Evaluation of Perceptions of Caregivers and Mothers on Early Infant Diagnosis and Treatment of HIV in Selected Health Facilities in Kenya

Emily Barsito, Dennis Magu, Yeri Kombe, Charles Fernandes Lumumba Mbakaya

Abstract


Introduction: Early infant diagnosis among human immunodeficiency virus (HIV)-exposed infants is a critical component of the prevention of mother-to-child transmission programs. The Kenya Ministry of Health recently revised their early infant diagnosis (EID) guidelines to include HIV DNA PCR testing at birth (pilot only), six weeks, six months, and 12 months postnatal and a final 18-month antibody test, to be in line with World Health guidelines on Management of HIV and treatment for infants. Despite these interventions to address barriers to IED, Kenya faces challenges in the uptake of EID. This study explored perceptions of caregivers and mothers of HIV positive infants in order to make recommendations to strengthen the provision of EID services in Kenya.

Methods: We sought to understand the determinants of caregivers and or mothers of HIV positive infants seeking early infant Diagnosis services and treatment in six public health facilities located in six counties of Kenya. We conducted ten focus group discussions with mothers and caretakers of infants seeking Early Infant Diagnosis services and treatment in level four and level five public health facilities in six counties with high, medium, and low prevalence of HIV in Kenya. All Focus Group Discussions were audiotaped, transcribed, translated, and coded for analysis.

Findings: Most respondents reported knowledge and awareness of EID services. However, respondents in rural counties reported less knowledge and awareness of EID compared to those from urban counties. Negative provider attitudes complicated respondents' pathway to seeking care in a stigma-free environment. Linkage by Community Health Volunteers to caregivers and mothers of an infant was noted as a critical component to care. While most respondents were satisfied with how they were treated by health providers while seeking services, most respondents complained about delays and long waiting times to receive services. At the community level, intimate partner violence is a key barrier to caretakers and mothers in seeking EID care.

Conclusion & Recommendations: Mothers and caregivers of infants had higher levels of awareness (knowledge and understanding) of EID. Interventions to ensure that caregivers and mothers of infants are not stigmatized as well as addressing delays and long waiting times for the provision of services should be implemented while ensuring interventions to assist mothers and caregivers 

 

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References


Achwoka, D., Mandala, J., Muriithi, M., Zeng, Y., Chen, M., Dirks, R., . . . Torpey, K. (2018). Progress toward elimination of perinatal HIV transmission in Kenya: analysis of early infant diagnosis data. International journal of STD & AIDS, 29(7), 632-640.

Adetokunboh, O. O., & Oluwasanu, M. (2016). Eliminating mother-to-child transmission of the human immunodeficiency virus in sub-Saharan Africa: The journey so far and what remains to be done. Journal of infection and public health, 9(4), 396-407.

Aseyo, R. E., Mumma, J., Scott, K., Nelima, D., Davis, E., Baker, K. K., . . . Dreibelbis, R. (2018). Realities and experiences of community health volunteers as agents for behaviour change: evidence from an informal urban settlement in Kisumu, Kenya. Human resources for health, 16(1), 53.

Aung, P. L., Silawan, T., Rawiworrakul, T., & Min, M. (2018). Perceived role and its enhancing factors among the village health volunteers regarding malaria control in rural myanmar. Indian journal of public health, 62(1), 10.

Baggaley, R., Doherty, M., Ball, A., Ford, N., & Hirnschall, G. (2015). The strategic use of antiretrovirals to prevent HIV infection: a converging agenda. Clinical Infectious Diseases, 60(suppl_3), S159-S160.

Berg, B. L., & Lune, H. (2004). Qualitative research methods for the social sciences (Vol. 5): Pearson Boston.

Bond, V., Nomsenge, S., Viljoen, L., Simuyaba, M., Mathema, H., Mainga, T., & Seeley, J. (2016). Healthcare worker reflections on the relationship between health facility space and HIV stigma in 21 South African and Zambian health facilities–the Elephant in the Room of HIV service delivery. Paper presented at the Abstract preseted at D 21st International AIDS Conference.

Brown, M., Wexler, C., Gautney, B., Goggin, K., Hurley, E. A., Odeny, B., . . . Finocchario-Kessler, S. (2019). eHealth Interventions for Early Infant Diagnosis: Mothers’ Satisfaction with the HIV Infant Tracking System in Kenya. AIDS and Behavior, 23(11), 3093-3102.

Carpenter, G. L., & Stacks, A. M. (2009). Developmental effects of exposure to intimate partner violence in early childhood: A review of the literature. Children and Youth Services Review, 31(8), 831-839.

Farid, S. (2018). Assessing the cost-effectiveness of national Kenyan repeat maternal HIV testing guidelines.

Friese, S. (2019). Qualitative data analysis with ATLAS. ti: SAGE Publications Limited.

Harrigan, M. The link between intimate partner violence and HIV.

Hassan, A. S., Sakwa, E. M., Nabwera, H. M., Taegtmeyer, M. M., Kimutai, R. M., Sanders, E. J., . . . Berkley, J. A. (2012). Dynamics and constraints of early infant diagnosis of HIV infection in rural Kenya. AIDS and Behavior, 16(1), 5-12.

HIV/AIDS, J. U. N. P. o. (2017). Ending AIDS: Progress towards the 90-90-90 targets. Global AIDS update.

Izudi, J., Auma, S., & Alege, J. B. (2017). Early diagnosis of HIV among infants born to HIV-positive mothers on option-B plus in Kampala, Uganda. AIDS research and treatment, 2017.

Manjate Cuco, R. M., Munguambe, K., Bique Osman, N., Degomme, O., Temmerman, M., & Sidat, M. M. (2015). Male partners’ involvement in prevention of mother-to-child HIV transmission in sub-Saharan Africa: a systematic review. SAHARA-J: Journal of Social Aspects of HIV/AIDS, 12(1), 87-105.

Nyandwi, J., Bazikamwe, S., Nisubire, D., Ndabashinze, P., Shaker, M. E., & Said, E. (2018). Prevention of Mother-to-Child Transmission and Early Real-Time DNA Polymerase Chain Reaction Results Among HIV-Exposed Infants in Bujumbura, Burundi. EA Health Research Journal, 2(2), 112-117.

Ochodo, E. A., Kakourou, A., Mallett, S., & Deeks, J. J. (2018). Point‐of‐care tests detecting HIV nucleic acids for diagnosis of HIV infection in infants and children aged 18 months or less. The Cochrane Database of Systematic Reviews, 2018(11).

Odeny, T. A., Onono, M., Owuor, K., Helova, A., Wanga, I., Bukusi, E. A., . . . Abuogi, L. L. (2018). Maximizing adherence and retention for women living with HIV and their infants in Kenya (MOTIVATE! study): study protocol for a randomized controlled trial. Trials, 19(1), 77.

Opollo, V. S., Nikuze, A., Ben-Farhat, J., Anyango, E., Humwa, F., Oyaro, B., . . . Akelo, V. (2018). Field evaluation of near point of care Cepheid GeneXpert HIV-1 Qual for early infant diagnosis. PLoS ONE, 13(12).

Patton, M. Q. (2005). Qualitative research. Encyclopedia of statistics in behavioral science.

Pricilla, R. A., Brown, M., Wexler, C., Maloba, M., Gautney, B. J., & Finocchario-Kessler, S. (2018). Progress toward eliminating mother to child transmission of HIV in Kenya: review of treatment guidelines uptake and pediatric transmission between 2013 and 2016—a follow up. Maternal and child health journal, 22(12), 1685-1692.

Richards, K. A. R., & Hemphill, M. A. (2018). A practical guide to collaborative qualitative data analysis. Journal of Teaching in Physical Education, 37(2), 225-231.

Rodrigues, R., Tavares, J. M. R., & Coelho, R. (2017). Healthcare Signage Design: What do the users expect? Paper presented at the 2nd Doctoral Congress in Engineering,, Faculdade de Engenharia da Universidade do Porto, Porto, Portugal, 8-9 of June, 2017.

Sabri, B., Wirtz, A. L., Ssekasanvu, J., Nonyane, B. A., Nalugoda, F., Kagaayi, J., . . . Wagman, J. A. (2019). Intimate partner violence, HIV and sexually transmitted infections in fishing, trading and agrarian communities in Rakai, Uganda. BMC public health, 19(1), 594.

Samson, S., Mpembeni, R. N., Njau, P. F., & Kishimba, R. S. (2018). Uptake of early infant diagnosis (EID) at six weeks after cessation of breastfeeding among HIV exposed children: A cross sectional survey at six high volume health facilities in Iringa, Tanzania. Journal of Interventional Epidemiology and Public Health, 1(10).

UNAIDS. (`2016). PREVENTION GAP REPORT. Retrieved from 20 Avenue Appia 1211 Geneva 27 Switzerland: https://www.unaids.org/sites/default/files/media_asset/2016-prevention-gap-report_en.pdf

Wilton, T., & Doyal, L. (2018). AIDS: Setting a feminist agenda: Routledge.

Yoon, A., Choi, S., Mun, J., Hong, J., Hahn, D., Kang, M., & Lee, S. (2018). Motivational signage increases stair usage on a Hispanic serving institution. Journal of American College Health, 1-6


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