‘If I am on ART, my new-born baby should be put on treatment immediately’

Exploring the acceptability, and appropriateness of Cepheid Xpert HIV-1 Qual assay for early infant diagnosis of HIV in Malawi

Bibliographic Data

ID21263570
AuthorsMaggie Nyirenda-Nyang’wa (0000-0002-9168-174X, Liverpool School of Tropical Medicine, corresponding author), Moses Kumwenda (0000-0003-3091-7330, University of Liverpool, corresponding author), Shona Horter (0000-0002-6565-7789, London School of Hygiene & Tropical Medicine, corresponding author), Mina C Hosseinipour (0000-0003-2174-313X, University of North Carolina at Chapel Hill, corresponding author), Maganizo Chagomerana (0000-0003-4231-4553, University of North Carolina at Chapel Hill, corresponding author), Neil Kennedy (0000-0002-6262-2679, Queen's University Belfast, corresponding author), Derek Fairley (0000-0002-6065-7931, Queen's University Belfast, corresponding author), Kevin Mortimer (0000-0002-8118-8871, University of Liverpool, corresponding author), Victor Mwapasa (0000-0002-2748-8902, Kamuzu Central Hospital, corresponding author), Chisomo Msefula (0000-0003-2304-886X, Kamuzu Central Hospital, corresponding author), Nigel Klein (0000-0003-3925-9258, University College London, corresponding author), Dagmar Alber (University College London, corresponding author), Angela Obasi (0000-0001-6801-8889, Liverpool School of Tropical Medicine, corresponding author)
EditorsJulia Robinson (0000-0003-0719-3995)
Year2023
Volume3
Issue3
Pagese0001135
Publication date2023-03-10
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenuePLOS Global Public Health (JOURNAL)
Journal identifiersISSN: 2767-3375 • E-ISSN: 2767-3375
PublisherPublic Library of Science (PLoS) (PUBLISHER)
DOI10.1371/journal.pgph.0001135
PMID36962982
OpenAlexW4323832118
LanguageEN
References cited17

Early infant diagnosis of HIV (EID-HIV) is key to reducing paediatric HIV mortality. Traditional approaches for diagnosing HIV in exposed infants are usually unable to optimally contribute to EID. Point-of-care testing such as Cepheid Xpert HIV-1 Qual assay-1 (XPertHIV) are available and could improve EID-HIV in resource constrained and high HIV burden contexts. We investigated the acceptability and perceived appropriateness of XpertHIV for EID-HIV in Mulanje Hospital, Malawi. Qualitative cross-sectional study using semi-structured interviews (SSI) among caregivers and health care workers at Mulanje District Hospital. The qualitative study was nested within a larger diagnostic study that evaluated the performance of XpertHIV using whole-blood-sample in a resource limited and high burden setting. A total of 65 SSIs were conducted among caregivers (n = 60) and health care providers (n = 5). Data were coded using deductive and inductive approaches while thematic approach was used to analyse data. Point-of-care XPertHIV was perceived to be acceptable among caregivers and health care providers. Caregivers’ motivations for accepting XPertHIV HIV-testing for their infants included perceived risk of HIV emanating from child’s exposure and validation of caregiver’s own HIV sero-status. Although concerns about pain of testing and blood sample volumes taken from an infant remained amplified, overall, both caregivers and health care providers felt XpertHIV was appropriate because of its quick result turn-around-time which decreased anxiety and stress, the prospect of early treatment initiation and reduction in hospital visits and related costs. Implementation of XpertHIV has a great potential to improve EID-HIV in Malawi because of its quick turn-around-time and associated benefits including overcoming access-related barriers. Scaled implementation of this diagnostic technology require a robust community engagement strategy for managing caregivers and community myths and misconceptions towards the amount of blood sample collected from infants

Anxiety · Family medicine · Health care · Point-of-care testing · Psychiatry · Qualitative research · Thematic analysis · Vital signs · HIV Research and Treatment · HIV/AIDS oral health manifestations · HIV/AIDS Research and Interventions · Medicine · Nursing · Immunology