Factors associated with loss-to-follow-up of HIV-positive mothers and their infants enrolled in HIV care clinic: A qualitative study
Factors associated with loss-to-follow-up of HIV-positive mothers and their infants enrolled in HIV care clinic: A qualitative study
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DOI：
10.1186/s12889-020-8373-x
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发表时间：
2020-03-06
影响因子：
4.5
通讯作者：
Mwapasa, V.
中科院分区：
文献类型：
--
作者：
Mpinganjira, S.;Tchereni, T.;Mwapasa, V.
背景：在马拉维，选择B+方案的HIV阳性孕妇和产后妇女失去随访(LTFU)极大地促进了次优保留，估计在产后12个月时为74%。这威胁到马拉维消除艾滋病毒母婴传播的努力。我们在母婴双方中调查了与LTFU相关的因素。方法：我们进行了一项定性研究，嵌套在“促进婴儿和母亲有效保留(Prime)”研究中，这是一项三臂整群随机试验，评估了在马拉维的Salima和Mangochi地区改善母婴对在HIV护理中保留的策略的有效性。从2016年7月到12月，我们追踪和采访了19名LTFU女性。此外，我们采访了来自LTFU妇女接受护理的卫生机构的30名医护人员。结果：据报道，导致母婴感染的原因如下：缺乏丈夫或家庭成员的支持；远离医疗机构；贫困；社区污名；抗逆转录病毒药物副作用；接受抗逆转录病毒治疗和采用其他替代治疗方案后自认为健康良好。结论：我们的研究在个人、家庭、社区和卫生系统层面发现了多种因素，导致母婴配对在艾滋病护理中的保留率较低。
Background: In Malawi, loss to follow-up (LTFU) of HIV-positive pregnant and postpartum women on Option B+ regimen greatly contributes to sub-optimal retention, estimated to be 74% at 12 months postpartum. This threatens Malawi's efforts to eliminate mother-to-child transmission of HIV. We investigated factors associated with LTFU among Mother-Infant Pairs.Methods: We conducted a qualitative study, nested within the "Promoting Retention Among Infants and Mothers Effectively (PRIME)" study, a 3-arm cluster randomized trial assessing the effectiveness of strategies for improving retention of mother-infant pairs in HIV care in Salima and Mangochi districts, Malawi. From July to December 2016, we traced and interviewed 19 LTFU women. In addition, we interviewed 30 healthcare workers from health facilities where the LTFU women were receiving care. Recorded interviews were transcribed, translated and then analysed using deductive content analysis.Results: The following reasons were reported as contributing to LTFU: lack of support from husbands or family members; long distance to health facilities; poverty; community-level stigma; ART side effects; perceived good health after taking ART and adoption of other alternative HIV treatment options.Conclusion: Our study has found multiple factors at personal, family, community and health system levels, which contribute to poor retention of mother-infant pairs in HIV care.