Facilitators and barriers to uptake and adherence to lifelong antiretroviral therapy among HIV infected pregnant women in Uganda: a qualitative study

Buregyeya, Esther; Naigino, Rose; Mukose, Aggrey; Makumbi, Fred; Esiru, Godfrey; Arinaitwe, Jim; Musinguzi, Joshua; Wanyenze, Rhoda K.

doi:10.1186/s12884-017-1276-x

Cited by 111 publications

(149 citation statements)

References 7 publications

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“…Frequently mentioned individual and family related factors identified in this study were fear of divorce, lack of family support, lack of partner support and lack of time. Like our research, other studies found that non-disclosure of HIV status, fear of divorce, fear of HIV stigma, and lack of partners support were some of the most common barriers to PMTCT service utilization [16,[19][20][21][22][23][24][25][26]. Another study in Sudan [27], and in Malawi [28] also revealed that women are not likely to disclose their HIV status due to stigma.…”

Section: Discussionsupporting

confidence: 72%

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Factors influencing prevention of mother to child HIV transmission service utilization among HIV positive women in Amhara National Regional State, Ethiopia: A thematic content analysis

et al. 2019

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Introduction:Mother to child transmission (MTCT) of HIV is the major source of HIV infection among children under the age of 15 years. Prevention of mother to child transmission (PMTCT) service has been an important strategy in preventing HIV infections in infants.However, improving PMTCT service uptake and continuum of care still remains a significant impediment in the Amhara Region of Ethiopia. The aim of this study was to explore factors that may hinder and promote PMTCT service utilization among HIV positive women.Methods: Phenomenological study design was used. Three focus group discussions (FGDs) with HIV positive women and five in-depth interviews with health care workers were conducted from the selected health institutions. Data analysis was conducted using thematic content analysis. ATLAS/ti version 7.5.16 software was used to assist in coding and analysis of the qualitative data. Results:The findings of the study revealed that there are a range of factors that influence HIV positive women on PMTCT service utilization. Stigma, discrimination, limited knowledge on HIV, lack of partner and family support, and not getting friendly service from health facility were factors that might hinder PMTCT service utilization. The experiences of HIV positive mothers revealed that continuous partner support, previous history of getting HIV free child, good health worker support, and advice by mother support group were factors that promote utilization of PMTCT service. Conclusions:Strengthening community awareness on HIV, engaging male involvement in PMTCT care and getting friendly service were the key determinants for the better PMTCT service utilization.

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Section: Discussionsupporting

confidence: 72%

“…In our study, the main reasons for women not taking PMTCT service mentioned by health workers were disclosure of the result, fear of partner, drug side effect, drug supply interruption, trained health care professional not giving attention to the work and work load. Other studies have also had similar findings [18,19,28].…”

Section: Discussionsupporting

confidence: 70%

Factors influencing prevention of mother to child HIV transmission service utilization among HIV positive women in Amhara National Regional State, Ethiopia: A thematic content analysis

et al. 2019

Preprint

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“…Having a treatment supporter may be an indication of HIV disclosure, which has been shown to be strongly associated with an individual's ability for sustained engagement in HIV care. 12,[22][23][24][25] Disclosing one's HIV status enables one to garner social support and removes the element of secrecy; women who have disclosed their HIV status are more likely to show up to their appointments without fear. [25][26][27][28] The present study relied on routinely collected clinical data, which did not include details about the characteristic of the treatment supporter, including the individual's relationship with the patient and the type of support they provide.…”

Section: Discussionmentioning

confidence: 99%

Unpacking Loss to Follow-Up Among HIV-Infected Women Initiated on Option B+ In Northern Tanzania: A Retrospective Chart Review

Mazuguni

Mwaikugile²,

Cichowitz

et al. 2019

EAHRJ

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Background: In 2014, Tanzania adopted the Option B+ policy for the prevention of mother-to-child transmission of HIV (PMTCT), which stipulates lifelong antiretroviral therapy (ART) for HIV-infected pregnant, postpartum and breastfeeding women, irrespective of CD4 count or WHO clinical staging. Loss to follow-up (LTFU) during pregnancy and the postpartum period may undermine the effectiveness of Option B+. Factors associated with no follow-up (NFU) care, may differ from those associated with LTFU at later time points. This study aimed to identify factors associated with NFU and LTFU among women who initiate ART under Option B+ in Moshi, Tanzania. Methods: We conducted a retrospective chart review of patients initiating ART on Option B+ between February 2014 and December 2015 in Moshi Municipality, Tanzania. Multivariable log-binomial regression was used to analyse factors associated with NFU. Kaplan-Meier survival functions were used to estimate time to LTFU. Multivariable Cox proportion hazards regression models were used to evaluate variables associated with time to LTFU. Results: Among 468 women initiating ART under the option B+ programme, 109 (23.3%) had NFU after the initial appointment. Factors associated with increased risk of NFU were: age < 25 years (adjusted hazard ratio [aRR] 1.7; 95% CI, 1.2 to 2.3), initiating ART at a hospital compared to a lower level health facilities (aRR 2.9; 95% CI, 2.1 to 3.9), and having no treatment supporter (aRR 1.5; 95% CI, 1.1 to 2.1). LTFU was higher in women aged < 25 years (aHR 1.4; 95% CI, 1.1 to 1.9), and in women with no treatment supporter (aHR 1.8; 95% CI, 1.4 to 2.3). In women who returned to the clinic after ART initiation, no factor was significantly associated with LTFU. Conclusion: The factors associated with NFU (being young, not having a treatment supporter, and being diagnosed at hospitals) reflect a vulnerable and potentially highly mobile population. Additional interventions are needed to support and retain this group at ART initiation on Option B+.

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“…The classification of a country as an LMIC was determined based on the 2018 World Bank classification criteria [7]. The Covidence tool was used to remove duplicate studies and to conduct study screening [8]. Two reviewers (ARM and CK) reviewed all titles and abstracts independently, followed by independent full text review of remaining articles.…”

Section: Methodsmentioning

confidence: 99%

Evaluating and optimizing the consolidated framework for implementation research (CFIR) for use in low- and middle-income countries: a systematic review

et al. 2020

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Background: The Consolidated Framework for Implementation Research (CFIR) is a determinants framework that may require adaptation or contextualization to fit the needs of implementation scientists in low-and middleincome countries (LMICs). The purpose of this review is to characterize how the CFIR has been applied in LMIC contexts, to evaluate the utility of specific constructs to global implementation science research, and to identify opportunities to refine the CFIR to optimize utility in LMIC settings.Methods: A systematic literature review was performed to evaluate the use of the CFIR in LMICs. Citation searches were conducted in Medline, CINAHL, PsycINFO, CINAHL, SCOPUS, and Web of Science. Data abstraction included study location, study design, phase of implementation, manner of implementation (ex., data analysis), domains and constructs used, and justifications for use, among other variables. A standardized questionnaire was sent to the corresponding authors of included studies to determine which CFIR domains and constructs authors found to be compatible with use in LMICs and to solicit feedback regarding ways in which CFIR performance could be improved for use in LMICs.Results: Our database search yielded 504 articles, of which 34 met final inclusion criteria. The studies took place across 21 countries and focused on 18 different health topics. The studies primarily used qualitative study designs (68%). Over half (59%) of the studies applied the CFIR at study endline, primarily to guide data analysis or to contextualize study findings. Nineteen (59%) of the contacted authors participated in the survey. Authors unanimously identified culture and engaging as compatible with use in global implementation research. Only two constructs, patient needs and resources and individual stages of change were commonly identified as incompatible with use. Author feedback centered on team level influences on implementation, as well as systems characteristics, such as health system architecture. We propose a "Characteristics of Systems" domain and eleven novel constructs be added to the CFIR to increase its compatibility for use in LMICs. Conclusions: These additions provide global implementation science practitioners opportunities to account for systemslevel determinants operating independently of the implementing organization. Newly proposed constructs require further reliability and validity assessments. Trial registration: PROSPERO, CRD42018095762

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Facilitators and barriers to uptake and adherence to lifelong antiretroviral therapy among HIV infected pregnant women in Uganda: a qualitative study

Cited by 111 publications

References 7 publications

Factors influencing prevention of mother to child HIV transmission service utilization among HIV positive women in Amhara National Regional State, Ethiopia: A thematic content analysis

Factors influencing prevention of mother to child HIV transmission service utilization among HIV positive women in Amhara National Regional State, Ethiopia: A thematic content analysis

Unpacking Loss to Follow-Up Among HIV-Infected Women Initiated on Option B+ In Northern Tanzania: A Retrospective Chart Review

Evaluating and optimizing the consolidated framework for implementation research (CFIR) for use in low- and middle-income countries: a systematic review

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