The prevention of mother-to-child HIV transmission programme in Lilongwe, Malawi: why do so many women drop out
The prevention of mother-to-child HIV transmission programme in Lilongwe, Malawi: why do so many women drop out
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DOI：
10.1016/s0968-8080(09)33440-0
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发表时间：
2009-05-01
影响因子：
--
通讯作者：
Martinson, Francis
中科院分区：
文献类型：
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作者：
Chinkonde, Jacqueline Rose;Sundby, Johanne;Martinson, Francis
母婴传播艾滋病毒是撒哈拉以南非洲新增艾滋病毒感染的一个沉重负担，后续行动的损失继续破坏预防母婴传播艾滋病毒方案。这项定性研究试图澄清为什么在马拉维利隆圭参加防止母婴传播方案的一些妇女在艾滋病毒检测呈阳性后的头六个月内没有充分参加后续访问。有目的地选择了28名妇女在两个诊所进行深入访谈，其中74名完全参加了该方案，74名中途退出。还与15名以前接受访谈的妇女和13名新征聘的妇女进行了重点小组讨论。还与12名妇女的丈夫进行了讨论。虽然据报告接受检测的妇女比例有所增加，但后续行动的损失已经发生变化，并发生在检测后的每一步。与分娩后六个月内退出防止母婴传播方案有关的主要新主题是避免非自愿披露艾滋病毒和社区的负面反应、不平等的性别关系、难以获得护理和治疗以及缺乏丈夫的支持。必须重新考虑实施防止母婴传播方案和家访的整个方法，以提高保密性，并尽量减少污名化。必须在经济上增强妇女的权能，并支持她们与其伴侣一起获得艾滋病毒治疗和护理，以使其整个家庭受益。02009生殖健康问题。All rights reserved.
Mother-to-child transmission of HIV constitutes a substantial burden of new HIV infections in sub-Saharan Africa, and losses to follow-up continue to undermine prevention of mother-to-child transmission of HIV (PMTCT) programmes. This qualitative study sought to clarify why some women who were enrolled in a PMTCT programme in Lilongwe, Malawi, did not fully participate in follow-up visits in the first six months after testing HIV-positive. Twenty-eight women, 74 who participated fully in the programme and 74 who dropped out, were purposively selected for in-depth interview at two clinics. Focus group discussions with 15 previously interviewed and 13 newly recruited women were also conducted. Discussions with 12 of the women's husbands were also carried out. Although the proportion of women being tested has reportedly increased, losses to follow-up have shifted and are occurring at every step after testing. Major emerging themes associated with dropping out of the PMTCT programme within six months after delivery were to avoid involuntary HIV disclosure and negative community reactions, unequal gender relations, difficulties accessing care and treatment, and lack of support from husbands. The whole approach to the delivery of the PMTCT programme and home visits must be reconsidered, to improve confidentiality and minimise stigmatization. Women need to be empowered economically and supported to access HIV treatment and care with their partners, to benefit their whole family. 02009 Reproductive Health Matters. All rights reserved.