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. 2016 Jan 27:10:57-72.
doi: 10.2147/PPA.S87228. eCollection 2016.

Barriers to uptake of prevention of mother-to-child transmission of HIV services among mothers of vertically infected HIV-seropositive infants in Makurdi, Nigeria

Emmanuel Ademola Anígilájé  1 , Bem Ruben Ageda  2 , Nnamdi Okechukwu Nweke  1
Affiliations

Barriers to uptake of prevention of mother-to-child transmission of HIV services among mothers of vertically infected HIV-seropositive infants in Makurdi, Nigeria

Emmanuel Ademola Anígilájé et al. Patient Prefer Adherence. .

Abstract

Background: Perinatal transmission of human immunodeficiency virus (HIV) continues in Nigeria because of the poor use of prevention of mother-to-child transmission of HIV (PMTCT) services. This study reports on the barriers preventing mothers of vertically infected HIV-seropositive infants to use the PMTCT services at the Federal Medical Centre, Makurdi, Nigeria.

Methods: This is a descriptive study conducted between January and April, 2014. A quantitative survey was applied to detect barriers along the PMTCT services cascade among 52 mothers of vertically infected HIV-seropositive infants. This includes 22 women who attended antenatal care at the Federal Medical Centre (designated as Group A mothers) and 30 women who did not receive any form of PMTCT service (Group B mothers). The study was supplemented with a focused group discussion involving 12 discussants from the two groups.

Results: In the quantitative assessment: among the Group A mothers, falling asleep was the most common reason (n=22, 100%) for missing therapeutic/prophylactic antiretroviral medicine; financial constraint (n=22, 100%) was the most common reason for antenatal care visit defaults; and a lot of the mothers (n=11, 50.0%) did not give nevirapine to their newborns because they delivered at home. Among Group B mothers, unawareness of HIV-seropositive status was the most common reason (n=28, 93.3%) given for not accessing PMTCT services. In the qualitative study: noninvolvement of male partners, stigma and discrimination experienced by HIV-seropositive mothers, financial constraints in couples, involvement of traditional birth attendants in antenatal care and delivery of HIV-infected women, unawareness of HIV-seropositive status by pregnant women, poor health system, and the lack of funding for PMTCT services at private and rural health facilities were the major barriers preventing the use of PMTCT services.

Conclusion: In order to reduce the missed opportunities for PMTCT interventions in Makurdi and by extension the Benue State it represents in Nigeria, strong political and financial commitments are needed to overcome the identified barriers.

Keywords: Makurdi; Nigeria; PMTCT services; obstacles.

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Figures

Figure 1
Figure 1
Cascades that define Group A and B mothers. Abbreviations: ANC, antenatal care; FMC, Federal Medical Centre; ART, antiretroviral therapy; ARV, antiretroviral; PMTCT, prevention of mother to child transmission; HIV, human immunodeficiency virus.
See this image and copyright information in PMC

References

    1. UNAIDS 2013 progress report on the Global Plan towards the elimination of new HIV infections among children by 2015 and keeping their mothers alive. 2013. [Accessed December 15, 2013]. Available from: http://www.zero-hiv.org/wp-content/uploads/2013/06/2013-progress-on-the-....
    1. National Agency for the Control of AIDS (NACA) PMTCT demand creation for accelerated uptake of services. A national prevention of mother-to-child transmission (PMTCT) of HIV communication strategy. Nigeria: 2014. [Accessed January 3, 2016]. Available from: https://c-changeprogram.org/sites/default/files/CChange_Nigeria_PMTCT_v9....

    1. Benue State AIDS Control Agency (2013) Fact Sheet: Role out of PMTCT sites.

    1. Anígilájé EA, Dabit OJ, Ageda B, Hwande S, Bitto TT. The prevalence and predictors of HIV infection among children of mothers who missed prevention of mother to child transmission of HIV interventions in Makurdi, Nigeria. J AIDS Clin Res. 2013;4:249.
    1. World Health Organization New guidance on prevention of mother-to-child transmission of HIV and infant feeding in the context of HIV. 2010. [Accessed December 15, 2013]. Available from: http://www.who.int/hiv/pub/mtct/PMTCTfactsheet/en/index.html.

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