Facilitators and barriers to treatment adherence within PMTCT programs in Malawi

被引:46
作者
Elwell, Kristan [1 ]
机构
[1] Michigan State Univ, Dept Anthropol, E Lansing, MI 48824 USA
来源
AIDS CARE-PSYCHOLOGICAL AND SOCIO-MEDICAL ASPECTS OF AIDS/HIV | 2016年 / 28卷 / 08期
关键词
HIV; AIDS; mother-to-child transmission; adherence; Option B; Malawi; HIV TRANSMISSION PROGRAM; TO-CHILD TRANSMISSION; RURAL MALAWI; FOLLOW-UP; PREVENTION; WOMEN;
D O I
10.1080/09540121.2016.1153586
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
摘要
In Malawi, an innovative prevention of mother-to-child transmission (PMTCT) of HIV program, Option B+, has greatly expanded access to antiretroviral treatment at no cost to women and their exposed infants. However, many women continue to experience social, cultural, and structural barriers impeding their ability to consistently access medical treatment. Understanding these women's perspectives may make programs more responsive to patients' needs. This qualitative study sought to explore factors influencing women's adherence within PMTCT programs in southern Malawi. Participants were current PMTCT patients (the first cohort following national implementation of Option B+), healthcare providers, community leaders, and patients who had dropped out of the program (defaulters). Qualitative interviews and focus groups were conducted to investigate barriers and facilitators to continued participation within PMTCT programs. Data were analyzed using content analysis. Barriers identified included fears of HIV disclosure to husbands, community-based HIV/AIDS stigma, and poor interactions with some health workers. Facilitators included the improved survival of PMTCT patients in recent years and the desire to remain healthy to care for one's children. This research highlights important sociocultural factors affecting adherence within HIV/AIDS treatment programs in Malawi. Recommendations to improve access to medical care for PMTCT patients include integrated services to increase attention to confidentiality and minimize stigma, shared HIV testing and counseling for couples to minimize conflict in gender-unequal relationships, and peer-led support groups to provide social support from other women with the shared experience of an HIV-positive serostatus.
引用
收藏
页码:971 / 975
页数:5
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