scholarly journals Perinatal HIV Transmission Prevention: Challenges among Women Living with HIV in sub-Saharan Africa

2020 ◽  
Vol 9 (3) ◽  
pp. 354-359
Author(s):  
Elizabeth Armstrong-Mensah ◽  
Krystal Ruiz ◽  
Aminata Fofana ◽  
Victoria Hawley

About 86 percent of the estimated 160,000 children newly-infected with the human immunodeficiency virus (HIV) live in sub-Saharan Africa. Despite global efforts to reduce perinatal HIV transmission, this phenomenon continues to be a public health problem in sub-Saharan Africa. This paper discusses challenges associated with perinatal HIV transmission prevention in sub-Saharan Africa and offers strategies for the way forward. These strategies include safe sex education and behavioral change, increased access to integrated antenatal care, training of unskilled traditional birth attendants into formal delivery systems, access to antiretroviral therapy, and investing in virologic testing. Key words: • HIV • Perinatal • Antiretroviral Therapy • Mother to Child HIV Transmission • HIV Prevention • Sub-Saharan Africa   Copyright © 2020 Armstrong-Mensah, et al. Published by Global Health and Education Projects, Inc. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY 4.0) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in this journal, is properly cited.

2017 ◽  
Vol 5 (1) ◽  
pp. 17 ◽  
Author(s):  
Olivia Ningeninawa Tuhadeleni ◽  
Linda Ndeshipandula Lukolo

Background: The benefits of antiretroviral therapy (ART) are undeniable: decreased morbidity and mortality, improved clinical outcomes, and decreased HIV transmission. In recent years, there have been remarkable efforts to roll out HIV support and treatment programs, resulting in ART access to nearly 4 million people in sub-Saharan Africa. However, a decisive step in improving outcomes of these programs relies on ART adherence. This study was conducted by aiming at exploring and describing the perceptions of patients on ART and treatment supporters about their roles in ART adherence. It was carried out at Oshakati ART clinic in the Intermediate Hospital Oshakati in Oshana region, Northern Namibia.Methods: The qualitative investigation was carried out on patients on ART and treatment supporters by means of unstructured interviews through convenient sampling technique. The data were analysed by content analytical method.Results: The study results from all respondents were consolidated, which gave a clear understanding regarding adherence at the ART clinic in Intermediate Hospital Oshakati. The perceptions of patients on ART and treatment supporters with regard to their role towards ART adherence were classified based on participants’ experiences into two main themes and sub-themes, including: 1) ART patients’ perceptions around their current roles in ART adherence comprise of four sub-themes of ART patients’ perceptions about taking medication daily, perceptions about collection of medicine supply and follow-up visits, perceptions about food and medication and perceptions about support in ART treatment; 2) Treatment supporters’ perceptions about their role in ART adherence consist of four sub-themes of perceptions about follow-up visits and collection of medicine, perceptions about psychosocial and emotional support, perceptions about giving food and medication and perceptions about encouraging personal hygiene.Conclusion: Patients and treatment supporters perceived adherence as an important aspect in the success of antiretroviral treatment. Giving patients correct information, personal motivation, patients understanding of treatment, traditional and religious beliefs were among other factors perceived by treatment supporters to be impacting on ART adherence.


2020 ◽  
Author(s):  
PROF DANIEL TER GOON ◽  
Anthony Idowu Ajayi ◽  
OLADELE VINCENT ADENIYI

Abstract Background: Exclusive breast feeding (EBF) is associated with reduction of post-natal HIV transmission and optimal infant growth. Given that the factors influencing EBF are multi-factorial and context-specific, we examined the prevalence and factors associated with EBF practice in the first six months among mothers on antiretroviral therapy (ART) in the Eastern Cape, South Africa. Methods: This was a prospective cross-sectional study conducted between January – May 2018 on 469 parturient women enlisted in the prevention of mother-to-child HIV transmission cohort study in the Eastern Cape. EBF was defined as infant feeding with breast milk only. We collected relevant socio-demographic, lifestyle and maternal information by interview. Bivariate and multivariate logistic regression analyses were fitted to determine the factors associated with EBF practice.Results: EBF for six months was practised by a few women (32.0%). The prevalence of EBF was significantly higher among married women (36.8%), unemployed women (36.6%), non-smokers (32.7%) and those who never drank alcohol (37.0%). Unemployed women (AOR = 1.66, 95% CI: 1.08-2.56) and those with grade 12 or less level of education (AOR =2.76, 95% CI: 1.02-7.49) had a higher likelihood of practising EBF for six months while mothers who consumed alcohol (AOR = 0.54, 95% CI: 0.34-0.85) were less likely to practice EBF for six months. Conclusions: Sub-optimal rate of EBF in this study is comparable with the national (31.6%), sub-Saharan Africa (36%) and WHO global (35%) rates. Advocacy campaign on EBF must target alcohol cessation and the creation of a favourable workplace environment for lactating mothers.


Author(s):  
Clare Bristow ◽  
Grace George ◽  
Grace Hillsmith ◽  
Emma Rainey ◽  
Sarah Urasa ◽  
...  

Abstract There are over 3 million people in sub-Saharan Africa (SSA) aged 50 and over living with HIV. HIV and combined antiretroviral therapy (cART) exposure may accelerate the ageing in this population, and thus increase the prevalence of premature frailty. There is a paucity of data on the prevalence of frailty in an older HIV + population in SSA and screening and diagnostic tools to identify frailty in SSA. Patients aged ≥ 50 were recruited from a free Government HIV clinic in Tanzania. Frailty assessments were completed, using 3 diagnostic and screening tools: the Fried frailty phenotype (FFP), Clinical Frailty Scale (CFS) and Brief Frailty Instrument for Tanzania (B-FIT 2). The 145 patients recruited had a mean CD4 + of 494.84 cells/µL, 99.3% were receiving cART and 72.6% were virally suppressed. The prevalence of frailty by FFP was 2.758%. FFP frailty was significantly associated with female gender (p = 0.006), marital status (p = 0.007) and age (p = 0.038). Weight loss was the most common FFP domain failure. The prevalence of frailty using the B-FIT 2 and the CFS was 0.68%. The B-FIT 2 correlated with BMI (r = − 0.467, p = 0.0001) and CD4 count in females (r = − 0.244, p = 0.02). There is an absence of frailty in this population, as compared to other clinical studies. This may be due to the high standard of HIV care at this Government clinic. Undernutrition may be an important contributor to frailty. It is unclear which tool is most accurate for detecting the prevalence of frailty in this setting as levels of correlation are low.


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