Exploring socio-economic conditions and poor follow-up rates of HIV-exposed infants in Johannesburg, South Africa

Abstract

In 2002, more than 280,000 HIV-exposed babies were born in South Africa. According to international PMTCT guidelines, these children require follow-up to 12 months of age. Worldwide, the high loss to follow-up rates experienced by PMTCT programs precludes them from identifying and managing HIV-infected children. Socio-economic factors have been identified as potential contributors to poor follow-up. A small descriptive study to examine socio-economic circumstances of women attending the Coronation Women and Children's Hospital PMTCT program was undertaken. Cross-sectional data from 176 women, interviewed at their infants' 12-month visit, was collected using a semi-structured questionnaire. Socio-economic factors such as poverty, geographical relocation and a lack of paternal support may affect the capacity of families to comply with the PMTCT follow-up program. Fifty-seven percent of mothers were unemployed, 25% of fathers did not support their children and only 58% of children remained resident in Johannesburg at the 12-month visit. The lack of follow-up of HIV-infected children denies them access to adequate medical care. Understanding the socio-economic factors that affect the ability of communities to comply with PMTCT programs will assist resource-poor countries in devising strategies to achieve follow-up of HIV-exposed infants.

Implementation and outcomes of an active defaulter tracing system for HIV, prevention of mother to child transmission of HIV (PMTCT), and TB patients in Kibera, Nairobi, Kenya

“…7 Patient retention has also been difficult for prevention of mother to child transmission of HIV (PMTCT) programmes. [8][9][10][11] There is even less literature on the true outcomes of TB defaulters. 12 Documented completion of TB treatment in Africa ranges from 22% to 94%.…”

How children access antiretroviral treatment at Kgapane District Hospital, Limpopo, South Africa

“…35 Poverty has been identified as a major barrier to accessing ART in other areas in South Africa. 8,16,29 Many caregivers depend on government grants and have to balance the needs of the whole family with those of the HIV-infected child. A lack of income makes it difficult to afford the cost of transport to access ART, especially if (as in this study) this is not available at the local clinic.…”

“…Factors that impede follow-up include poverty, poor paternal support, a different caregiver postpartum, and misconceptions about HIV risk and testing. [7][8][9] In Southern Africa only 9% of HIV-exposed infants are currently started on co-trimoxazole prophylaxis, which also demonstrates the poor follow-up of babies born to HIV-positive mothers. S Afr Fam Pract 2012 which includes the assessment of HIV risk in all children.…”

Assessing the efficiency of mother-to-child HIV prevention in low- and middle-income countries using data envelopment analysis

“…In particular, there is evidence suggesting that in rural areas health care facilities are less accessible, and therefore, that pregnant women living in these areas are at higher risk of not complying with PMTCT programmes (e.g. Jones et al [36]). In order to account for this factor we have included in our DEA model the variable "People living in urban areas (millions)".…”