scholarly journals A qualitative study of the barriers and enhancers to retention in care for pregnant and postpartum women living with HIV

2021 ◽  
Vol 1 (10) ◽  
pp. e0000004
Author(s):  
John Humphrey ◽  
Marsha Alera ◽  
Bett Kipchumba ◽  
Elizabeth J. Pfeiffer ◽  
Julia Songok ◽  
...  
Keyword(s):  
Hiv Transmission ◽  
Male Partner ◽  
Retention In Care ◽  
Postpartum Women ◽  
Provider Attitudes ◽  
Women Living With Hiv ◽  
Motivational Support ◽  
Related Stigma ◽  
The Individual ◽  
Living With Hiv

Retention in care is a major challenge for pregnant and postpartum women living with HIV (PPHIV) in the prevention of mother-to-child HIV transmission (PMTCT) continuum. However, the factors influencing retention from the perspectives of women who have become lost to follow-up (LTFU) are not well described. We explored these factors within an enhanced sub-cohort of the East Africa International Epidemiology Databases to Evaluate AIDS Consortium. From 2018–2019, a purposeful sample of PPHIV ≥18 years of age were recruited from five maternal and child health clinics providing integrated PMTCT services in Kenya. Women retained in care were recruited at the facility; women who had become LTFU (last visit >90 days) were recruited through community tracking. Interview transcripts were analyzed thematically using a social-ecological framework. Forty-one PPHIV were interviewed. The median age was 27 years, 71% were pregnant, and 39% had become LTFU. In the individual domain, prior PMTCT experience and desires to safeguard infants’ health enhanced retention but were offset by perceived lack of value in PMTCT services following infants’ immunizations. In the peer/family domain, male-partner financial and motivational support enhanced retention. In the community/society domain, some women perceived social pressure to attend clinic while others perceived pressure to utilize traditional birth attendants. In the healthcare environment, long queues and negative provider attitudes were prominent barriers. HIV-related stigma and fear of disclosure crossed multiple domains, particularly for LTFU women, and were driven by perceptions of HIV as a fatal disease and fear of partner abandonment and abuse. Both retained and LTFU women perceived that integrated HIV services increased the risk of disclosure. Retention was influenced by multiple factors for PPHIV. Stigma and fear of disclosure were prominent barriers for LTFU women. Multicomponent interventions and refining the structure and efficiency of PMTCT services may enhance retention for PPHIV.

scholarly journals Assessing the Acceptability of a Peer Mentor Mother Intervention to Improve Retention in Care of Postpartum Women Living with HIV

Health Equity ◽  
2019 ◽  
Vol 3 (1) ◽  
pp. 336-342 ◽  
Author(s):  
Yetunde Akinde ◽  
Allison K. Groves ◽  
Hervette Nkwihoreze ◽  
Erika Aaron ◽  
Gregg Alleyne ◽  
...  
Keyword(s):  
Retention In Care ◽  
Postpartum Women ◽  
Peer Mentor ◽  
Women Living With Hiv ◽  
Living With Hiv

scholarly journals HIV/AIDS Stigma Reduction as a Risk Factor for New HIV Infections: A Lived Experience Study of HIV Positive Young Women in a Rural Setting of Northern Uganda

2020 ◽  
Author(s):  
Amir Kabunga ◽  
Maxson Anyolitho Kenneth
Keyword(s):  
Young Women ◽  
Hiv Transmission ◽  
Unprotected Sex ◽  
Rural Setting ◽  
Hiv Positive ◽  
Stigma Reduction ◽  
Sexual Activities ◽  
Women Living With Hiv ◽  
Related Stigma ◽  
Living With Hiv

Abstract BackgroundHIV/AIDS-related stigma is a global problem among HIV patients with far-reaching implications. However, stigma reduction among HIV positive young women may be a catalyst to new HIV infections. This study aimed at exploring the coping strategies used and influence of HIV-related stigma on new infections among HIV positive young women in a rural setting. MethodsA cross-sectional exploratory research design was used. HIV positive young women in the catchment area of Aboke Health Center IV were part of the study. In-depth interviews were used to collect data and analysis was done using thematic approach. ResultsThe results from the data showed that acceptance of counseling and social support are some of the ways HIV-positive young women coped up with stigma. The results also showed that While HIV-related reduction has influenced positively for some HIV positive young mothers, to others as HIV-related stigma reduces, young women living with HIV are likely to get involved in risky sexual activities like having unprotected sex thus increasing HIV transmission. ConclusionsHIV-related reduction has influenced positively for some HIV positive young mothers. However, to others as HIV-related stigma reduces, young women living with HIV are likely to get involved in risky sexual activities like having unprotected sex thus increasing HIV transmission. Based on the results, there is need to understand the negative effects HIV-related stigma reduction as this may have implications for further transmission and control of HIV pandemic. Also, further research is needed to understand whether lessening HIV-related stigma encourages risky sexual behaviors among young women.

Surviving Surveillance: How Pregnant Women and Mothers Living With HIV Respond to Medical and Social Surveillance

2017 ◽  
Vol 27 (14) ◽  
pp. 2088-2099 ◽  
Author(s):  
Saara Greene ◽  
Allyson Ion ◽  
Gladys Kwaramba ◽  
Lisa Lazarus ◽  
Mona Loutfy
Keyword(s):  
Pregnant Women ◽  
Infant Feeding ◽  
Hiv Transmission ◽  
Service Providers ◽  
Negative Impact ◽  
Infant Feeding Practices ◽  
Women Living With Hiv ◽  
Related Stigma ◽  
Living With Hiv ◽  
The Relationship

Pregnant women and mothers living with HIV are under surveillance of service providers, family members, and the community at large. Surveillance occurs throughout the medical management of their HIV during pregnancy, preventing HIV transmission to their baby, infant feeding practices, and as part of assessments related to their ability to mother. Enacted and anticipatory HIV-related stigma can exacerbate the negative impact that being under surveillance has on mothers living with HIV as they move through their pregnancy, birthing, and mothering experiences. In response, women living with HIV find ways to manage their experiences of surveillance through engaging in acts of distancing, planning, and resisting at different points in time, and sometimes enacting all three practices at once. Positioning the narratives of pregnant women and mothers living with HIV in relation to their experiences of surveillance illuminates the relationship between the surveillance of mothers living with HIV and HIV-related stigma.

scholarly journals The role of unintended pregnancy in internalized stigma among women living with HIV in Kenya

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sara Chace Dwyer ◽  
Aparna Jain ◽  
Wilson Liambila ◽  
Charlotte E. Warren
Keyword(s):  
Unintended Pregnancy ◽  
Hiv Treatment ◽  
Outcome Variable ◽  
Internalized Stigma ◽  
Health Seeking ◽  
Logistic Regression Models ◽  
Stigma And Discrimination ◽  
Women Living With Hiv ◽  
Related Stigma ◽  
Living With Hiv

Abstract Background Kenya has successfully expanded HIV treatment, but HIV-related stigma and discrimination, and unintended pregnancy remain issues for many Kenyan women living with HIV. While HIV-related stigma can influence the health seeking behaviors of those living with HIV, less is known about how reproductive health outcomes influence internalized stigma among women living with HIV. Methods Baseline data only were used in this analysis and came from an implementation science study conducted in Kenya from 2015 to 2017. The analytic sample was limited to 1116 women who are living with HIV, between 18 to 44 years old, and have ever experienced a pregnancy. The outcome variable was constructed from 7 internalized stigma statements and agreement with at least 3 statements was categorized as medium/high levels of internalized stigma. Unintended pregnancy, categorized as unintended if the last pregnancy was mistimed or unwanted, was the key independent variable. Univariate and multivariate logistic regression models were used to assess the association between unintended pregnancy and internalized stigma. Associations between internalized stigma and HIV-related discrimination and violence/abuse were also explored. Results About 48% agreed with at least one internalized stigma statement and 19% agreed with at least three. Over half of women reported that their last pregnancy was unintended (59%). Within the year preceding the survey, 52% reported experiencing discrimination and 41% reported experiencing violence or abuse due to their HIV status. Women whose last pregnancy was unintended were 1.6 times (95% CI 1.2–2.3) more likely to have medium/high levels of internalized stigma compared to those whose pregnancy was wanted at the time, adjusting for respondents’ characteristics, experiences of discrimination, and experiences of violence and abuse. Women who experienced HIV-related discrimination in the past 12 months were 1.8 times (95% CI 1.3–2.6) more likely to have medium/high levels of internalized stigma compared to those who experienced no discrimination. Conclusions Results suggest that unintended pregnancy is associated with internalized stigma. Integrated HIV and FP programs in Kenya should continue to address stigma and discrimination while increasing access to comprehensive voluntary family planning services for women living with HIV.

The Meaning and Perceptions of HIV-Related Stigma in African American Women Living With HIV in Rural Florida

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Renessa S. Williams ◽  
Nichole E. Stetten ◽  
Christa Cook ◽  
Robert Cook ◽  
Miriam O. Ezenwa ◽  
...  
Keyword(s):  
African American ◽  
African American Women ◽  
American Women ◽  
Women Living With Hiv ◽  
Related Stigma ◽  
Rural Florida ◽  
Living With Hiv

scholarly journals Burden of HIV-Related Stigma and Post-Partum Depression: A Cross-Sectional Study of Patients Attending Prevention of Mother-to-Child Transmission Clinic at Kenyatta National Hospital in Nairobi

2021 ◽  
Vol 11 ◽  
Author(s):  
Obadia Yator ◽  
Muthoni Mathai ◽  
Tele Albert ◽  
Manasi Kumar
Keyword(s):  
Postpartum Depression ◽  
Post Partum ◽  
Internalized Stigma ◽  
Child Transmission ◽  
National Hospital ◽  
Cross Sectional ◽  
Women Living With Hiv ◽  
Related Stigma ◽  
Living With Hiv ◽  
Mother To Child

Background: We look at how various HIV-related stigma subtypes, especially internalizing types, interact with postpartum depression (PPD) among women living with HIV. Additionally, we identify key psychosocial risk factors that influence stigma and PPD among women attending Prevention of Mother-to-Child Transmission (PMTCT) clinics.Methods: In this cross-sectional design, 123 women living with HIV were recruited. Participants ages between 18 and 50, who were at least 8 weeks postpartum seeking PMTCT services at Kenyatta National Hospital (KNH), between June and September 2014 participated in the study. HIV/AIDS Stigma Instrument—PLWHA (HASI–P) was used to assesses stigma and Postpartum depression was assessed by Edinburgh Postnatal Depression Scale (EPDS). Bivariate and multivariate regression models were used to determine the individual characteristics associated with the HIV-related stigma Scale. Post survey a few in-depth-interviews were conducted to explore individuals' stigma and depression experiences.Results: The mean age was 31.2 years (SD = 5.2). Fifty-nine (48%) women screened positive for significant depressive symptoms. Post-partum depression was a significant predictor of internalized stigma, enacted, and total stigma (P < 0.05). Older age was associated with less internalized stigma. Living with a partner was associated with more internalized stigma. Having an income above 100 USD per month was protective against stigma. Having good family social support was protective against internalized stigma. A higher educational level was protective against enacted stigma. Being treated for STIs was a risk factor for both enacted and overall stigma.Conclusions: HIV-related stigma needs to be addressed through integrated mental health care programs in PMTCT. Postpartum depression requires comprehensive management to improve short- and long-term outcomes of women living with HIV.

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