scholarly journals Community involvement in the prevention of mother-to-child transmission of HIV: Insights and recommendations

2001 ◽  

Mother-to-child transmission is the primary route of HIV infection in children under 15 years of age. Since the beginning of the HIV epidemic, an estimated 5.1 million children worldwide have been infected with HIV. Clinical trials in several countries have shown that mother-to-child transmission of HIV can be greatly reduced through administering antiretroviral therapy to pregnant women. These trials culminated in a recommendation by UNAIDS and its partners in the Interagency Task Team for the Prevention of Mother-to-Child Transmission that prevention of perinatal transmission should be a part of the standard package of care for HIV-positive women and their children. Moreover, prevention programs can enhance communities’ response to HIV. In 1999, the Population Council and the International Center for Research on Women initiated activities to identify mechanisms for enhancing community involvement in efforts to prevent mother-to-child transmission. The organizations reviewed the literature on community involvement in the introduction of technologies and assessed community views on preventing mother-to-child transmission in Botswana and Zambia. The literature review provided information about community involvement in earlier introductions of technologies. As noted in this report, that information can guide appropriate and effective community involvement.

2009 ◽  
Vol 41 (2) ◽  
pp. 269-278 ◽  
Author(s):  
TIMOTHY ADAIR

SummaryIn Lesotho, the risk of mother-to-child-transmission (MTCT) of HIV is substantial; women of childbearing age have a high HIV prevalence rate (26·4%), low knowledge of HIV status and a total fertility rate of 3·5 births per woman. An effective means of preventing MTCT is to reduce unwanted fertility. This paper examines the unmet need for contraception to limit and space births among HIV-positive women in Lesotho aged 15–49 years, using the 2004 Lesotho Demographic and Health Survey. HIV-positive women have their need for contraception unmet in almost one-third of cases, and multivariate analysis reveals this unmet need is most likely amongst the poor and amongst those not approving of family planning. Urgent action is needed to lower the level of unmet need and reduce MTCT. A constructive strategy is to improve access to family planning for all women in Lesotho, irrespective of HIV status, and, more specifically, integrate family planning with MTCT prevention and voluntary counselling and testing services.


2012 ◽  
Vol 2012 ◽  
pp. 1-5 ◽  
Author(s):  
Siobhan Mark ◽  
Kellie E. Murphy ◽  
Stanley Read ◽  
Ari Bitnun ◽  
Mark H. Yudin

Objective. To evaluate whether the length of time of rupture of membranes (ROM) in optimally managed HIV-positive women on highly active antiretroviral therapy (HAART) with low viral loads (VL) is predictive of the risk of mother to child transmission (MTCT) of the human immunodeficiency virus (HIV).Study Methods. A retrospective case series of all HIV-positive women who delivered at two academic tertiary centers in Toronto, Canada from January 2000 to November 2010 was completed.Results. Two hundred and ten HIV-positive women with viral loads <1,000 copies/ml delivered during the study period. VL was undetectable (<50 copies/mL) for the majority of the women (167, 80%), and <1,000 copies/mL for all women. Mode of delivery was vaginal in 107 (51%) and cesarean in 103 (49%). The median length of time of ROM was 0.63 hours (range 0 to 77.87 hours) for the entire group and 2.56 hours (range 0 to 53.90 hours) for those who had a vaginal birth. Among women with undetectable VL, 90 (54%) had a vaginal birth and 77 (46%) had a cesarean birth. Among the women in this cohort there were no cases of MTCT of HIV.Conclusions. There was no association between duration of ROM or mode of delivery and MTCT in this cohort of 210 virally suppressed HIV-positive pregnant women.


2001 ◽  

This paper offers lessons learned from a literature review of community involvement in biomedical and other technologies that can guide appropriate and effective introduction of services for prevention of mother-to-child transmission of HIV. A companion paper discusses research in Botswana and Zambia that showed gaps in community knowledge about HIV transmission, particularly from mother to child, and yielded insights into community perspectives about barriers to using voluntary counseling and testing services; stigma and fear associated with HIV; traditional norms on breastfeeding; and the role of family and community members in women’s decisions to participate in programs to prevent mother-to-child transmission of HIV. A separate publication (“Community involvement in the prevention of mother-to-child transmission of HIV: Insights and recommendations”) offers recommendations for community involvement strategies. Placed within the framework of community involvement, an intervention that addresses mother-to-child transmission of HIV offers an enormous opportunity to improve HIV prevention and care. Successful interventions can influence how AIDS is perceived by the community, reduce stigma, and have an effect beyond the immediate prevention of perinatal transmission.


Author(s):  
A. Mohammed ◽  
D. Chiroma ◽  
C. H. Laima ◽  
M. A. Danimoh ◽  
P. A. Odunze

Background: Elimination of mother-to-child transmission (EMTCT) of Human Immunodeficiency Virus (HIV) requires adequate and continuous use of family planning commodities among women of reproductive age. This can be made possible by reducing the proportion of HIV positive women with unmet need for family planning. The study aims to determine the factors associated with having unmet need among women in HIV care. Methods: A cross sectional study was conducted using an interviewer administered questionnaire to study 325 women on HIV care. Cluster sampling technique was used to select the study respondents from the clinic. Results: Less than half of the respondents (40%) were currently using family planning, 35% had unmet need for family planning with 53.6% having unmet need for spacing while 46.4% having unmet need for limiting. Women with no history of previous use of family planning were fifteen times more likely to have unmet need for family planning than those with history of previous use of family planning (p value <0.001, CI 2.511-15.770). Also women with more than five deliveries were eight times more likely to have unmet need for family planning (p value 0.004, CI 0.001-0.279) while women with 2-5 deliveries are four times likely to have unmet need for family planning (p value 0.035, CI 0.005-0.832). Conclusion: A high proportion of women receiving ART care still have unmet need for family planning despite incorporating this service in HIV care. It is therefore important to target high risk groups to reduce the proportion of women with unmet need for family planning which will invariable reduce mother to child transmission of HIV.


2017 ◽  
Vol 6 (1) ◽  
pp. 27 ◽  
Author(s):  
Karen Marie Hampanda, PhD, MPH ◽  
Lisa L. Abuogi, MD, MS ◽  
Yusuf Ahmed, MPH, BM

Background and Objectives: HIV-positive women’s adherence to antiretrovirals is critical for prevention of mother-to-child transmission. We aimed to establish if mothers taking triple lifelong antiretroviral therapy report higher adherence compared to mothers taking short-course prophylaxis under Option A in Lusaka, Zambia.Methods: In this clinic-based cross-sectional study, we interviewed 320 HIV-positive mothers at a large public health facility in Lusaka in 2014. Participants reported adherence using a visual analog scale. Multiple logistic regression models were used to determine the adjusted odds of adherence by mother’s prescribed regimen.Results: Women taking lifelong triple antiretroviral therapy report higher adjusted odds of adherence during pregnancy, postpartum, and to giving the infant prophylaxis compared to women to women taking short-course prophylaxis.Discussion: Women on lifelong therapy may have better adherence compared to women on short course prophylaxis because they knew their positive status for longer or were symptomatic with HIV-related disease. The lifelong therapy regimen may be easier for women to follow, particularly because they are required to give the infant prophylaxis for a shorter duration of time.Conclusions and Global Health Implications: Our results indicate that lifelong triple antiretroviral therapy has the potential to promote better drug adherence during and after pregnancy among women living with HIV in sub-Saharan Africa, compared to short-course antiretroviral regimens.Key words: HIV-positive Women • Prevention of Mother-to-Child Transmission • Antiretroviral Therapy • Adherence • Zambia • Option A • PMTCT • ARTCopyright © 2017 Hampanda et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


2013 ◽  
Vol 62 (3) ◽  
pp. 50-57 ◽  
Author(s):  
Dariko Alexandrovna Niauri ◽  
Ekaterina Vladimirovna Musatova ◽  
Andrey Viktorovich Kolobov ◽  
Margarita Mihailovna Martirosyan ◽  
Vadim Evgenievich Karev ◽  
...  

The retrospective analysis of pregnancy and delivery at 12 HIV-positive mothers who have performed mother-to-child transmission. In reference group — 11 HIV-positive women who have given birth to not-infected children. The study of placentae was done with immunohistochemical methods. For placentae of the infected children decrease of expression of CD31 and CD68 and increase of expression of TGF-в1 was typical. Leading factor in transmission of HIV is absence of ARVT.


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