Utilization of "prevention of mother-to-child transmission" of HIV services by adolescent and young mothers in Mulago Hospital, Uganda
Utilization of "prevention of mother-to-child transmission" of HIV services by adolescent and young mothers in Mulago Hospital, Uganda
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DOI：
10.1186/s12879-018-3480-3
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发表时间：
2018-11-14
影响因子：
3.7
通讯作者：
Nabukeera-Barungi, Nicolette
中科院分区：
文献类型：
--
作者：
Mustapha, Mariama;Musiime, Victor;Nabukeera-Barungi, Nicolette
背景：预防母婴传播（PMTCT）降低了全球儿童艾滋病毒的发病率。在非洲，艾滋病毒母婴传播的风险仍然很高，那里的年轻女孩和妇女怀孕率很高，寻求保健的行为也很差。方法：在这项横断面混合方法研究中，我们评估了乌干达一家公立城市转诊医院15至24岁的青少年和年轻产后母亲对预防母婴传播服务的利用及其相关因素。hiv阳性和hiv阴性的参与者都被招募。利用预防母婴传播服务被定义为使用预防母婴传播级联服务，包括进行艾滋病毒检测、接收艾滋病毒检测结果；如果检测呈阴性，随后重新检测长达14周；如果检测呈阳性，为母亲提供抗逆转录病毒药物，为婴儿提供抗逆转录病毒药物和septrin预防，安全分娩，更安全的婴儿喂养，在6周内对婴儿进行早期诊断，并与治疗和护理联系起来。预防母婴传播的最佳利用被定义为在接受采访时报告的艾滋病毒状况与预防母婴传播服务的利用情况一致。利用描述性统计确定了最佳利用预防母婴传播服务的参与者的总体比例。定性数据采用内容专题方法手工分析。结果：在418名参与者中，65人（15.5%）为HIV阳性。总体而言，418名参与者中只有126人（30.1%）充分利用了预防母婴传播服务。然而，艾滋病毒阳性母亲对预防母婴传播服务的利用情况更好，有83%（54/65）的母亲充分利用了这些服务，而艾滋病毒阴性母亲中只有20% (72/353)（OR 18.2 (95% CI; 9.0-36.7)）。了解自己的艾滋病毒状况、未出生婴儿的健康状况以及卫生工作者和同伴的咨询和支持所带来的好处是促使青少年和年轻母亲利用预防母婴传播服务的主要因素，而污名化、财政限制、不披露以及缺乏伴侣和家庭支持是主要的消极因素。结论：这些青少年和年轻母亲对预防母婴传播服务的利用情况不理想。在设计消除母婴传播（EMTCT）方案时，应特别考虑到青少年和年轻妇女，以提高预防母婴传播服务的利用率。
Background: Prevention of mother to child transmission (PMTCT) has lowered the incidence of paediatric HIV globally. The risk of mother-to-child transmission of HIV (MTCT) remains high in Africa, where there is a high prevalence of pregnancy and poor health-seeking behaviour among young girls and women.Methods: In this cross-sectional, mixed-methods study, we evaluated the utilization of PMTCT services and associated factors among adolescent and young postpartum mothers aged 15 to 24 years at a public urban referral hospital in Uganda. Both HIV-positive and HIV-negative participants were recruited. Utilization of PMTCT services was defined as use of the PMTCT cascade of services including ever testing for HIV, receiving HIV test results; If tested negative, subsequent retesting up to 14 weeks; If tested positive, Antiretroviral drugs (ARVs) for the mother, ARVs and septrin prophylaxis for infant, safe delivery, safer infant feeding, early infant diagnosis within 6 weeks, and linkage to treatment and care. Optimal utilization of PMTCT was defined as being up to date with utilization of PMTCT services for reported HIV status at the time of being interviewed. The overall proportion of participants who optimally utilized PMTCT services was determined using descriptive statistics. Qualitative data was analyzed manually using the content thematic approach.Results: Of the 418 participants, 65 (15.5%) were HIV positive. Overall, only 126 of 418 participants (30.1%) had optimally utilized PMTCT services. However, utilization of PMTCT services was better among HIV positive mothers, with 83% (54/65) having utilized the services optimally, compared to only 20% (72/353) of the HIV negative mothers (OR 18.2 (95% CI; 9.0-36.7)). The benefits of knowing ones HIV status, health of the unborn child, and counseling and support from health workers and peers, were the major factors motivating adolescent and young mothers to utilize PMTCT services, while stigma, financial constraints, non-disclosure, and lack of partner and family support were key demotivating factors.Conclusion: Utilization of PMTCT services by these adolescent and young mothers was suboptimal. Special consideration should be given to adolescents and young women in the design of elimination of mother to child transmission (EMTCT) programs, to improve the utilization of PMTCT services.