scholarly journals The yield of HIV testing during pregnancy and postnatal period, Uganda, 2015–2018: analysis of surveillance data

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Yvette Wibabara ◽  
Ivan Lukabwe ◽  
Irene Kyamwine ◽  
Benon Kwesiga ◽  
Alex R. Ario ◽  
...  
Keyword(s):  
Antenatal Care ◽  
Pregnant Women ◽  
Hiv Testing ◽  
Postnatal Period ◽  
Surveillance Data ◽  
Hiv Positive ◽  
Health Management Information System ◽  
Mother To Child Transmission ◽  
Child Transmission ◽  
Mother To Child

Abstract Background Uganda has registered a reduction in new HIV infections among children in recent years. However, mother-to-child transmission of HIV still occurs, especially among pregnant women who present late. To eliminate this transmission, all HIV-positive pregnant women should be identified during antenatal HIV testing. We described women newly identified HIV-positive during pregnancy and postnatal period 2015–2018. Methods We extracted surveillance data for women identified as HIV-positive during pregnancy and the postnatal period reported through the Health Management Information System from 2015–2018. We calculated proportions newly positive at antenatal, labor, and postnatal periods nationally and at district levels. We disaggregated data into ‘tested early’ (during antenatal care) and ‘tested late’ (during labor or postnatal period) and calculated the proportion positive. We evaluated trends in these parameters at national and district levels. Results Overall, 8,485,854 mothers were tested for HIV during this period. Of these, 2.4% tested HIV-positive for the first time. While the total number of mothers tested increased from 1,327,022 in 2015 to 2,514,212 in 2018, the proportion testing HIV-positive decreased from 3.0% in 2015 to 1.7% in 2018 (43% decline over the study period, p < 0.001). Of 6,781,047 tested early, 2.2% tested HIV-positive. The proportion positive among those tested early dropped from 2.5% in 2015 to 1.7% in 2018. Of 1,704,807 tested late, 3.2% tested HIV-positive. The proportion positive among those tested late dropped from 5.2% in 2015 to 1.6% in 2018. At the district level, Kalangala District had the highest proportion testing positive at 13% (909/11,312) in 2015; this dropped to 5.2% (169/3278) in 2018. Conclusion The proportion of women newly testing HIV-positive during pregnancy and postnatal declined significantly during 2015–2018. A higher proportion of mothers who tested late vs early were HIV-positive. Failure to identify HIV early represents an increased risk of transmission. Ministry of Health should strengthen Elimination of Mother to Child Transmission (eMTCT) services to sustain this decrease through targeted interventions for poorly-performing districts. It should strengthen community-based health education on antenatal care and HIV testing and enhance the implementation of other primary prevention strategies targeting adolescents and young women.

scholarly journals Progress and Challenges of Implementing Decentralized HIV Testing For Prevention of Mother-to-Child Transmission of HIV – Myanmar

2019 ◽  
Vol 8 (1) ◽  
pp. 44-53
Author(s):  
San Hone ◽  
Li Li ◽  
Sung-Jae Lee ◽  
W. Scott Comulada ◽  
Roger Detels
Keyword(s):  
Antenatal Care ◽  
Pregnant Women ◽  
Hiv Testing ◽  
Service Providers ◽  
Point Of Care ◽  
Mother To Child Transmission ◽  
Child Transmission ◽  
Stigma And Discrimination ◽  
Testing Uptake ◽  
Mother To Child

Background: Myanmar has adopted point-of-care (POC) HIV testing for its prevention of mother-to-child transmission of HIV program, and was initiated in 84 townships in 2013. This study assessed the progress of HIV testing uptake from 2012, one year prior to POC testing, to 2015, and the challenges faced by service providers during the rapid rollout of this testing strategy. Methods: This serial cross-sectional study included 23 townships randomly selected from the 84 townships. An open-question survey was used to collect information on the challenges faced by service providers. A random effects logistic model was used for assessing the progress of HIV testing uptake among urban and rural health center groups. Results: HIV testing uptake for antenatal care (ANC) attendees increased from 60% to 90% for rural and from 70% to 90% for urban attendees. The proportion of ANC attendees who were tested at their first visit increased from 70% to 80% for rural and from 70% to 90% for urban attendees. In addition, the proportion receiving same-day test results increased from less than 10% to 90% for both groups. Major challenges faced during the initial rollout included low health awareness among pregnant women, fear of stigma and discrimination, long travel times and costs, and increased workloads of providers in rural settings. Conclusions and Global Health Implications: The program should consider recruiting local volunteers to help reduce the workloads of service providers. Professional education based on need and continued mentoring and quality control schemes for HIV testing need to be in place. This decentralized strategy would be applicable to other resource-limited countries. Key words:  • HIV/AIDS • Pregnant Women • Point-of-Care (POC) HIV Testing • Antenatal Care (ANC) • Prevention of Mother-to-Child Transmission of HIV (PMCT) • Service Cascade • Stigma and Discrimination   Copyright © 2019 Hone et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

scholarly journals Does facility readiness promote high-quality of provider-initiated HIV testing and counseling to pregnant women? A national survey for improving policy of prevention of mother-to-child transmission of HIV in Tanzania

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Deogratius Bintabara ◽  
Athanase Lilungulu ◽  
Shakilu Jumanne ◽  
Mzee M. Nassoro ◽  
Bonaventura C. Mpondo
Keyword(s):  
Pregnant Women ◽  
Hiv Testing ◽  
Mother To Child Transmission ◽  
Child Transmission ◽  
High Quality ◽  
Hiv Testing And Counseling ◽  
Mother To Child ◽  
Facility Readiness ◽  
Testing And Counseling

Abstract Background Provider-initiated HIV testing and counseling (PITC) is a recommended approach to screen for HIV to all pregnant women during antenatal care (ANC) visits, and all with HIV positive results have to be enrolled into prevention of mother-to-child transmission of HIV (PMTCT) program. However, little is known about the relationship between facility readiness and the uptake of PITC to pregnant women attending ANC in Tanzania. Therefore, this study assessed whether the facility readiness promotes the uptake of PITC to the pregnant women attending ANC for the purpose of improving the PMTCT interventions in Tanzania. Methods This study analyzed data for health facilities obtained from the 2014–2015 Tanzania service provision assessment survey. The Primary outcome measure was a composite variable (with score of 0–5) in which its higher scores indicates provision of high-quality of PITC. Also, facilities scored higher in the PMTCT service readiness index were considered to have high readiness to provide PMTCT services. In Poisson regression analyses, a series of models were fitted to assess whether there is an association between provision of high-quality of PITC and facility readiness. In all statistical analysis, a P < 0.05 was considered significant. Results Out of 1853 included first-visit ANC consultations, only about one-third of pregnant women received all five components required for PITC. The mean percentage of PMTCT readiness score was moderate 63.96 [61.32–66.59]%. In adjusted model, we found that facility with high readiness to provide PMTCT services was significantly associated with the provision of high-quality of PITC (model 2: [β = 0.075, P = 0.00]). Conclusion In order to increase high-quality of PITC services, efforts should be made to improve the PMTCT facility readiness by increasing availability of trained staffs, diagnostic tools, and ARTs among health facilities in Tanzania.

scholarly journals Towards Elimination of Mother-to-Child Transmission of HIV: The Impact of a Rapid Results Initiative in Nyanza Province, Kenya

2012 ◽  
Vol 2012 ◽  
pp. 1-6 ◽  
Author(s):  
Lisa L. Dillabaugh ◽  
Jayne Lewis Kulzer ◽  
Kevin Owuor ◽  
Valerie Ndege ◽  
Arbogast Oyanga ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Highly Active Antiretroviral Therapy ◽  
Cohort Analysis ◽  
Hiv Positive ◽  
Maternal Child Health ◽  
Mother To Child Transmission ◽  
Child Transmission ◽  
Nyanza Province ◽  
The Impact ◽  
Mother To Child

Many HIV-positive pregnant women and infants are still not receiving optimal services, preventing the goal of eliminating mother-to-child transmission (MTCT) and improving maternal child health overall. A Rapid Results Initiative (RRI) approach was utilized to address key challenges in delivery of prevention of MTCT (PMTCT) services including highly active antiretroviral therapy (HAART) uptake for women and infants. The RRI was conducted between April and June 2011 at 119 health facilities in five districts in Nyanza Province, Kenya. Aggregated site-level data were compared at baseline before the RRI (Oct 2010–Jan 2011), during the RRI, and post-RRI (Jul–Sep 2011) using pre-post cohort analysis. HAART uptake amongst all HIV-positive pregnant women increased by 40% (RR 1.4, 95% CI 1.2–1.7) and continued to improve post-RRI (RR 1.6, 95% CI 1.4–1.8). HAART uptake in HIV-positive infants remained stable (RR 1.1, 95% CI 0.9–1.4) during the RRI and improved by 30% (RR 1.3, 95% CI 1.0–1.6) post-RRI. Significant improvement in PMTCT services can be achieved through introduction of an RRI, which appears to lead to sustained benefits for pregnant HIV-infected women and their infants.

scholarly journals Barriers and opportunities for implementing prevention of mother to child transmission (PMTCT) in Bangli District

2017 ◽  
Vol 5 (1) ◽  
pp. 67
Author(s):  
Ketut Espana Giri ◽  
Ni Made Sri Nopiyani ◽  
Ketut Tuti Parwati Merati
Keyword(s):  
Pregnant Women ◽  
Hiv Testing ◽  
Health Centre ◽  
Community Leaders ◽  
Pmtct Program ◽  
Mother To Child Transmission ◽  
Child Transmission ◽  
Public Health Centre ◽  
Mother To Child ◽  
Village Health

Background and purpose: HIV testing among pregnant women can reduce the risk of mother to child HIV transmission. The implementation of prevention of mother to child transmission (PMTCT) program in Bangli District is suboptimal. This study aims to explore challenges and opportunities for implementing PMTCT program from both user and provider perspectives.Methods: A qualitative approach was conducted in Bangli District between April and May 2016. Data were collected using in-depth interviews with 18 informants. All informants were purposively selected and covered of 10 pregnant women, two counsellors, two laboratory analysts, two head of community health centres, one disease control officer from Bangli District Health Office and one officer from Bangli District AIDS Commission. Data were analysed using thematic method.Results: Pregnant women chose to have ANC service at private midwife and obstetrician instead of  public health centre. From health providers’ perspectives barrier of PMTCT implementation included lack of health human resources and a high level of stigma and discrimination related to HIV/AIDS in the community. This study revealed that there was an opportunity for PMTCT implementation in Bangli District due to positive attitudes and supports from husband and health provider toward HIV testing. Another opportunity is to involve village health cadres and community leaders in promoting HIV testing among pregnant women.Conclusions: Implementation of PMTCT program in health centre should include network of private practitioner and enhance village health cadres’ and community leaders’ participation.

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.

scholarly journals Effectiveness of interventional package on knowledge and attitude towards prenatal HIV testing and mother to child transmission among antenatal mothers

2020 ◽  
Vol 11 (2) ◽  
pp. 1729-1733
Author(s):  
Priyadarsini A ◽  
Priya O S
Keyword(s):  
Pregnant Women ◽  
Hiv Testing ◽  
The Body ◽  
Mother To Child Transmission ◽  
Child Transmission ◽  
Teaching Programme ◽  
Structured Teaching ◽  
Post Test ◽  
Knowledge And Attitude ◽  
Mother To Child

Human Immunodeficiency Virus (HIV) is an infection that assaults immune cells called CD4 cells, which are a kind of T cell. These are white platelets that move around the body, recognizing flaws and inconsistencies in cells just as contaminations. The present study aimed to effectiveness of interventional package on knowledge and attitude towards prenatal HIV testing and parent to child transmission among pregnant women in selected settings.60 pregnant women sample in Quantitative approach with Pre experimental one group pre-test and post-test design, sample selection was done by Non Probability – Purposive Sampling Technique, Effectiveness of structured teaching programme in meaning pregnant women gained 35% etiology and effects gained 31% in management and precautions in PCT pregnant women gained 41% prevention 36.8% overall they gained 37.28% and Attitude gained 23.3% after intervention. Pre-existing knowledge was assessed by using semi structured teaching programme, pregnant mothers gained 23.3% more knowledge score than pretest score and the mean difference is 12.80 by using generalized McNamara’s chi-square test, it is statistically significant. In pretest, mothers were having 10.77score whereas, in post-test they were having 23.57 score. Difference score is 12.80.The difference is large and it is statistically significant. Successful intervention toward prevention of mother-to-child transmission (PMTCT) and achieving the goal of eliminating the new HIV infection is highly dependent on everyone; especially, women of child-bearing age should have accurate and up-to-date knowledge about HIV transmission, risk of transmission to babies, and possible interventions.

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

2019 ◽  
Author(s):  
Laurence Ahoua ◽  
Thierry Tiendrebeogo ◽  
Shino Arikawa ◽  
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 of retention of HIV-positive pregnant women on ART leads to increased mortality for the mother and her child. This study evaluated different retention measures intended to measure 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 at 12-months post-antiretroviral treatment (ART) initiation or any time thereafter) to the following definitions: alive and in care at 12 months post-ART initiation (Ministry of Health); attendance at a health facility up to 15 months post-ART initiation (World Health Organisation); alive and in treatment at 1, 2, 3, 6, 9, and 12 months post-ART initiation (Inter-Agency Task Team); and alive and in care at 12 months post-ART initiation with ≥75% appointment or on-time adherence during follow-up (‘appointment adherence’ and ‘on-time adherence’ retentions). Kaplan-Meier survival curves were produced to assess variability in retention rates. We used ‘on-time adherence’ retention as a gold standard 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 months 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 programmes. Policy makers and programme managers should include attendance at follow-up visits when measuring retention in care to better guide planning, scaling up, and monitoring of interventions.

scholarly journals HIV Retesting of HIV-Negative Pregnant Women in the Context of Prevention of Mother-to-Child Transmission of HIV in Primary Health Centers in Rural Zambia: What Did We Learn?

2019 ◽  
Vol 18 ◽  
pp. 232595821882353 ◽  
Author(s):  
Justin Mandala ◽  
Prisca Kasonde ◽  
Titilope Badru ◽  
Rebecca Dirks ◽  
Kwasi Torpey
Keyword(s):  
Pregnant Women ◽  
Hiv Positive ◽  
Antenatal Visit ◽  
Mother To Child Transmission ◽  
Child Transmission ◽  
Loss To Follow Up ◽  
Hiv Test ◽  
Hiv Exposed ◽  
Mother To Child ◽  
Hiv Negative

Background: This observational study describes implementation of HIV retesting of HIV-negative women in prevention of mother-to-child transmission (PMTCT) services in Zambia. Methods: Uptake of retesting and PMTCT services were compared across age, parity, and weeks of gestation at the time of the first HIV test, antiretrovirals regime, and HIV early diagnosis results from infants born to HIV-positive mothers. Results: A total of 19 090 pregnant women were tested for HIV at their first antenatal visit, 16 838 tested HIV-negative and were offered retesting 3 months later: 11 339 (67.3%) were retested; of those, 55 (0.5%) were HIV positive. Uptake of the PMTCT package by women HIV positive at retest was not different but HIV-exposed infants born to women who retested HIV positive were infected at a higher rate (11.1%) compared to those born to women who tested HIV positive at their initial test (3.2%). Conclusion: We suggest rigorously (1) measuring the proportion of MTCT attributable to women who seroconvert during pregnancy and possibly adjust PMTCT approaches and (2) addressing the substantial loss to follow-up of HIV-negative pregnant women before HIV retesting.

Sign in / Sign up

Export Citation Format

Share Document