Experiences of transfer of care among postpartum women living with HIV attending primary healthcare services in South Africa

Bibliographic Data

ID15540925
AuthorsJasantha Odayar (0000-0002-6030-7878, University of Cape Town, corresponding author), Landon Myers (0000-0002-8106-7658, University of Cape Town), Siti Kabanda (University of Cape Town), Lucia Knight (0000-0001-9938-6887, University of Cape Town)
Year2024
Volume19
Issue1
Pages2356624-2356624
Publication date2024-05-31
Open AccessYes
TypeARTICLE
VenueGlobal Public Health (JOURNAL)
Journal identifiersISSN: 1744-1692 • E-ISSN: 1744-1706
PublisherTaylor & Francis (PUBLISHER • GB)
DOI10.1080/17441692.2024.2356624
PMID38820565
OpenAlexW4399202106
LanguageEN
Citations received1
References cited33

Transfers between health facilities for postpartum women living with HIV are associated with disengagement from care. In South Africa, women must transfer from integrated antenatal/HIV care to general HIV services post-delivery. Thereafter, women transfer frequently e.g. due to geographic mobility. To explore barriers to transfer, we conducted in-depth interviews >2 years post-delivery in 28 participants in a trial comparing postpartum HIV care at primary health care (PHC) antiretroviral therapy (ART) facilities versus a differentiated service delivery model, the adherence clubs, which are the predominant model implemented in South Africa. Data were thematically analysed using inductive and deductive approaches. Women lacked information including where they could transfer to and transfer processes. Continuity mechanisms were affected when women transferred silently i.e. without informing facilities or obtaining referral letters. Silent transfers often occurred due to poor relationships with healthcare workers and were managed inconsistently. Fear of disclosure to family and community stigma led to transfers from local PHC ART facilities to facilities further away affecting accessibility. Mobility and the postpartum period presented unique challenges requiring specific attention. Information regarding long-term care options and transfer processes, ongoing counselling regarding disclosure and social support, and increased health system flexibility are required

Developing country · Economic growth · Environmental health · Family medicine · Health care · Human immunodeficiency virus (HIV · Political science · Population · Primary care · Primary health care · Global Maternal and Child Health · HIV/AIDS Impact and Responses · HIV/AIDS Research and Interventions · Medicine · Nursing

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