with MTCT prevention and voluntary counselling and testing services.

scholarly journals Predictors of Unmet Need for Family Planning among HIV Positive Women in Care in Federal Teaching Hospital Gombe, Nigeria

2020 ◽  
pp. 26-33
Author(s):  
A. Mohammed ◽  
D. Chiroma ◽  
C. H. Laima ◽  
M. A. Danimoh ◽  
P. A. Odunze
Keyword(s):  
Family Planning ◽  
Unmet Need ◽  
Hiv Care ◽  
Hiv Positive ◽  
P Value ◽  
Mother To Child Transmission ◽  
Child Transmission ◽  
Hiv Positive Women ◽  
History Of ◽  
Mother To Child

Background: Elimination of mother-to-child transmission (EMTCT) of Human Immunodeficiency Virus (HIV) requires adequate and continuous use of family planning commodities among women of reproductive age. This can be made possible by reducing the proportion of HIV positive women with unmet need for family planning. The study aims to determine the factors associated with having unmet need among women in HIV care. Methods: A cross sectional study was conducted using an interviewer administered questionnaire to study 325 women on HIV care. Cluster sampling technique was used to select the study respondents from the clinic. Results: Less than half of the respondents (40%) were currently using family planning, 35% had unmet need for family planning with 53.6% having unmet need for spacing while 46.4% having unmet need for limiting. Women with no history of previous use of family planning were fifteen times more likely to have unmet need for family planning than those with history of previous use of family planning (p value <0.001, CI 2.511-15.770). Also women with more than five deliveries were eight times more likely to have unmet need for family planning (p value 0.004, CI 0.001-0.279) while women with 2-5 deliveries are four times likely to have unmet need for family planning (p value 0.035, CI 0.005-0.832). Conclusion: A high proportion of women receiving ART care still have unmet need for family planning despite incorporating this service in HIV care. It is therefore important to target high risk groups to reduce the proportion of women with unmet need for family planning which will invariable reduce mother to child transmission of HIV.

scholarly journals Hubungan Persepsi tentang Penularan HIV/AIDS dari Ibu ke Anak terhadap Praktik Penggunaan Kontrasepsi pada Wanita Usia Subur Penerima Obat Antiretroviral di Kota Bandung

2020 ◽  
Vol 29 (4) ◽  
Author(s):  
Riska Regia Catur Putri ◽  
Zulvayanti Zulvayanti ◽  
Panji Fortuna Hadisoemarto ◽  
Deni K. Sunjaya ◽  
Elsa Pudji Setiawati ◽  
...  
Keyword(s):  
Contraceptive Use ◽  
Health Belief ◽  
Hiv Positive ◽  
Childbearing Age ◽  
Perceived Susceptibility ◽  
Perceived Severity ◽  
Hiv Positive Women ◽  
Belief Model ◽  
Mother To Child ◽  
Hiv Aids

Abstract    More than 90% of cases of Human Immunodeficiency Virus (HIV) / Acquired Immune Deficiency Syndrom (AIDS) in children, occur due to transmission from mother to child. Prevention of unwanted pregnancies with contraception in HIV positive women is important strategy to reduce the rate of mother to child HIV/AIDS transmission. The practice of contraceptive use in HIV positive women is strongly influenced by individual beliefs regarding the benefits and effectiveness of contraception for the prevention of mother to child HIV/AIDS transmission. This study aims to determine the relationship of perceptions based on the construct of the Health Belief Model (HBM) wich consists of perceived susceptibility, perceived severity, perceived benefit, perceived barrier, self efficacy, and cues to action and based on pluralistic ignorance on the practice of contraceptive use among woman of childbearing age recipients of antiretroviral in Bandung. The design of this study was quantitative non-experimental with survey methods. Data were collected for one month, using questionnaire from 188 women of childbearing age  receiving  antiretroviral drughs taken by consecutive sampling (non-probability) technique. Data were analyzed by logistic regression. The results revealed perceived susceptibility is an HBM construct that affects contraceptive use (Adjusted Odds Ratio (AOR):4.5). While knowledge (AOR:7.3) and age (AOR:0.801), emerged as other factors that influence contraceptive use among WUS recipients of antiretroviral in Bandung. The HBM is used to predict contraceptive behavior in women. HIV positive women who believe themselves to be at high risk of infecting HIV/AIDS from mother to child will tend to use contraception, besides that knowledge is the basis for HIV positive women taking action to use contraception. Abstrak Lebih dari 90% kasus Human Immunodeficiency Virus (HIV)/Acquired Immune Deficiency Syndrom (AIDS) pada anak, terjadi akibat penularan dari ibu ke anak. Pencegahan kehamilan yang tidak direncanakan dengan kontrasepsi pada wanita HIV positif merupakan strategi penting untuk menurunkan angka penularan HIV/AIDS dari ibu ke anak. Praktik penggunaan kontrasepsi oleh wanita HIV positif sangat dipengaruhi oleh keyakinan individu terkait manfaat dan efektivitas kontrasepsi terhadap pencegahan penularan HIV/AIDS dari ibu ke anak. Penelitian ini bertujuan untuk mengetahui hubungan persepsi berdasarkan konstruk Health Belief Model (HBM) yang terdiri dari perceived susceptibility, perceived severity, perceived benefit, perceived barrier, self efficacy, dan cues to action serta berdasarkan ketidaktahuan majemuk terhadap praktik penggunaan kontrasepsi pada Wanita Usia Subur (WUS) penerima obat antiretroviral di Kota Bandung. Desain penelitian ini adalah kuantitatif non-experimental dengan metode survei. Data dikumpulkan selama satu bulan, menggunakan kuesioner dari 188 WUS penerima obat antiretroviral yang diambil dengan teknik consecutive sampling (non-probability). Data dianalisis dengan regresi logistik. Hasil penelitian mengungkapkan perceived susceptibility adalah konstruk HBM yang berpengaruh terhadap penggunaan kontrasepsi (Adjusted Odds Ratio (AOR):4,5). Sementara pengetahuan (AOR:7,3) dan usia (AOR:0,801) muncul sebagai faktor-faktor lain yang berpengaruh terhadap praktik penggunaan kontrasepsi pada WUS penerima obat antiretroviral di Kota Bandung. HBM digunakan untuk memprediksi perilaku kontrasepsi pada wanita. Wanita HIV positif yang meyakini dirinya berisiko tinggi dapat menularkan HIV/AIDS ke anak, akan cenderung menggunakan kontrasepsi, disamping itu pengetahuan menjadi dasar bagi wanita HIV positif dalam mengambil tindakan untuk menggunakan kontrasepsi.

scholarly journals Describing Point of Entry into Care and Being Lost to Program in a Cohort of HIV Positive Pregnant Women in a Large Urban Centre in Uganda

2017 ◽  
Vol 2017 ◽  
pp. 1-6 ◽  
Author(s):  
Rachel Musomba ◽  
Frank Mubiru ◽  
Shadia Nakalema ◽  
Hope Mackline ◽  
Ivan Kalule ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Older Women ◽  
First Trimester ◽  
Hiv Positive ◽  
Urban Centre ◽  
Factors Associated ◽  
Point Of Entry ◽  
Art Initiation ◽  
Hiv Positive Women

Introduction. We aim to describe the time of entry into care and factors associated with being lost to program (LTP) in pregnant women on Option B Plus in an integrated HIV and antenatal care (ANC) clinic in Uganda. Methods. We included all pregnant women enrolled into the integrated HIV-ANC clinic from January 2012 to 31st July 2014, while the follow up period extended up to October 30th 2015. LTP was defined as being out of care for ≥3 months. Results. Overall 856 women were included. Only 36.4% (86/236) of the women were enrolled in the first trimester. Overall 69 (8.1%) were LTP. In the multivariate analysis older women (HR: 0.80 per five-year increase, CI: 0.64–1.0, and P=0.060) and women on ART at the time of pregnancy (0.58, CI: 0.34–0.98, and P=0.040) were more likely not to be LTP. Among women already on ART at the time of pregnancy no factor was associated with LTP. Conclusion. Our results suggest the need for interventions to enhance prompt linkage of HIV positive women to HIV services for ART initiation and for increased retention particularly in young and ART naive women.

Successful Community Follow-up and Reduced Recidivism in HIV Positive Women Prisoners

1997 ◽  
Vol 4 (1) ◽  
pp. 5-17 ◽  
Author(s):  
Joo Y. Kim ◽  
Josiah Rich ◽  
Sally Zierler ◽  
Kevin Lourie ◽  
Kevin Vigilante ◽  
...  
Keyword(s):  
Women Prisoners ◽  
Hiv Positive ◽  
Hiv Positive Women

scholarly journals Challenges in Assessing Outcomes among Infants of Pregnant HIV-Positive Women Receiving ART in Uganda

2017 ◽  
Vol 2017 ◽  
pp. 1-4
Author(s):  
Barbara Castelnuovo ◽  
Frank Mubiru ◽  
Ivan Kalule ◽  
Shadia Nakalema ◽  
Agnes Kiragga
Keyword(s):  
Clinical Trials ◽  
Pregnant Women ◽  
Median Time ◽  
Hiv Transmission ◽  
Cd4 Count ◽  
Hiv Positive ◽  
Hiv Positive Women

Since 2012, the WHO recommends lifelong ART with TDF+FTC/3TC+EFV for all HIV-positive pregnant and breastfeeding women (Option B-plus). In this analysis we describe the proportion of early and late transmission in mothers with high retention in Kampala, Uganda. We included 700 pregnant women from January 2012 to August 2014 with a follow-up extended to August 2016; the median age was 31 years (IQR: 26–35), 36.3% in WHO stage 3/4; median CD4 count was 447 cells/μL (IQR: 301–651) and 73.3% were already on ART for a median time of 28 (IQR: 10–57) months; 52% infants were male and median weight was 3.2 Kg (IQR: 2.5–3.5). Five hundred and sixty-five (80.7%) infants had at least one test for HIV; 22 (3.1%) infants died, all with unknown serostatus; 3 tested positive at week 6 and one additional at months 12 and 18. Two of the mothers of the 4 HIV-positive infants were ART-naïve at the time of pregnancy. We report very low documented HIV transmission comparable with those reported in clinical trials settings; however, demonstrating the efficacy of Option B-plus in terms of averted transmission in routine settings is challenging since high proportion of infants do not have documented HIV tests.

scholarly journals A prospective study of demographic features and quality of life in HIV-positive women with cervical cancer treated at Tygerberg Hospital

2015 ◽  
Vol 16 (1) ◽  
Author(s):  
George Du Toit ◽  
Martin Kidd
Keyword(s):  
Quality Of Life ◽  
Cervical Cancer ◽  
Cancer Treatment ◽  
Hiv Positive ◽  
Hiv Positive Women ◽  
Eortc Qlq C30 ◽  
Eortc Qlq ◽  
Hiv Negative

Background: Cervical cancer and human immunodeficiency virus (HIV) infection/acquired immune deficiency syndrome (AIDS) both have a high incidence in South Africa. Cervical cancer treatment of HIV-positive women poses challenges. Treatment-related changes in quality of life (QOL) of such women are important to future treatment protocols.Aim: To examine demographic data of HIV-negative and HIV-positive women at diagnosis of cervical cancer and describe their changes in QOL as a result of treatment.Methods and materials: All newly diagnosed patients with cervical cancer at Tygerberg Hospital were approached to participate in the study. The European Organisation for Research and Treatment of Cancer Quality of Life Core Questionnaire (EORTC QLQ-C30) and the Cervix Cancer Module (QLQ-CX24) were used. General QOL was measured with the EORTC QLQ-C30 and cervical-specific QOL with the QLQ-CX24 questionnaire. The patients completed the questionnaire at diagnosis, on completion of treatment and at 3 months’ follow-up.Results: The study included a total of 221 women of whom 22% were HIV-positive; the latter were younger and of higher educational level than the rest. Mean monthly income and stage distribution was similar between the two groups. HIV-positive patients underwent radiation therapy more commonly than chemoradiation. HIV-positive women showed statistically significantly higher loss to follow-up during the study. HIV-positive women experienced no improvement in insomnia, appetite loss, nausea, vomiting, diarrhoea, social role or any of the sexual domains. In contrast, HIV-negative women experienced statistically significant improvement in all sexual domains other than sexual/vaginal functioning. The QOL improvement of HIV-negative women was statistically significantly greater than their HIV-positive counterparts in the majority of QOL domains. Global health improved in both groups, with HIV-negative women experiencing greater improvement. HIV-positive women experienced an initial decline of peripheral neuropathy (PN) symptoms post treatment with a return to pretreatment values at 3 months’ follow-up. The change in PN was statistically significant between the HIV-negative and HIV-positive women.Conclusion: Demographic differences exist between the HIV-negative and HIV-positive groups. The differential outcome in the QOL of HIV-positive and HIV-negative women treated for cervical cancer might be related to persistence of AIDS-related symptoms on completion of cervical cancer treatment.

scholarly journals Measuring retention in care for HIV-positive pregnant women in Prevention of Mother-to-Child Transmission of HIV (PMTCT) option B+ programs: the Mozambique experience

2020 ◽  
Author(s):  
Laurence Ahoua ◽  
Shino Arikawa ◽  
Thierry Tiendrebeogo ◽  
Maria Laheurta ◽  
Dario Aly ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Retention In Care ◽  
Retention Rates ◽  
Hiv Positive ◽  
Mother To Child Transmission ◽  
Child Transmission ◽  
Appointment Adherence ◽  
Art Initiation ◽  
Mother To Child

Abstract Background : Failure to retain HIV-positive pregnant women on antiretroviral therapy (ART) leads to increased mortality for the mother and her child. This study evaluated different retention measures for women’s engagement along the continuum of care for prevention of mother-to-child transmission (PMTCT) option B+ services in Mozambique. Methods : We compared ‘point’ retention (patient’s presence in care 12-month post-ART initiation or any time thereafter) with the following definitions: alive and in care 12 month post-ART initiation (Ministry of Health; MOH); attendance at a health facility up to 15-month post-ART initiation (World Health Organization; WHO); alive and in treatment at 1-, 2-, 3-, 6-, 9-, and 12-month post-ART initiation (Inter-Agency Task Team; IATT); and alive and in care 12-month post-ART initiation with ≥75% appointment adherence during follow-up (i.e. ‘appointment adherence’ retention) or with ≥75% of appointments met on time during follow-up (i.e. ‘on-time adherence’ retention). Kaplan-Meier survival curves were produced to assess variability in retention rates. We used ‘on-time adherence’ retention as our reference to estimate sensitivity, specificity, and proportion of misclassified patients. Results : Considering the ‘point’ retention definition, 16,840 HIV-positive pregnant women enrolled in option B+ PMTCT services were identified as ‘retained in care’ 12-month post-ART initiation. Of these, 60.3% (95% CI 59.6–61.1), 84.8% (95% CI 84.2–85.3), and 16.4% (95% CI 15.8–17.0) were classified as ‘retained in care’ using MOH, WHO, and IATT definitions, respectively, and 1.2% (95% CI 1.0–1.4) were classified as ‘retained in care’ using the ‘≥75% on-time adherence’ definition. All definitions provided specificity rates of ≥98%. The sensitivity rates were 3.0% with 78% of patients misclassified according to the WHO definition and 4.3% with 54% of patients misclassified according to the MOH definition. The ‘point’ retention definition misclassified 97.6% of patients. Using IATT and ‘appointment adherence’ retention definitions, sensitivity rates (9.0% and 11.7%, respectively) were also low; however, the proportion of misclassified patients was smaller (15.9% and 18.3%, respectively). Conclusion : More stringent definitions indicated lower retention rates for PMTCT programs. Policy makers and program managers should include attendance at follow-up visits when measuring retention in care to better guide planning, scale-up, and monitoring of interventions.

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