scholarly journals Factors associated with loss-to-follow-up of HIV-positive mothers and their infants enrolled in HIV care clinic: A qualitative study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
S. Mpinganjira ◽  
T. Tchereni ◽  
A. Gunda ◽  
V. Mwapasa
Keyword(s):  
Qualitative Study ◽  
Hiv Care ◽  
Hiv Positive ◽  
Care Clinic ◽  
Loss To Follow Up ◽  
Factors Associated ◽  
Hiv Positive Mothers

scholarly journals Factors Associated With Loss-To-Follow-Up Of Hiv-Positive Mothers And Their Infants Enrolled In Hiv Care Clinic: A Qualitative Study

2019 ◽  
Author(s):  
Samuel Lawrent Mpinganjira ◽  
Timothy Tchereni ◽  
Andrews Gunda ◽  
Victor Mwapasa
Keyword(s):  
Qualitative Study ◽  
Health Facilities ◽  
System Level ◽  
Hiv Care ◽  
Hiv Positive ◽  
Long Distance ◽  
Care Clinic ◽  
Loss To Follow Up ◽  
Factors Associated

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+

scholarly journals Factors Associated With Loss-to-follow-up Of Hiv-positive Mothers And Their Infants Enrolled In Hiv Care Clinic: A Qualitative Study

2019 ◽  
Author(s):  
Samuel Lawrent Mpinganjira ◽  
Timothy Tchereni ◽  
Andrews Gunda ◽  
Victor Mwapasa
Keyword(s):  
Qualitative Study ◽  
Health Facilities ◽  
System Level ◽  
Hiv Care ◽  
Hiv Positive ◽  
Long Distance ◽  
Care Clinic ◽  
Loss To Follow Up ◽  
Factors Associated

Abstract Background In Malawi, loss to follow-up (LTFU) greatly contributes to sub-optimal retention (74%) of HIV-positive (HIV+) women initiated on antiretroviral therapy (ART) during pregnancy under Option B+ strategy. This threatens Malawi’s efforts to eliminate mother-to-child transmission of HIV. We investigated factors associated with LTFU among Mother-Infant Pairs (MIP). 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 MIPs in HIV care in Salima and Mangochi districts, Malawi. From July to December 2016, we traced 19 LTFU women and conducted in-depth interviews (IDIs) with them and also with 30 healthcare workers (HCWs) 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 treatment options. Conclusion Our study has found multiple factors at personal, family, community and health system level which contribute to poor retention of MIPs in HIV care. Key words PRIME, PMTCT, eMTCT, loss to follow up, mother-infant pairs, Option B+

scholarly journals Factors Associated With Loss-To-Follow-Up Of Hiv-Positive Mothers And Their Infants Enrolled In Hiv Care Clinic: A Qualitative Study

2020 ◽  
Author(s):  
Samuel Lawrent Mpinganjira ◽  
Timothy Tchereni ◽  
Andrews Gunda ◽  
Victor Mwapasa
Keyword(s):  
Qualitative Study ◽  
Hiv Treatment ◽  
Health Facilities ◽  
Hiv Care ◽  
Hiv Positive ◽  
Long Distance ◽  
Care Clinic ◽  
Loss To Follow Up ◽  
Factors Associated

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 to be 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 and interviewed 19 LTFU women. In addition, we interviewed 30 healthcare workers from health facilities where the LTFU women were receiving care. Recorded interviews were transcribed, translated and then analysed using deductive content analysis. Results The following reasons were reported as contributing to LTFU: lack of support from husbands or family members; long distance to health facilities; poverty; 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 levels, which contribute to poor retention of mother-infant pairs in HIV care. Key words PRIME, PMTCT, loss to follow up, mother-infant pairs, retention, Option B+

Retaining HIV-positive patients in HIV care: a personalised approach for those at risk of loss to follow-up at an inner city sexual health service

Sexual Health ◽  
2018 ◽  
Vol 15 (1) ◽  
pp. 91
Author(s):  
Loretta Healey ◽  
Catherine C. O'Connor
Keyword(s):  
Health Service ◽  
Sexual Health ◽  
Text Messages ◽  
Hiv Care ◽  
Hiv Positive ◽  
Hiv Patients ◽  
Loss To Follow Up ◽  
Sexual Health Service ◽  
Lost To Follow Up

In 2013 a personalised approach to follow-up of HIV patients who had withdrawn from HIV care was taken at RPA Sexual Health, a Sydney metropolitan sexual health service. HIV patients were telephoned, sent text messages, emailed and sent letters multiple times where applicable. With this intervention 20 of 23 people who had withdrawn from HIV care re-engaged. Since that time, active follow-up of all people diagnosed with HIV has resulted in only 2% of HIV patients at RPA Sexual Health being lost to follow-up.

Retention in HIV care and factors associated with loss to follow-up in Oman: a countrywide study from the Middle East

AIDS Care ◽  
2021 ◽  
pp. 1-7
Author(s):  
Ali Elgalib ◽  
Samir Shah ◽  
Adil Al-Wahaibi ◽  
Zeyana Al-Habsi ◽  
Maha Al-Fouri ◽  
...  
Keyword(s):  
Middle East ◽  
Hiv Care ◽  
Loss To Follow Up ◽  
Factors Associated ◽  
Retention In Hiv Care

scholarly journals 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 ◽  
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.

scholarly journals How Follow-Up Counselling Increases Linkage to Care Among HIV-Positive Persons Identified Through Home-Based HIV Counselling and Testing: A Qualitative Study in Uganda

SAGE Open ◽  
2020 ◽  
Vol 10 (1) ◽  
pp. 215824401990016
Author(s):  
Dominic Bukenya ◽  
Janet Seeley ◽  
Grace Tumwekwase ◽  
Elizabeth Kabunga ◽  
Eugene Ruzagira
Keyword(s):  
Qualitative Study ◽  
Partner Violence ◽  
Linkage To Care ◽  
Hiv Treatment ◽  
Hiv Care ◽  
Hiv Positive ◽  
Accurate Information ◽  
Home Based ◽  
Linkage To Hiv Care

We investigated how follow-up counselling had increased linkage to HIV care in a trial of referral to care and follow-up counseling, compared to referral to care only, for participants diagnosed as HIV-positive through home-based HIV counseling and testing. We carried out a cross-sectional qualitative study. Using random stratified sampling, we selected 43 trial participants (26 [60%] in the intervention arm). Sample stratification was by sex, distance to an ART facility, linkage, and nonlinkage to HIV care. Twenty-six in-depth interviews were conducted with participants in the intervention arm: 17 people who had linked to HIV care and 9 who had not linked after 6 months of follow-up. Home-based follow-up counseling helped to overcome worries resulting from an HIV-positive test result. In addition, the counseling offered an opportunity to address questions on HIV treatment side effects, share experiences of intimate partner violence or threats, and general problems linking to care. The counselling encouraged early linkage to HIV care and use of biomedical medicines, discouraging alternative medicine usage. Home-based follow-up counseling also helped to promote HIV sero-status disclosure, facilitating linkage to, retention in and adherence to HIV care and treatment. This study successfully demonstrated that home-based follow-up counselling increased linkage to care through encouragement to seek care, provision of accurate information about HIV care services and supporting the person living with HIV to disclose and manage stigma.

scholarly journals Incidence and Predictors of Loss to Follow-Up Among Pregnant and Lactating Mothers Living with HIV and Enrolled in HIV Care Clinic in Ethiopia: A Systematic Review and Meta-Analysis

2021 ◽  
Author(s):  
Asteray Ayenew
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Pediatric Hiv ◽  
Hiv Care ◽  
Cochrane Library ◽  
Care Clinic ◽  
Loss To Follow Up ◽  
Lactating Mothers ◽  
Living With Hiv

Abstract BackgroundMother-to-Child Transmission of HIV accounts for more than 90% of all pediatric HIV infections. Ethiopia has recently adopted lifelong antiretroviral therapy (ART) for all HIV-positive pregnant and breastfeeding women (Option B+ strategy), regardless of CD4 count or clinical stage. Therefore, the aim of this systematic review and meta-analysis was to estimate the pooled incidence and predictors of loss to follow-up among pregnant and lactating mothers living with HIV and enrolled in HIV care clinics in Ethiopia.MethodThe Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline was followed. All observational published studies were retrieved using relevant search terms in PubMed, Google Scholar, Cochrane Library, Scopus, African Journals Online, CINHAL, and Ethiopian's university research repository online library. STATA 11 software was used to analyze the data. The Cochrane Q and I2 tests were used to assess the heterogeneity of studies. The pooled estimated prevalence and odds ratios with 95% confidence intervals were computed by a random-effects model.Result: The pooled magnitude of loss to follow-up among pregnant and lactating mothers living with HIV and enrolled in HIV care clinics in Ethiopia was 14.28% (95%CI: 10.12-18.44). Poor/fair antiretroviral treatment adherence (Adjusted odds ratio (AOR) = 3.68; 95% CI: 2.89–4.69), who does not know their CD4 level (AOR = 3.68; 95% CI: 2.40–5.63), disclosure of HIV status to partner (AOR = 2.69; 95% CI: 2.08–3.48), experienced drug side effect (AOR =7.91; 95% CI: 2.94–21.33), residing in the rural area (AOR =2.66; 95% CI: 2.34–3.03), and no education (AOR =4.28; 95% CI: 3.62–5.00) were the significant predictors of loss to follow up.ConclusionThe magnitude of loss to follow-up among pregnant and lactating mothers was high in Ethiopia. Thus, counseling, strengthening the linkage and referral system, establishing appropriate tracing mechanisms, and determining CD4 level is crucial to decrease loss to follow-up among pregnant and lactating mothers living with HIV.

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