Murithi, L. K., Masho, S. W., & Vanderbilt, A. A. AIDS and Behavior (November 2014), E-publication ahead of print.
This study investigated enabling social, structural, and individual factors that increased utilization of and adherence to prevention of mother-to-child transmission (PMTCT) services among HIV-positive women with HIV-negative infants, and examined the reasons for success as explained by the women themselves. Fifty-five women completed a structured interview, and a subset of 15 women participated in in-depth interviews. The findings pointed to four key factors in successful PMTCT: supportive counseling; striving for motherhood (desiring children); assurance of confidentiality; and confirmation, affirmation, and admiration. Supportive counseling was by far the most important factor in influencing the women’s decision to test for HIV, disclose their status, initiate antiretrovirals, and discontinue breastfeeding at six months. For women who were striving for motherhood, adherence to PMTCT programs made it possible to ensure that their infants were born HIV-negative. Confidentiality of services was vital: women expressed willingness to travel long distances and endure long waiting times at a clinic offering such services. Women also emphasized confirmation, saying that a successful PMTCT experience by a close friend, or even a public figure, helped them with their PMTCT adherence. The authors concluded PMTCT programs should consider these enabling factors, along with attention to access, health education, and functional health care systems, to ensure that women are provided with services that meet their needs.