Women's expectations of treatment and care after an antenatal HIV diagnosis in Lilongwe, Malawi

Women in sub-Saharan Africa are increasingly learning their HIV status in prevention of mother-to-child transmission of HIV (PMTCT) programmes in the context of antenatal care. This paper examines women's decisions about HIV testing and their experience of PMTCT and HIV-related care in one clinic in Lilongwe, Malawi. It is based on qualitative, ethnographic research conducted in 2004 and 2005, including interviews and focus group discussions with 55 HIV-positive women participating in a PMTCT programme, and 21 interviews with key informants from the programme and the health system. Women's expectations from testing were consistent with the benefits for their own health and their infants' health, as communicated by nurses. However, the PMTCT programme only poorly met their expectations. Reasons for this disjuncture included the construction of women as still healthy even when they needed treatment, a focus only on infant health, health system weaknesses, lack of integrated care and timely referral, and defining HIV exclusively as a medical issue, while ignoring the social determinants of health. Women's own health was particularly marginalised within the PMTCT programme, yet good models exist for comprehensive care for women, infants and their families that should be implemented as testing is scaled up

Developing country · Economic growth · Environmental health · Family medicine · Focus group · Health care · Population · Public health · Qualitative research · Referral · Sociology · Adolescent Sexual and Reproductive Health · HIV/AIDS Impact and Responses · HIV/AIDS Research and Interventions · Medicine · Nursing

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• A systematic review of qualitative findings on factors enabling and deterring uptake of HIV testing in Sub-Saharan Africa

  Open Access•Maurice Musheke, Harriet Ntalasha et al.•BMC Public Health•2013

  Incluir item

• A comprehensive review of the barriers and promoters health workers experience in delivering prevention of vertical transmission of HIV services in sub-Saharan Africa

  Roseanne C Schuster, Devon E McMahon et al.•AIDS Care•2016

  Incluir item

• Maternal Mortality-a Neglected Tragedy

  Open Access•Allan Rosenfield, Deborah Maine•The Lancet•1985

  Incluir item

• A public health dilemma

  Susan Kippax•AIDS Care•2006

  Incluir item

• Expanding Access to Antiretroviral Therapy in Sub-Saharan Africa

  David Mccoy, Mickey Chopra et al.•American Journal of Public Health•2005

  Incluir item

• Tackling Malawi's Human Resources Crisis

  Debbie Palmer•Reproductive Health Matters•2006

  Incluir item

• Sexual and Reproductive Health Services and HIV Testing

  Emma Bell, Promise Mthembu et al.•Reproductive Health Matters•2007

  Incluir item

• Voluntary counseling and testing for couples

  Open Access•Thomas M Painter•Social Science & Medicine•2001

  Incluir item

• Defining Women's Health

  Open Access•M C Inhorn•Medical Anthropology Quarterly•2006

  Incluir item