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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Determinants of failure to access care in mothers referred to HIV treatment programs in Nairobi, Kenya
AIDS Care - Psychological and Socio-Medical Aspects of AIDS/HIV, Volume 22, No. 6, Year 2010
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Description
Background. As prevention of mother-to-child transmission of HIV (PMTCT) programs and HIV treatment programs rapidly expand in parallel, it is important to determine factors that influence the transition of HIV-infected women from maternal to continuing care. Design. This study aimed to determine rates and co-factors of accessing HIV care by HIV-infected women exiting maternal care. A cross-sectional survey of women who had participated in a PMTCT research study and were referred to care programs in Nairobi, Kenya was conducted. Methods. A median of 17 months following referral, women were located by peer counselors and interviewed to determine whether they accessed HIV care and what influenced their care decisions. Fisher's exact test was used to assess the association between client characteristics and access to care. Results. Peer counselors traced 195 (82%) residences, where they located 116 (59%) participants who provided information on care. Since exit, 50% of participants had changed residence, and 74% reported going to the referral HIV program. Reasons for not accessing care included lack of money, confidentiality, and dislike of the facility. Women who did not access care were less likely to have informed their partner of the referral (p=0.001), and were less likely believe that highly active antiretroviral therapy (HAART) is effective (p<0.01). Among those who accessed care, 33% subsequently discontinued care, most because they did not qualify for HAART. Factors cited as barriers to access included stigma, denial, poor services, and lack of money. Factors that were cited as making care attractive included health education, counseling, free services, and compassion. Conclusion. A substantial number of women exiting maternal care do not transit to HIV care programs. Partner involvement, a standardized referral process and more comprehensive HIV education for mothers diagnosed with HIV during pregnancy may facilitate successful transitions between PMTCT and HIV care programs. © 2010 Taylor & Francis.
Authors & Co-Authors
Otieno, Phelgona Apondi O.
Kenya, Nairobi
Kenya Medical Research Institute
Kohler, Pamela K.
United States, Seattle
University of Washington
Bosire, Rose Kerubo
Kenya, Nairobi
Kenya Medical Research Institute
Brown, Elizabeth R.
United States, Seattle
University of Washington
MacHaria, Steven W.
Kenya, Nairobi
Kenya Medical Research Institute
John-Stewart, Grace C.
United States, Seattle
University of Washington
Statistics
Citations: 82
Authors: 6
Affiliations: 2
Identifiers
Doi:
10.1080/09540120903373565
ISSN:
09540121
e-ISSN:
13600451
Research Areas
Health System And Policy
Infectious Diseases
Maternal And Child Health
Sexual And Reproductive Health
Study Design
Cross Sectional Study
Study Approach
Quantitative
Study Locations
Kenya
Participants Gender
Female