The Achilles' heel of prevention to mother-to-child transmission of HIV
Protocol implementation, uptake, and sustainability
Bibliographic Data
The Joint United Nations Programme on HIV and AIDS proposed to reduce the vertical transmission of HIV from ∼72,200 to ∼8300 newly infected children by 2015 in South Africa (SA). However, cultural, infrastructural, and socio-economic barriers hinder the implementation of the prevention of mother-to-child transmission (PMTCT) protocol, and research on potential solutions to address these barriers in rural areas is particularly limited. This study sought to identify challenges and solutions to the implementation, uptake, and sustainability of the PMTCT protocol in rural SA. Forty-eight qualitative interviews, 12 focus groups discussions (n = 75), and one two-day workshop (n = 32 participants) were conducted with district directors, clinic leaders, staff, and patients from 12 rural clinics. The delivery and uptake of the PMTCT protocol was evaluated using the Consolidated Framework for Implementation Research (CFIR); 15 themes associated with challenges and solutions emerged. Intervention characteristics themes included PMTCT training and HIV serostatus disclosure. Outer-setting themes included facility space, health record management, and staff shortage; inner-setting themes included supply use and availability, staff-patient relationship, and transportation and scheduling. Themes related to characteristics of individuals included staff relationships, initial antenatal care visit, adherence, and culture and stigma. Implementation process themes included patient education, test results delivery, and male involvement. Significant gaps in care were identified in rural areas. Information obtained from participants using the CFIR framework provided valuable insights into solutions to barriers to PMTCT implementation. Continuously assessing and correcting PMTCT protocol implementation, uptake and sustainability appear merited to maximize HIV prevention
Alternative medicine · Business · Family medicine · Focus group · Implementation research · Psychiatry · Psychological intervention · Qualitative research · Serostatus · Sociology · Sustainability · Viral load · Adolescent Sexual and Reproductive Health · Global Maternal and Child Health · HIV/AIDS Research and Interventions · Medicine · Nursing
Mixed-methods cross-sectional study of the prevention of vertical HIV transmission program users unaware of male partner’s HIV status, in six South African districts with a high antenatal HIV burden
Improving Male Partner Involvement in HIV-Positive Women's Care Through Behavioral Change Interventions in Malawi (WeMen Study)
Psychological and Physical Intimate Partner Violence and Maternal Depressive Symptoms during the Pre- and Post-Partum Period among Women Living with HIV in Rural South Africa
Influences on Exclusive Breastfeeding Among Rural HIV-Infected South African Women
Factor structure of a male involvement index to increase the effectiveness of prevention of mother-to-child HIV transmission (PMTCT) programs
Sexual risk behavior among HIV-infected women in South Africa at 12-months postpartum
Stigma interdependence among pregnant HIV-infected couples in a cluster randomized controlled trial from rural South Africa
Maternal and infant antiretroviral therapy adherence among women living with HIV in rural South Africa
Barriers and facilitating factors to the uptake of antiretroviral drugs for prevention of mother‐to‐child transmission of HIV in sub‐Saharan Africa
Prevention of Mother-to-Child HIV Transmission in Resource-Poor Countries
Health in South Africa
Fostering implementation of health services research findings into practice
The Discovery of Grounded Theory
Clients’ perspectives on HIV/Aids care and treatment and reproductive health services in South Africa
Barriers to accessing PMTCT services in a rural area of South Africa
Pre- and post-intervention assessment of a PMTCT-programme-strengthening initiative in a rural area of the Eastern Cape, South Africa
Comparing two service delivery models for the prevention of mother-to-child transmission (PMTCT) of HIV during transition from single-dose nevirapine to multi-drug antiretroviral regimens
Factors Determining Prenatal HIV Testing for Prevention of Mother to Child Transmission of HIV in Mpumalanga, South Africa
First population-level effectiveness evaluation of a national programme to prevent HIV transmission from mother to child, South Africa
Global Progress in PMTCT and Paediatric HIV Care and Treatment in Low-and Middle-Income Countries in 2004-2005
| Unique citing works | 8 |
|---|---|
| Citations per year | 1 |
| Citation span | 2018 - 2023 (6) |
| Citation velocity | historical |
| Highly cited | No |
| Citation types | Neutral: 8 |