Factors Associated With History of HIV Testing Among Pregnant Women and Their Partners in Cameroon: Baseline Data From a Behavioral Intervention Trial (ANRS 12127 Prenahtest)

Tchendjou, Patrice; Koki, Paul Olivier; Eboko, Fred; Malateste, Karen; Essounga, Angeline Ngo; Amassana, Denise; Mossus, Tatiana; Tejiokem, Mathurin Cyrille; Boisier, P.; Orne-Gliemann, Joanna

doi:10.1097/qai.0b013e31821ec6e2

Cited by 10 publications

(10 citation statements)

References 10 publications

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“…Self-motivation and self-efficacy came out as strong facilitators of PMTCT utilization across the care continuum. Studies have documented the contribution of self-motivation and efficacy on the uptake of PMTCT services such as care seeking and appropriate infant feeding practices [ 23 – 25 ]. Unless women believe that their ANC attendance, HIV testing, enrolment into PMTCT and health facility delivery can result in their improved health and HIV negative baby, they may not have incentive to enrol and remain in PMTCT programs.…”

Section: Discussionmentioning

confidence: 99%

?You Know You Are Sick, Why Do You Carry A Pregnancy Again?? Applying the Socio-Ecological Model to Understand Barriers to PMTCT Service Utilization in Western Kenya

et al. 2015

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Objective Throughout most of sub-Saharan Africa (SSA), prevention of mother-to-child transmission (PMTCT) services are readily available. However, PMTCT programs in SSA have had suboptimal performance compared to other regions of the world. The main objective of this study is to explore the socio-ecological and individual factors influencing the utilization of PMTCT services among HIV-positive pregnant women in western Kenya using a social ecological model as our analytical lens. Methods Data were collected using in-depth interviews with 33 HIV-infected women attending government health facilities in rural western Kenya. Women with HIV-infected infants aged between 6 weeks to 6 months with a definitive diagnosis of HIV in the infant, as well as those with an HIV-negative test result in the infant were interviewed between November 2012 and June 2013. Coding and analysis of the transcripts followed grounded theory tenets. Coding reports were discussed in a series of meetings held among the authors. We then employed constant comparative analysis to discover dominant individual, family, society and structural determinants of PMTCT use. Results Barriers to women’s utilization of PMTCT services fell within the broad constructs of the socio-ecological model of individual, family, society and structural determinants. Several themes cut across the different steps of PMTCT cascade and relate to different constructs of the socio-ecological model. These themes include: self-motivation, confidence and resilience, family support, absence or reduced stigma, right provider attitude and quality of health services provided. We also found out that these factors ensured enhanced maternal health and HIV negative children. Conclusion The findings of this study suggest that a woman’s social environment is an important determinant of MTCT. PMTCT Interventions must comprehensively address multiple factors across the different ecological levels. More research is however required for the development of multi-component interventions that combine strategies at different ecological levels.

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Section: Discussionmentioning

confidence: 99%

?You Know You Are Sick, Why Do You Carry A Pregnancy Again?? Applying the Socio-Ecological Model to Understand Barriers to PMTCT Service Utilization in Western Kenya

et al. 2015

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“…Family relationships: Household inequities in access to resources can mean women rely on others to decide whether or not they initiate PMTCT [15,16]. Male partners play a significant role; some women refuse HCT or do not collect their results, fearing partner disapproval [2,17]. Threats of intimate partner violence (IPV) also reduce enrolment in PMTCT [18] and studies have shown that women living with HIV can experience higher levels of IPV than others [19].…”

Section: Barriers To Pmtct Uptake and Retentionmentioning

confidence: 99%

Community‐based approaches for prevention of mother to child transmission in resource‐poor settings: a social ecological review

Busza

Walker

Hairston

et al. 2012

Journal of the International AIDS Society

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IntroductionNumerous barriers to optimal uptake of prevention of mother to child transmission (PMTCT) services occur at community level (i.e., outside the healthcare setting). To achieve elimination of paediatric HIV, therefore, interventions must also work within communities to address these barriers and increase service use and need to be informed by evidence. This paper reviews community-based approaches that have been used in resource-limited settings to increase rates of PMTCT enrolment, retention in care and successful treatment outcomes. It aims to identify which interventions work, why they may do so and what knowledge gaps remain.MethodsFirst, we identified barriers to PMTCT that originate outside the health system. These were used to construct a social ecological framework categorizing barriers to PMTCT into the following levels of influence: individual, peer and family, community and sociocultural. We then used this conceptual framework to guide a review of the literature on community-based approaches, defined as interventions delivered outside of formal health settings, with the goal of increasing uptake, retention, adherence and positive psychosocial outcomes in PMTCT programmes in resource-poor countries.ResultsOur review found evidence of effectiveness of strategies targeting individuals and peer/family levels (e.g., providing household HIV testing and training peer counsellors to support exclusive breastfeeding) and at community level (e.g., participatory women’s groups and home-based care to support adherence and retention). Evidence is more limited for complex interventions combining multiple strategies across different ecological levels. There is often little information describing implementation; and approaches such as “community mobilization” remain poorly defined.ConclusionsEvidence from existing community approaches can be adapted for use in planning PMTCT. However, for successful replication of evidence-based interventions to occur, comprehensive process evaluations are needed to elucidate the pathways through which specific interventions achieve desired PMTCT outcomes. A social ecological framework can help analyze the complex interplay of facilitators and barriers to PMTCT service uptake in each context, thus helping to inform selection of locally relevant community-based interventions.

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“…Peer and family influences have been shown to be particularly important determinants of PMTCT involvement; with lack of partner support reducing the likelihood of a woman engaging with services [19], [20]. Non-disclosure makes it more difficult for women to adhere to PMTCT guidance; as opposed to situations where partners are aware that Nevirapine is being provided to an infant, where adherence is higher [21].…”

Section: Introductionmentioning

confidence: 99%

Mother to Mother (M2M) Peer Support for Women in Prevention of Mother to Child Transmission (PMTCT) Programmes: A Qualitative Study

Shroufi¹,

Mafara²,

Saint-Sauveur³

et al. 2013

PLoS ONE

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IntroductionMother-to-Mother (M2M) or “Mentor Mother” programmes utilise HIV positive mothers to provide support and advice to HIV positive pregnant women and mothers of HIV exposed babies. Médecins Sans Frontières (MSF) supported a Mentor Mother programme in Bulawayo, Zimbabwe from 2009 to 2012; with programme beneficiaries observed to have far higher retention at 6–8 weeks (99% vs 50%, p<0.0005) and to have higher adherence to Prevention of Mother to Child Transmission (PMTCT) guidelines, compared to those not opting in. In this study we explore how the M2M progamme may have contributed to these findings.MethodsIn this qualitative study we used thematic analysis of in-depth interviews (n = 79). This study was conducted in 2 urban districts of Bulawayo, Zimbabwe’s second largest city.ResultsInterviews were completed by 14 mentor mothers, 10 mentor mother family members, 30 beneficiaries (women enrolled both in PMTCT and M2M), 10 beneficiary family members, 5 women enrolled in PMTCT but who had declined to take part in the M2M programme and 10 health care staff members. All beneficiaries and health care staff reported that the programme had improved retention and provided rich information on how this was achieved. Additionally respondents described how the programme had helped bring about beneficial behaviour change.ConclusionsM2M programmes offer great potential to empower communities affected by HIV to catalyse positive behaviour change. Our results illustrate how M2M involvement may increase retention in PMTCT programmes. Non-disclosure to one’s partner, as well as some cultural practices prevalent in Zimbabwe appear to be major barriers to participation in M2M programmes.

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Factors Associated With History of HIV Testing Among Pregnant Women and Their Partners in Cameroon: Baseline Data From a Behavioral Intervention Trial (ANRS 12127 Prenahtest)

Cited by 10 publications

References 10 publications

?You Know You Are Sick, Why Do You Carry A Pregnancy Again?? Applying the Socio-Ecological Model to Understand Barriers to PMTCT Service Utilization in Western Kenya

?You Know You Are Sick, Why Do You Carry A Pregnancy Again?? Applying the Socio-Ecological Model to Understand Barriers to PMTCT Service Utilization in Western Kenya

Community‐based approaches for prevention of mother to child transmission in resource‐poor settings: a social ecological review

Mother to Mother (M2M) Peer Support for Women in Prevention of Mother to Child Transmission (PMTCT) Programmes: A Qualitative Study

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