Objective To calculate the number of pregnant women who receive standardized prevention of mother-to-child transmission(PMTCT)services for HIV annually.Methods HIV-positive pregnant women in six counties of Liangshan ...Objective To calculate the number of pregnant women who receive standardized prevention of mother-to-child transmission(PMTCT)services for HIV annually.Methods HIV-positive pregnant women in six counties of Liangshan Prefecture in 2017 were selected as study subjects.The entire process,from when the subjects first received the PMTCT of HIV services to the end,was divided into four stages,which were further divided into 25 phases.The equivalent coefficient was used to indicate the weight of workload in each phase.Seven experts were invited to score the equivalent coefficient;the number of pregnant women who received standardized services to prevent the transmission of HIV was calculated.Results A total of 663 HIV-positive pregnant women were registered in six Liangshan Prefecture counties in 2017.This figure was converted into 7,780 person-months devoted to HIV-positive pregnant women,with 260 person-months(3.34%)spent on the first antenatal care,1,510 person-months(19.41%)during pregnancy,378 person-months(4.86%)on delivery,and 5,632 person-months(72.39%)on post-partum period.The equivalent coefficient calculation showed that 314 HIV-positive pregnant women received standardized PMTCT services.Conclusion The number of pregnant women receiving standardized services for the PMTCT of HIV can be calculated accurately using the equivalent method to identify the gap between the level of PMTCT of HIV intervention services needed and the actual workload.展开更多
Introduction: The prevalence of HIV infection amongst pregnant women in Cameroon is 5.6%. Mother-to-child transmission is a major expansion factor. In 2010, Cameroon adopted new strategies pegged to WHO guidelines. Ob...Introduction: The prevalence of HIV infection amongst pregnant women in Cameroon is 5.6%. Mother-to-child transmission is a major expansion factor. In 2010, Cameroon adopted new strategies pegged to WHO guidelines. Objectives: The objective of this study was to evaluate the implementation of the new guidelines of prevention of mother to-child transmission (PMTCT) of HIV in the Yaoundé Central Hospital and the Yaoundé Teaching Hospital. Methodology: It was a cross sectional descriptive and prospective study over a period of 6 months in Yaoundé. It included all HIV-positive women, doing their antenatal care in the above cited hospitals, and having given their consent. The studied variables included socio demographic features, obstetrical history, the antenatal care, the initiation of anti retroviral (ARV) drugs, the ARV regimen, the number of years on ARV drugs, the mode of delivery and the mother and child outcome. The data was collected using a pre-tested questionnaire. They were obtained by interview of the seropositive pregnant women. Data were analysed using Epi info 3.5.3. Results: We performed 3104 antenatal consultations and 287 women were recruited in the study. The prevalence of HIV infection was 9.24%. The mean age of women was 28.77 (SD: 5.13) years. The women were aged between 20 and 29 years in 51.20%. Amongst the 156 women who knew their status before pregnancy, 109 (70.50%) had their first ANC in the first trimester. All were managed according to the 2010 WHO recommendations on PMTCT of HIV. Amongst the women unaware of their status, 25.20% had their booking ANC in the first trimester, 25.14% started ARVs at 14 weeks, 69.46% at 28 weeks. We had 125 live births, 84.8% by vaginal route, neonatal prophylaxis in all babies was effective. Conclusion: PMTCT of HIV is available and guidelines are well applied in Yaoundé. Late treatment initiation still remains a problem to optimize care.展开更多
Background: Nigeria has the largest paediatric HIV-infected population in the world. Missed opportunities for prevention of mother-to-child transmission of HIV (PMTCT) compromise efforts at eliminating new pediatric H...Background: Nigeria has the largest paediatric HIV-infected population in the world. Missed opportunities for prevention of mother-to-child transmission of HIV (PMTCT) compromise efforts at eliminating new pediatric HIV infections. Methods: Six hundred children, aged < 15 years, presenting to the pediatric units of the University College Hospital (UCH), Ibadan Southwest Nigeria between June to December 2007 were studied. The demographics, HIV status and socioeconomic status of mothers and their children were studied. A 4-step hierarchy was used to assess the missed opportunities for PMTCT. Step 1: utilization of a health facility for antenatal care and delivery;Step 2: maternal HIV status determination during pregnancy;Step 3: provision of antiretroviral medication to HIV-infected mother and baby;and Step 4: avoidance of mixed feeding in HIV-exposed children. The rates of missed opportunities for PMTCT services at different steps in the PMTCT cascade, perinatal transmission rates, and associated factors were reported. Results: There were 599 mothers and 600 children (one set of twins), 60 (10%) were HIV infected and 56 (93.3%) of these were adjudged perinatally infected. Of 78 HIV-infected women, 7 (9.0%) accessed all interventions in the PMTCT cascade and 71 (91.0%) had missed opportunities for PMTCT. Missed opportunities for PMTCT occurred 42.9% in cascade Step 1, 64.2% in Step 2, 52.6% in step 3 and 73.7% in Step 4. All mother-baby pairs who accessed complete PMTCT interventions received care at a teaching hospital. Among infants with perinatal HIV infection, 53 (94.6%) were born to mothers who had missed opportunities for PMTCT. Most women with missed opportunities attended antenatal care outside the teaching hospital setting and belonged to low socioeconomic status. Conclusion: It is imperative to expand PMTCT access to women who receive antenatal care outside the teaching hospitals and to those of low socioeconomic status.展开更多
Nurses work within a multidimensional scope of practice, which includes a reactive approach of treating health problems, a proactive stance of health promotion, and disease prevention. The purpose of this paper is to ...Nurses work within a multidimensional scope of practice, which includes a reactive approach of treating health problems, a proactive stance of health promotion, and disease prevention. The purpose of this paper is to discuss the contribution of the intersectionality framework in building nursing knowledge related to the PMTCT of HIV and show how the intersectionality framework can contribute to the improvement of nursing practice, policy, and research related to PMTCT of HIV. A comprehensive literature review was conducted to be able to discuss the contribution of intersectionality framework in nursing knowledge. Intersectionality is a nice perspective that gives insight into different identities that link and work together to provide inequalities. Intersectionality is a well-suited approach in a nursing profession where we strive to offer efficient and better care to our patients or clients;an excellent tool to explore more on the roots of inequality, oppression, and discrimination.展开更多
Background: Maximising women’s participation and ensuring optimal outcomes will require that the women’s perception barriers to postnatal prevention of Mother-to-Child Transmission (PMTCT) programme of HIV be addres...Background: Maximising women’s participation and ensuring optimal outcomes will require that the women’s perception barriers to postnatal prevention of Mother-to-Child Transmission (PMTCT) programme of HIV be addressed. However, little is known about women’s perception barriers to postnatal PMTCT programme of HIV and how these barriers affect the women’s health seeking behavior and uptake. Objective: This study sought to explore the women’s perception barriers to postnatal PMTCT programme at a Johannesburg Community Health Centre during April-May, 2016. Methods: A qualitative study on 30 women (aged 20 - 39 years) was conducted at a Johannesburg community health (CHC), South Africa, during May-June 2016, after obtaining their consent. The data was analysed thematically to understand women’s perception barriers to postnatal PMTCT programme. Results: The study found that inadequate counselling was perceived to be the single key health service barrier to PMTCT programme. At the individual level, adherence to ART was considered the leading women’s barriers to the postnatal PMTCT. Exclusive breastfeeding was, however, perceived as important women’s barriers to the postnatal PMTCT. Inadequate emotional support from families and community was a noteworthy women’s perception barrier to the programme. Conclusion: The study makes two recommendations: firstly, the staff, programme managers and health policy makers need to be aware of the women’s perception barriers to the postnatal PMTCT programme. Secondly, the programme should be strengthened by addressing perception barriers to the programme to enhance women participation to ensure optimal outcomes for women and their infants.展开更多
Missed Prevention of Mother-to-Child Transmission of HIV (PMTCT) visits have contributed to the delayed achievement of elimination of mother-to-child transmission of HIV. Missed visits promote attrition from preventio...Missed Prevention of Mother-to-Child Transmission of HIV (PMTCT) visits have contributed to the delayed achievement of elimination of mother-to-child transmission of HIV. Missed visits promote attrition from prevention of mother-to-child transmission of HIV program and antiretroviral drug resistance. The purpose of the study was to determine the prevalence of missed PMTCT visits and its associated predictors. A descriptive cross sectional survey was carried out at a District Hospital in Goromonzi, Zimbabwe. Fifty-three women completed closed-ended questionnaires pertaining to PMTCT visits and exposure to PMTCT activities. A total of 24.5% missed at least one scheduled PMTCT visit. Statistically significant predictors of not missing a PMTCT visit were satisfaction with family support (β = −0.73, p = 0.029) and level of satisfaction with PMTCT services (β = −0.00076;p = 0.04). The number of days by which scheduled visits were missed were inversely correlated with visit number (β = −2.99, p = 0.04). Enhanced family support and quality improvement to improve patient satisfaction may reduce missed visits. Availing women with a more active role in PMTCT may also reduce the prevalence of missed visits.展开更多
The objective of the study was to identify the failure factors of community interventions in terms of HIV activities in the province of Haut-Katanga during the year 2016. Materials and Methods: The study was phenomeno...The objective of the study was to identify the failure factors of community interventions in terms of HIV activities in the province of Haut-Katanga during the year 2016. Materials and Methods: The study was phenomenological of the factors, carried out in Haut Katanga. All health facilities (FOSAs) having integrated the prevention of transmission of HIV infection from mother to child (PMTCT) were included in the study. The collection was carried out through individual semi-structured interviews with PMTCT focal points, mentor mothers and people living with HIV (PLWHA) cared for in some of these health facilities (FOSAs). The number of participants was determined by the saturation of responses. Nvivo v.11 software was used for the analyses. The data of each woman was handled confidentially. The authorization of the ethics committee of the University of Kinshasa ESP/CE091/2015, the free and written consent, was obtained before collecting the information. Results: It was observed the socio-cultural factors of success and failure of the interventions: the social fear generated by contradictory messages in the sensitization of the community;the lack of an obvious strategy for the involvement of the partner;the weak coordination of community care activities between the central office of the health zone;the FOSA and the community worker: low interest in community care evidenced by weak accountability of FOSAs, community and program providers in this regard;that relates to community activities;coordination of care between care units;overload of the staff in charge of activities within the health structure and their low motivation;the low communication time devoted to people living with HIV in the FOSAs. Conclusion: The study shows that interventions that can improve the quality and outcomes of prevention of mother-to-child transmission of HIV (PMTCT) services can be directly linked to the program itself, as well as come from another or the community, which generally remains the weak link in which efforts are even less noticeable, at least as far as PMTCT is concerned. Integrating care data for the mother-child couple improve the continuum of services between the different care units as well as the quality of data management.展开更多
Background: Despite the efforts at establishing Prevention of Mother to Child Transmission (PMTCT) programs in Rwanda, there are still children who are becoming infected through mother-to-child transmission of HIV. Th...Background: Despite the efforts at establishing Prevention of Mother to Child Transmission (PMTCT) programs in Rwanda, there are still children who are becoming infected through mother-to-child transmission of HIV. The purpose of our research study was to explore the experiences of HIV positive women using PMTCT program to prevent HIV transmission in Rwanda. Methodology: In this study, a qualitative approach using a critical ethnographic design was used to answer to our research question and with the aim to discover the meaning, process, and context of the studied phenomenon. In this paper, we discussed ethnography, critical ethnography, and its related philosophical assumptions as well as illustrating the rational for the use of critical ethnography to study the PMTCT program. Critical ethnography ultimately will contribute to raising awareness on how we can prevent new infections among children born from HIV positive mothers who are using the PMTCT program. The findings suggested a wide range of challenging factors that are shaped by social, political, cultural, economic, ethnic, and gender values, and that directly and indirectly affect the uptake of the PMTCT program. While using the critical realist ontology, we discovered multiple truths about the challenging factors for HIV+ mothers experience to uptake the PMTCT program. We triangulated their experiences with the findings gathered from healthcare providers, PMTCT leaders and policymakers, field observation, and document analysis. No previous studies on this phenomenon used a critical lens to explore the reality behind a wide range of experiences of mothers using the PMTCT program to prevent HIV transmission in Rwanda. Conclusion: The critical nature of this inquiry contributed to the depth and breadth of knowledge related to the delivery of the PMTCT program to prevent MTCT of HIV.展开更多
HIV status disclosure to partners is critical in improving the health and well-being of mother-infant dyad in the prevention of HIV transmission from mother to child (PMTCT) program. This study assesses the HIV disclo...HIV status disclosure to partners is critical in improving the health and well-being of mother-infant dyad in the prevention of HIV transmission from mother to child (PMTCT) program. This study assesses the HIV disclosure rate to intimate partners, associated factors, and outcomes among women in the PMTCT program in two large HIV clinics in Abuja, Nigeria. A descriptive cross-sectional study employed a multi-stage sampling technique in selecting 220 pregnant women enrolled in PMTCT care in two clinics. Outcomes measures include HIV status disclosure to intimate partner, women’s viral suppression status (suppressed < 1000 copies/mL, unsuppressed ≥ 1000 copies/mL), and previous MTCT experience. Exposure variables include the participant’s socio-demographic characteristics and HIV care history. Data were presented using frequency tables. Simple and multivariate logistic regression was done to ascertain the predictors of HIV status disclosure and assess the association between HIV disclosure, viral suppression, and MTCT experience at a p-value of less than 0.05. Only 205 (96.7%) entries were completed and analyzed A larger percentage of the participants were married women, 158 (77.1%), within the age group 26 - 35 years (53.3%). Women’s HIV status disclosure rate to intimate partners was 49.3% (101/205). Factors associated with HIV disclosure rate to intimate partners at the univariate level were the participant’s age, Christian religion [COR: 1.80, 95%CI: 1.04 - 3.21, p = 0.04], full employment [COR: 1.92, 95%CI: 1.10 - 3.34, p = 0.02], HIV positivity prior to PMTCT enrollment [COR: 2.88, 95%CI: 1.26 - 6.59, p < 0.01], duration on antiretroviral therapy [COR: 1.07, 95%CI: 1.01 - 1.13, p = 0.03], and knowledge of partner’s HIV status [COR: 0.20, 95%CI: 0.08 - 0.51, p < 0.01]. Only HIV positivity prior to PMTCT enrollment [AOR: 3.27, 95%CI: 1.23 - 8.70, p < 0.01] and awareness of the partner’s HIV status, [AOR: 0.17, 95%CI: 0.06 - 0.49, p < 0.01] were significant predictors of HIV status disclosure after controlling for confounder. The two study outcomes;women’s viral suppression and MTCT experience were not significantly associated with participants’ HIV status disclosure to intimate partners. Our study shows that HIV disclosure to intimate partners is still a big challenge among pregnant women in PMTCT settings in Nigeria, with awareness of the partner’s HIV status and the type of patient enrollment in the PMTCT setting being the two strong predictors of pregnant women’s HIV disclosure status to partners.展开更多
Introduction: HIV infection and AIDS is a public health problem worldwide, particularly affecting the populace in resource challenged setting like sub-saharan Africa. Women of reproductive age are mostly affected and ...Introduction: HIV infection and AIDS is a public health problem worldwide, particularly affecting the populace in resource challenged setting like sub-saharan Africa. Women of reproductive age are mostly affected and infected with the HIV disease. Methodology: A cross-sectional study of 216 randomly selected women that booked for antenatal care at the Faith Alive Foundation and PMTCT centre Jos between 1st July to 31st December, 2014 was carried out. Information regarding age, parity, gestational age at booking, educational status and HIV sero-status of the clients was analysed. Screening test was conducted in a serial two step approval using determine and UNIGOLD as the confirmatory test, while STAT-PAK was the tie-beaker with discordant result as per the national algorithm. Positive samples were confirmed by western blot method. Result: A total of 18 women out of the 216 women studied were positive giving a sero-prevalence rate of 8.3%. The highest sero-prevalent rate was amongst 25 - 29 years age group (31.5%). Women of parity 1 - 4 constituted the highest group of 62.9%. Majority of the women 65.7% booked in the second trimester while 26.9% booked in the 3rd trimester. Most of the women 47.2% had secondary school education while only 5.6% of them had no form of education. Conclusion: HIV infection prevalence rate among antenatal attendants at Faith Alive Foundation and PMTCT centre Jos is still high. Multisectorial approach and intervention strategies should be further scaled up for the prevention of vertical transmission of the virus. However, it is worth noting that it is mainly an HIV/AIDS hospital which should have affected the outcome.展开更多
HIV双阳家庭是指夫妻双方均为HIV感染者。对于这类家庭中的孕妇来说,抗逆转录病毒治疗(antiretroviral therapy,ART)和母婴阻断技术是预防母婴传播(prevention of mother-to-child transmission,PMTCT)的关键。早期ART干预可有效降低母...HIV双阳家庭是指夫妻双方均为HIV感染者。对于这类家庭中的孕妇来说,抗逆转录病毒治疗(antiretroviral therapy,ART)和母婴阻断技术是预防母婴传播(prevention of mother-to-child transmission,PMTCT)的关键。早期ART干预可有效降低母婴传播的风险,但依从性管理、伴侣间交叉感染及社会心理压力仍是挑战。本文综述了程序化ART的实施标准、临床效果及母婴阻断技术的进展,并探讨了其联合应用的协同效应及经济价值。尽管干预措施的落地使得母婴传播率有了明显的下降,但资源不均、耐药性监测不足等因素仍然限制了干预效果。未来,HIV母婴传播的防控应采取更加综合的策略,包括优化个性化ART方案、强化家庭健康教育、减少社会歧视,并结合长效抗病毒药物与新兴技术等,以期进一步降低HIV母婴传播的风险。展开更多
基金funded by the Research Project of the Chinese Center for Disease Control and Prevention[JY18-2-37]。
文摘Objective To calculate the number of pregnant women who receive standardized prevention of mother-to-child transmission(PMTCT)services for HIV annually.Methods HIV-positive pregnant women in six counties of Liangshan Prefecture in 2017 were selected as study subjects.The entire process,from when the subjects first received the PMTCT of HIV services to the end,was divided into four stages,which were further divided into 25 phases.The equivalent coefficient was used to indicate the weight of workload in each phase.Seven experts were invited to score the equivalent coefficient;the number of pregnant women who received standardized services to prevent the transmission of HIV was calculated.Results A total of 663 HIV-positive pregnant women were registered in six Liangshan Prefecture counties in 2017.This figure was converted into 7,780 person-months devoted to HIV-positive pregnant women,with 260 person-months(3.34%)spent on the first antenatal care,1,510 person-months(19.41%)during pregnancy,378 person-months(4.86%)on delivery,and 5,632 person-months(72.39%)on post-partum period.The equivalent coefficient calculation showed that 314 HIV-positive pregnant women received standardized PMTCT services.Conclusion The number of pregnant women receiving standardized services for the PMTCT of HIV can be calculated accurately using the equivalent method to identify the gap between the level of PMTCT of HIV intervention services needed and the actual workload.
文摘Introduction: The prevalence of HIV infection amongst pregnant women in Cameroon is 5.6%. Mother-to-child transmission is a major expansion factor. In 2010, Cameroon adopted new strategies pegged to WHO guidelines. Objectives: The objective of this study was to evaluate the implementation of the new guidelines of prevention of mother to-child transmission (PMTCT) of HIV in the Yaoundé Central Hospital and the Yaoundé Teaching Hospital. Methodology: It was a cross sectional descriptive and prospective study over a period of 6 months in Yaoundé. It included all HIV-positive women, doing their antenatal care in the above cited hospitals, and having given their consent. The studied variables included socio demographic features, obstetrical history, the antenatal care, the initiation of anti retroviral (ARV) drugs, the ARV regimen, the number of years on ARV drugs, the mode of delivery and the mother and child outcome. The data was collected using a pre-tested questionnaire. They were obtained by interview of the seropositive pregnant women. Data were analysed using Epi info 3.5.3. Results: We performed 3104 antenatal consultations and 287 women were recruited in the study. The prevalence of HIV infection was 9.24%. The mean age of women was 28.77 (SD: 5.13) years. The women were aged between 20 and 29 years in 51.20%. Amongst the 156 women who knew their status before pregnancy, 109 (70.50%) had their first ANC in the first trimester. All were managed according to the 2010 WHO recommendations on PMTCT of HIV. Amongst the women unaware of their status, 25.20% had their booking ANC in the first trimester, 25.14% started ARVs at 14 weeks, 69.46% at 28 weeks. We had 125 live births, 84.8% by vaginal route, neonatal prophylaxis in all babies was effective. Conclusion: PMTCT of HIV is available and guidelines are well applied in Yaoundé. Late treatment initiation still remains a problem to optimize care.
文摘Background: Nigeria has the largest paediatric HIV-infected population in the world. Missed opportunities for prevention of mother-to-child transmission of HIV (PMTCT) compromise efforts at eliminating new pediatric HIV infections. Methods: Six hundred children, aged < 15 years, presenting to the pediatric units of the University College Hospital (UCH), Ibadan Southwest Nigeria between June to December 2007 were studied. The demographics, HIV status and socioeconomic status of mothers and their children were studied. A 4-step hierarchy was used to assess the missed opportunities for PMTCT. Step 1: utilization of a health facility for antenatal care and delivery;Step 2: maternal HIV status determination during pregnancy;Step 3: provision of antiretroviral medication to HIV-infected mother and baby;and Step 4: avoidance of mixed feeding in HIV-exposed children. The rates of missed opportunities for PMTCT services at different steps in the PMTCT cascade, perinatal transmission rates, and associated factors were reported. Results: There were 599 mothers and 600 children (one set of twins), 60 (10%) were HIV infected and 56 (93.3%) of these were adjudged perinatally infected. Of 78 HIV-infected women, 7 (9.0%) accessed all interventions in the PMTCT cascade and 71 (91.0%) had missed opportunities for PMTCT. Missed opportunities for PMTCT occurred 42.9% in cascade Step 1, 64.2% in Step 2, 52.6% in step 3 and 73.7% in Step 4. All mother-baby pairs who accessed complete PMTCT interventions received care at a teaching hospital. Among infants with perinatal HIV infection, 53 (94.6%) were born to mothers who had missed opportunities for PMTCT. Most women with missed opportunities attended antenatal care outside the teaching hospital setting and belonged to low socioeconomic status. Conclusion: It is imperative to expand PMTCT access to women who receive antenatal care outside the teaching hospitals and to those of low socioeconomic status.
文摘Nurses work within a multidimensional scope of practice, which includes a reactive approach of treating health problems, a proactive stance of health promotion, and disease prevention. The purpose of this paper is to discuss the contribution of the intersectionality framework in building nursing knowledge related to the PMTCT of HIV and show how the intersectionality framework can contribute to the improvement of nursing practice, policy, and research related to PMTCT of HIV. A comprehensive literature review was conducted to be able to discuss the contribution of intersectionality framework in nursing knowledge. Intersectionality is a nice perspective that gives insight into different identities that link and work together to provide inequalities. Intersectionality is a well-suited approach in a nursing profession where we strive to offer efficient and better care to our patients or clients;an excellent tool to explore more on the roots of inequality, oppression, and discrimination.
文摘Background: Maximising women’s participation and ensuring optimal outcomes will require that the women’s perception barriers to postnatal prevention of Mother-to-Child Transmission (PMTCT) programme of HIV be addressed. However, little is known about women’s perception barriers to postnatal PMTCT programme of HIV and how these barriers affect the women’s health seeking behavior and uptake. Objective: This study sought to explore the women’s perception barriers to postnatal PMTCT programme at a Johannesburg Community Health Centre during April-May, 2016. Methods: A qualitative study on 30 women (aged 20 - 39 years) was conducted at a Johannesburg community health (CHC), South Africa, during May-June 2016, after obtaining their consent. The data was analysed thematically to understand women’s perception barriers to postnatal PMTCT programme. Results: The study found that inadequate counselling was perceived to be the single key health service barrier to PMTCT programme. At the individual level, adherence to ART was considered the leading women’s barriers to the postnatal PMTCT. Exclusive breastfeeding was, however, perceived as important women’s barriers to the postnatal PMTCT. Inadequate emotional support from families and community was a noteworthy women’s perception barrier to the programme. Conclusion: The study makes two recommendations: firstly, the staff, programme managers and health policy makers need to be aware of the women’s perception barriers to the postnatal PMTCT programme. Secondly, the programme should be strengthened by addressing perception barriers to the programme to enhance women participation to ensure optimal outcomes for women and their infants.
文摘Missed Prevention of Mother-to-Child Transmission of HIV (PMTCT) visits have contributed to the delayed achievement of elimination of mother-to-child transmission of HIV. Missed visits promote attrition from prevention of mother-to-child transmission of HIV program and antiretroviral drug resistance. The purpose of the study was to determine the prevalence of missed PMTCT visits and its associated predictors. A descriptive cross sectional survey was carried out at a District Hospital in Goromonzi, Zimbabwe. Fifty-three women completed closed-ended questionnaires pertaining to PMTCT visits and exposure to PMTCT activities. A total of 24.5% missed at least one scheduled PMTCT visit. Statistically significant predictors of not missing a PMTCT visit were satisfaction with family support (β = −0.73, p = 0.029) and level of satisfaction with PMTCT services (β = −0.00076;p = 0.04). The number of days by which scheduled visits were missed were inversely correlated with visit number (β = −2.99, p = 0.04). Enhanced family support and quality improvement to improve patient satisfaction may reduce missed visits. Availing women with a more active role in PMTCT may also reduce the prevalence of missed visits.
文摘The objective of the study was to identify the failure factors of community interventions in terms of HIV activities in the province of Haut-Katanga during the year 2016. Materials and Methods: The study was phenomenological of the factors, carried out in Haut Katanga. All health facilities (FOSAs) having integrated the prevention of transmission of HIV infection from mother to child (PMTCT) were included in the study. The collection was carried out through individual semi-structured interviews with PMTCT focal points, mentor mothers and people living with HIV (PLWHA) cared for in some of these health facilities (FOSAs). The number of participants was determined by the saturation of responses. Nvivo v.11 software was used for the analyses. The data of each woman was handled confidentially. The authorization of the ethics committee of the University of Kinshasa ESP/CE091/2015, the free and written consent, was obtained before collecting the information. Results: It was observed the socio-cultural factors of success and failure of the interventions: the social fear generated by contradictory messages in the sensitization of the community;the lack of an obvious strategy for the involvement of the partner;the weak coordination of community care activities between the central office of the health zone;the FOSA and the community worker: low interest in community care evidenced by weak accountability of FOSAs, community and program providers in this regard;that relates to community activities;coordination of care between care units;overload of the staff in charge of activities within the health structure and their low motivation;the low communication time devoted to people living with HIV in the FOSAs. Conclusion: The study shows that interventions that can improve the quality and outcomes of prevention of mother-to-child transmission of HIV (PMTCT) services can be directly linked to the program itself, as well as come from another or the community, which generally remains the weak link in which efforts are even less noticeable, at least as far as PMTCT is concerned. Integrating care data for the mother-child couple improve the continuum of services between the different care units as well as the quality of data management.
文摘Background: Despite the efforts at establishing Prevention of Mother to Child Transmission (PMTCT) programs in Rwanda, there are still children who are becoming infected through mother-to-child transmission of HIV. The purpose of our research study was to explore the experiences of HIV positive women using PMTCT program to prevent HIV transmission in Rwanda. Methodology: In this study, a qualitative approach using a critical ethnographic design was used to answer to our research question and with the aim to discover the meaning, process, and context of the studied phenomenon. In this paper, we discussed ethnography, critical ethnography, and its related philosophical assumptions as well as illustrating the rational for the use of critical ethnography to study the PMTCT program. Critical ethnography ultimately will contribute to raising awareness on how we can prevent new infections among children born from HIV positive mothers who are using the PMTCT program. The findings suggested a wide range of challenging factors that are shaped by social, political, cultural, economic, ethnic, and gender values, and that directly and indirectly affect the uptake of the PMTCT program. While using the critical realist ontology, we discovered multiple truths about the challenging factors for HIV+ mothers experience to uptake the PMTCT program. We triangulated their experiences with the findings gathered from healthcare providers, PMTCT leaders and policymakers, field observation, and document analysis. No previous studies on this phenomenon used a critical lens to explore the reality behind a wide range of experiences of mothers using the PMTCT program to prevent HIV transmission in Rwanda. Conclusion: The critical nature of this inquiry contributed to the depth and breadth of knowledge related to the delivery of the PMTCT program to prevent MTCT of HIV.
文摘HIV status disclosure to partners is critical in improving the health and well-being of mother-infant dyad in the prevention of HIV transmission from mother to child (PMTCT) program. This study assesses the HIV disclosure rate to intimate partners, associated factors, and outcomes among women in the PMTCT program in two large HIV clinics in Abuja, Nigeria. A descriptive cross-sectional study employed a multi-stage sampling technique in selecting 220 pregnant women enrolled in PMTCT care in two clinics. Outcomes measures include HIV status disclosure to intimate partner, women’s viral suppression status (suppressed < 1000 copies/mL, unsuppressed ≥ 1000 copies/mL), and previous MTCT experience. Exposure variables include the participant’s socio-demographic characteristics and HIV care history. Data were presented using frequency tables. Simple and multivariate logistic regression was done to ascertain the predictors of HIV status disclosure and assess the association between HIV disclosure, viral suppression, and MTCT experience at a p-value of less than 0.05. Only 205 (96.7%) entries were completed and analyzed A larger percentage of the participants were married women, 158 (77.1%), within the age group 26 - 35 years (53.3%). Women’s HIV status disclosure rate to intimate partners was 49.3% (101/205). Factors associated with HIV disclosure rate to intimate partners at the univariate level were the participant’s age, Christian religion [COR: 1.80, 95%CI: 1.04 - 3.21, p = 0.04], full employment [COR: 1.92, 95%CI: 1.10 - 3.34, p = 0.02], HIV positivity prior to PMTCT enrollment [COR: 2.88, 95%CI: 1.26 - 6.59, p < 0.01], duration on antiretroviral therapy [COR: 1.07, 95%CI: 1.01 - 1.13, p = 0.03], and knowledge of partner’s HIV status [COR: 0.20, 95%CI: 0.08 - 0.51, p < 0.01]. Only HIV positivity prior to PMTCT enrollment [AOR: 3.27, 95%CI: 1.23 - 8.70, p < 0.01] and awareness of the partner’s HIV status, [AOR: 0.17, 95%CI: 0.06 - 0.49, p < 0.01] were significant predictors of HIV status disclosure after controlling for confounder. The two study outcomes;women’s viral suppression and MTCT experience were not significantly associated with participants’ HIV status disclosure to intimate partners. Our study shows that HIV disclosure to intimate partners is still a big challenge among pregnant women in PMTCT settings in Nigeria, with awareness of the partner’s HIV status and the type of patient enrollment in the PMTCT setting being the two strong predictors of pregnant women’s HIV disclosure status to partners.
文摘Introduction: HIV infection and AIDS is a public health problem worldwide, particularly affecting the populace in resource challenged setting like sub-saharan Africa. Women of reproductive age are mostly affected and infected with the HIV disease. Methodology: A cross-sectional study of 216 randomly selected women that booked for antenatal care at the Faith Alive Foundation and PMTCT centre Jos between 1st July to 31st December, 2014 was carried out. Information regarding age, parity, gestational age at booking, educational status and HIV sero-status of the clients was analysed. Screening test was conducted in a serial two step approval using determine and UNIGOLD as the confirmatory test, while STAT-PAK was the tie-beaker with discordant result as per the national algorithm. Positive samples were confirmed by western blot method. Result: A total of 18 women out of the 216 women studied were positive giving a sero-prevalence rate of 8.3%. The highest sero-prevalent rate was amongst 25 - 29 years age group (31.5%). Women of parity 1 - 4 constituted the highest group of 62.9%. Majority of the women 65.7% booked in the second trimester while 26.9% booked in the 3rd trimester. Most of the women 47.2% had secondary school education while only 5.6% of them had no form of education. Conclusion: HIV infection prevalence rate among antenatal attendants at Faith Alive Foundation and PMTCT centre Jos is still high. Multisectorial approach and intervention strategies should be further scaled up for the prevention of vertical transmission of the virus. However, it is worth noting that it is mainly an HIV/AIDS hospital which should have affected the outcome.
文摘HIV双阳家庭是指夫妻双方均为HIV感染者。对于这类家庭中的孕妇来说,抗逆转录病毒治疗(antiretroviral therapy,ART)和母婴阻断技术是预防母婴传播(prevention of mother-to-child transmission,PMTCT)的关键。早期ART干预可有效降低母婴传播的风险,但依从性管理、伴侣间交叉感染及社会心理压力仍是挑战。本文综述了程序化ART的实施标准、临床效果及母婴阻断技术的进展,并探讨了其联合应用的协同效应及经济价值。尽管干预措施的落地使得母婴传播率有了明显的下降,但资源不均、耐药性监测不足等因素仍然限制了干预效果。未来,HIV母婴传播的防控应采取更加综合的策略,包括优化个性化ART方案、强化家庭健康教育、减少社会歧视,并结合长效抗病毒药物与新兴技术等,以期进一步降低HIV母婴传播的风险。
