Menu ENN Search

Pregnant women’s uptake of antiretroviral prophylaxis

Summary of published research 1

Arecent study in Abidjan, Cote d'Ivoire set out to determine why pregnant women, who receive HIV-1 positive test results and are offered short courses of antiretroviral prophylaxis to prevent transmission of HIV from mother to child (PMTCT), do not participate in necessary follow up visits before starting prophylaxis. The study was set up based on findings from PMTCT work in Abidjan which found that during the programme's first 15 months of operations (February 1998 to end of May 1999), 72% of 9657 pregnant women who were offered HIV testing accepted. Of the 884 women who tested positive for HIV-1, 395 received their test results. Only 118 (35%) of the 333 women who tested as positive for HIV, who received their test results and who were invited to return for follow up visits during this period, eventually started taking zidovudine. Of the 215 women who did not start taking zidovudine, 181 had refused to return or discontinued follow up visits. Another 34 were lost to follow up or removed from the programme because they were ineligible.

In this study, a purposive sample of 27 women was selected. These women had received HIV-1 positive tests and were invited to return for monthly follow up visits before starting prophylaxis with zidovudine at 36 weeks gestation, but had either refused or discontinued the visits. None of the women started prophylaxis.

Most of the women explained their non-participation in follow up visits by referring to negative experiences that they had had while interactingwith programme staff or to their views about the programme. Additional reasons concerned their disbelief of HIV positive test results and personal factors.

The study concluded that training and supervision of programme staff may increase the likelihood of positive interactions between staff and clients, thereby facilitating women's participation in preventing transmission of HIV from mother to child. Outreach and mobilisation in communities that are served by prevention programmes may complement these measures at programme level, by contributing to increased social support for women's efforts to prevent transmission of HIV from mother to child. Involving women's partners in the prevention of mother to child transmission of HIV is widely recognised to be desirable, but this rarely occurs.

Show footnotes

1Painter T et al (2004). Women's reasons for not participating in follow up visits before starting short course antiretroviral prophylaxis for prevention of mother to child transmission of HIV: qualitative interview study. BMJ volume 329, 4th September, 2004, pp 343-345

More like this

FEX: Infant feeding strategies and PMTCT - Mashi trial from Botswana

Summary of published research1 Arecently published paper compares the efficacy and safety of two infant feeding strategies for the prevention of postnatal mother-to-child HIV...

FEX: Cotrimoxazole as a Prophylaxis for HIV Positive Malnourished Children

Summary of review1 By Susan Thurstans, AAH Susan Thurstans is the HIV adviser with Action Against Hunger (AAH), based in Malawi Thanks to Amador Gomez, Technical Advisor,...

FEX: On the ground perceptions of WFP food assistance and PMTCT in Zambia

Summary of a qualitative study1 By Pamela Fergusson The risk of mother to child transmission is approx 40% in Zambia Pamela Fergusson is a dietitian/nutritionist whose...

FEX: Patterns of body composition among HIV-infected, pregnant Malawians and famine effects

Summary of research1 Mothers attending antenatal clinic Few studies have examined maternal anthropometry and its predictors during pregnancy in sub-Saharan Africa in the...

FEX: Counselling on infant feeding choice: Some practical realities from South Africa

By Tanya Doherty (pictured), Mickey Chopra and Mike Colvin Tanya is currently a senior scientist at the Health Systems Trust and Medical Research Council in Capetown, South...

FEX: Meeting Point : Local CBO in Uganda

By Fiona Mitchell, GOAL, and Mary Corbett, ENN A Meeting Point staff member with a young child Fiona Mitchell is the Development Programme Coordinator, GOAL Uganda The...

FEX: Integrated PMTCT Services in a Rural Setting in Malawi

By Gertrude Kara, WFP and Mary Corbett, ENN Gertrude Kara is the Programme Officer responsible for HIV/AIDS programmes in WFP Malawi. She has wide experience in the area of...

FEX: Research snapshots

Factors influencing pastoral and agropastoral household vulnerability to food insecurity in Kenya Kenya has a population of more than 38 million, 10% of whom are classified as...

Resource: Infant feeding strategies & PMTCT - Mashi Trial from Botswana (summary)

Summary of published paper in Field Exchange 29, December 2006, p.6 Published paper: Thior et al (2006). Breastfeeding Plus Infant Zidovudine Prophylaxis for 6 Months vs...

FEX: Animal husbandry and agriculture efforts toward programme sustainability

Lamech (WHM Agriculture Extension Officer) and beneficiary's father with a Matiti Project goat By Stephanie Jilcott, Karen Masso, Lamech Tugume, Scott Myhre and Jennifer Myhre...

FEX: HIV and Infant Feeding: A Programme Challenge

By Joanne Csete, Regional Programme Planning Officer UNICEF Regional Office for Eastern and Southern Africa Among the greatest programme challenges of recent years for United...

FEX: Infant Feeding Alternatives for HIV Positive Mothers in Kenya

By Tom Oguta, Abiud Omwega and Jaswant Sehmi Tom Oguta is currently a PhD student of Nutrition at the University of Nairobi. He has worked as a Research Officer at KIRDI...

FEX: Nutritional Support Through HBC in Malawi

By Mieke Moens, MSF Mieke Moens is a paediatric nurse, and is responsible for the PMTCT and nutrition programme for MSF Thyolo, Malawi The author would like to acknowledge...

FEX: Using IMRs to inform policy decisions on infant feeding and HIV

Summary of published research1 Feeding bottles in a camp in Pakistan A recently published paper presents an analysis of the impact of WHO infant feeding recommendations in...

FEX: Better Practice in Targeted Food Assistance

Summary of published report1 C-Safe, a consortium of non-governmental organisations (NGOs) for the southern Africa food security emergency, has recently completed its second...

FEX: HIV and Child Mortality

Summary of published research1 HIV contributes substantially to child mortality, but factors underlying these deaths are inadequately described. With individual data from seven...

FEX: Examining the integration of Food by Prescription into HIV care and treatment in Zambia

By Kate A. Greenaway, Elizabeth C. Jere, Milika E. Zimba, Cassim Masi and Beatrice Mazinza Kawana Kate Greenaway is Senior Technical Advisor, HIV Unit, Catholic Relief...

FEX: HIV-Positive Mothers in Uganda Return to Breastfeeding

Summary of published research1 An increasing number of mothers with HIV in Uganda are breastfeeding their babies after UNICEF stopped donating free infant formula, according to...

en-net: Should you recommend wet nursing in HIV prevalent areas where replacement feeding is not safe but there is no HIV testing available?

Current WHO guidance on infant feeding and HIV (2010) emphasises a public health approach to infant feeding choice in the HIV context. It emphasises that feeding...

FEX: Home Based Treatment of Severe Malnutrition in Kabul

By Muriele Therry Muriele Therry studied ethnology at Masters level. After two missions with ACF, one year in Sakhalin as food security officer and 6 months in Afghanistan as...

Close

Reference this page

Pregnant women’s uptake of antiretroviral prophylaxis. Field Exchange 25, May 2005. p9. www.ennonline.net/fex/25/pregnant