scholarly journals Acceptability of community-based mentor mothers to support HIV-positive pregnant women on antiretroviral treatment in western Kenya: a qualitative study

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Iris Wanga ◽  
Anna Helova ◽  
Lisa L. Abuogi ◽  
Elizabeth A. Bukusi ◽  
Wafula Nalwa ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Pregnant Women ◽  
Antiretroviral Treatment ◽  
Hiv Positive ◽  
Community Based ◽  
Western Kenya

Individual and healthcare supply-related barriers to treatment initiation in HIV-positive patients enrolled in the Cameroonian antiretroviral treatment access programme

2020 ◽  
Author(s):  
Pierre-Julien Coulaud ◽  
Camélia Protopopescu ◽  
Khadim Ndiaye ◽  
Maël Baudoin ◽  
Gwenaëlle Maradan ◽  
...  
Keyword(s):  
Antiretroviral Treatment ◽  
Cox Model ◽  
Task Shifting ◽  
Hiv Positive ◽  
Treatment Access ◽  
Community Based ◽  
Related Factors ◽  
Hiv Services ◽  
Community Based Organizations ◽  
Art Initiation

Abstract Increasing demand for antiretroviral treatment (ART) together with a reduction in international funding during the last decade may jeopardize access to ART. Using data from a cross-sectional survey conducted in 2014 in 19 HIV services in the Centre and Littoral regions in Cameroon, we investigated the role of healthcare supply-related factors in time to ART initiation in HIV-positive patients eligible for ART at HIV diagnosis. HIV service profiles were built using cluster analysis. Factors associated with time to ART initiation were identified using a multilevel Cox model. The study population included 847 HIV-positive patients (women 72%, median age: 39 years). Median (interquartile range) time to ART initiation was 1.6 (0.5–4.3) months. Four HIV service profiles were identified: (1) small services with a limited staff practising partial task-shifting (n = 4); (2) experienced and well-equipped services practising task-shifting and involving HIV community-based organizations (n = 5); (3) small services with limited resources and activities (n = 6); (4) small services providing a large range of activities using task-shifting and involving HIV community-based organizations (n = 4). The multivariable model showed that HIV-positive patients over 39 years old [hazard ratio: 1.26 (95% confidence interval) (1.09–1.45), P = 0.002], those with disease symptoms [1.21 (1.04–1.41), P = 0.015] and those with hepatitis B co-infection [2.31 (1.15–4.66), P = 0.019] were all more likely to initiate ART early. However, patients in the first profile were less likely to initiate ART early [0.80 (0.65–0.99), P = 0.049] than those in the second profile, as were patients in the third profile [association only significant at the 10% level; 0.86 (0.72–1.02), P = 0.090]. Our findings provide a better understanding of the role played by healthcare supply-related factors in ART initiation. In HIV services with limited capacity, task-shifting and support from community-based organizations may improve treatment access. Additional funding is required to relieve healthcare supply-related barriers and achieve the goal of universal ART access.

scholarly journals Reaching hard-to-reach men through home-based couple HIV testing among pregnant women and their male partners in western Kenya: a qualitative study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Daisy Krakowiak ◽  
Pamela Makabong’o ◽  
Marielle Goyette ◽  
John Kinuthia ◽  
Alfred Onyango Osoti ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Pregnant Women ◽  
Hiv Testing ◽  
Male Partners ◽  
Western Kenya ◽  
Home Based ◽  
Couple Hiv Testing

scholarly journals Identifying barriers to ART initiation and adherence: An exploratory qualitative study on PMTCT in Zambia

PLoS ONE ◽  
2022 ◽  
Vol 17 (1) ◽  
pp. e0262392
Author(s):  
Tukiya Kanguya ◽  
Aybüke Koyuncu ◽  
Anjali Sharma ◽  
Thankian Kusanathan ◽  
Martha Mubanga ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Pregnant Women ◽  
Male Involvement ◽  
System Level ◽  
Hiv Positive ◽  
Male Partners ◽  
Joint Decision ◽  
Female Partners ◽  
Art Initiation ◽  
Maternal Love

Background Though antiretroviral therapy (ART) is widely available, HIV positive pregnant women in Zambia are less likely to start and remain on therapy throughout pregnancy and after delivery. This study sought to understand readiness to start ART among HIV pregnant women from the perspectives of both women and men in order to suggest more holistic programs to support women to continue life-long ART after delivery. Methods We conducted a qualitative study with HIV positive pregnant women before and after ART initiation, and men with female partners, to understand readiness to start lifelong ART. We conducted 28 in-depth interviews among women and 2 focus group discussions among male partners. Data were transcribed verbatim and analyzed in NVivo 12 using thematic analysis. Emerging themes from the data were organized using the social ecological framework. Results Men thought of their female partners as young and needing their supervision to initiate and stay on ART. Women agreed that disclosure and partner support were necessary preconditions to ART initiation and adherence and, expressed fear of divorce as a prominent barrier to disclosure. Maternal love and desire to look after one’s children instilled a sense of responsibility among women which motivated them to overcome individual, interpersonal and health system level barriers to initiation and adherence. Women preferred adherence strategies that were discrete, the effectiveness of which, depended on women’s intrinsic motivation. Conclusion The results support current policies in Zambia to encourage male engagement in ART care. To appeal to male partners, messaging on ART should be centered on emphasizing the importance of male involvement to ensure women remain engaged in ART care. Programs aimed at supporting postpartum ART adherence should design messages that appeal to both men’s role in couples’ joint decision-making and women’s maternal love as motivators for adherence.

scholarly journals Why do HIV-positive pregnant women discontinue with comprehensive PMTCT services? A qualitative study

2018 ◽  
Vol 6 (1) ◽  
pp. 73
Author(s):  
Putu Emy Suryanti ◽  
Komang Ayu Kartika Sari ◽  
Pande Putu Januraga ◽  
Dinar Lubis
Keyword(s):  
Qualitative Study ◽  
Pregnant Women ◽  
Hiv Positive ◽  
People Living With Hiv ◽  
Pmtct Program ◽  
Care Providers ◽  
Mother To Child Transmission ◽  
Child Transmission ◽  
Related Information ◽  
Mother To Child

AbstractBackground and purpose: Prevention of mother to child transmission (PMTCT) is a government program aimed at preventing mother-to-child transmission of HIV. A comprehensive PMTCT program involves the implementation of HIV testing up to antiretroviral (ARV) treatment for mothers with positive HIV test results. Coverage of comprehensive PMTCT remains low, with many HIV-positive pregnant women who discontinued ARV treatment. This study aims to explore the reasons of HIV-positive pregnant women to discontinue with the comprehensive PMTCT program.Methods: A qualitative study was carried out in Badung District, Bali Province, with seven respondents: one HIV-positive pregnant woman who did not continue the ARV treatment, two HIV-positive women who gave birth the previous year and did not take ARV, three public health centre (PHC) providers, and one head of PHC. Respondents were selected using a purposive sampling technique. Data were collected through in-depth interviews and analyzed thematically. The results presented narratively to illustrate the reasons why HIV-positive pregnant women discontinued with the comprehensive PMTCT program.Results: The emerging themes related to the reasons of HIV-positive pregnant women discontinued with the comprehensive PMTCT program included the lack of comprehensive PMTCT-related information, the lack of health provider assistance, and the high stigma towards people living with HIV (PLHIV). These barriers were affecting the willingness of HIV-positive pregnant women to continue with the program.Conclusions: Lack of comprehensive PMTCT-related information, lack of assistance by health care providers, and high public stigma impacts upon HIV-positive pregnant women’s willingness to continue with comprehensive PMTCT program. There is a need for a minimum service standard in the implementation of comprehensive PMTCT services and comprehensive information on HIV infection in order to reduce the stigma towards PLHIV.

scholarly journals Understanding Zika virus as an STI: findings from a qualitative study of pregnant women in the Bronx

2019 ◽  
Vol 96 (2) ◽  
pp. 80-84 ◽  
Author(s):  
Miguel Rodriguez ◽  
Ayla Lord ◽  
Carolina C Sanabia ◽  
Abigail Silverio ◽  
Meleen Chuang ◽  
...  
Keyword(s):  
At Risk ◽  
Qualitative Study ◽  
Pregnant Women ◽  
Zika Virus ◽  
Sexual Transmission ◽  
Coping Mechanism ◽  
Theory Approach ◽  
New Disease ◽  
Prevention Measures ◽  
Community Based

ObjectivesPregnant women in the Bronx were at risk for travel-related Zika exposure in the USA between 2016 and 2017. This qualitative study explored the experiences of 13 pregnant women to learn about their knowledge of Zika and prevention measures.MethodsIn the summer of 2017, pregnant women at risk of travel-related Zika exposure were interviewed in either Spanish or English to learn about their experiences and transcripts were analysed using a grounded theory approach.ResultsMost participants were Latinas living in the Bronx, median age of 29 years and median household income between $26 000 and $50 000. Participants displayed a strong understanding of Zika transmission via mosquito bites yet lacked knowledge about its sexual transmission. Interviews revealed three key themes: (1) Zika as a new disease, (2) denial as a coping mechanism and (3) the recommendation to treat Zika as an STI. Women observed Zika as a brand new disease with early messages emphasising mosquito-borne transmission. They lacked awareness of newer messaging about sexual transmission. Furthermore, if women did read about risk of sexual transmission, many stated being in denial and struggling with recommendations to prevent sexual transmission. Barriers included problems changing travel plans and rejection of condom use. Women unanimously suggested labelling Zika as an STI and adding it to existing lists of STIs for messaging and outreach in community-based and clinical prevention.ConclusionMany pregnant women were unaware that Zika virus can be sexually transmitted due to: (1) novelty of Zika, (2) denial as a coping mechanism and (3) Zika not being listed along with well-known STIs. Overcoming these barriers via community-based as well as clinical education for pregnant women in the Bronx would be helpful in 2019 and beyond when the risk of travel-related Zika exposure remains a public health threat to optimal pregnancy outcomes.

scholarly journals Estimating antiretroviral treatment coverage rates and viral suppression rates for homosexual men in Australia

Sexual Health ◽  
2015 ◽  
Vol 12 (5) ◽  
pp. 453 ◽  
Author(s):  
Nicole L. De La Mata ◽  
Limin Mao ◽  
John De Wit ◽  
Don Smith ◽  
Martin Holt ◽  
...  
Keyword(s):  
Viral Load ◽  
Antiretroviral Treatment ◽  
Viral Suppression ◽  
Undetectable Viral Load ◽  
Hiv Positive ◽  
Community Based ◽  
Study Objective ◽  
Hiv Epidemic ◽  
Sex With Men ◽  
Coverage Rates

Gay and other men who have sex with men (GMSM) are disproportionally affected by the HIV epidemic in Australia. The study objective is to combine a clinical-based cohort with a community-based surveillance system to present a broader representation of the GMSM community to determine estimates of proportions receiving antiretroviral therapy (ART) and/or with an undetectable viral load. Between 2010 and 2012, small increases were shown in ART uptake (to 70.2%) and proportions with undetectable viral load (to 62.4%). The study findings highlight the potential for significantly increasing ART uptake among HIV-positive GMSM to reduce the HIV epidemic in Australia.

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