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Why do HIV-positive pregnant women discontinue with comprehensive PMTCT services? A qualitative study

Putu Emy Suryanti , Komang Ayu Kartika Sari, Pande Putu Januraga, Dinar Lubis

Putu Emy Suryanti
Mitra Usadha Clinic. Email: emy.boo89@gmail.com

Komang Ayu Kartika Sari
Department of Public Health and Preventive Medicine, Faculty of Medicine, Udayana University

Pande Putu Januraga
Department of Public Health and Preventive Medicine, Faculty of Medicine, Udayana University

Dinar Lubis
Department of Public Health and Preventive Medicine, Faculty of Medicine, Udayana University
Online First: July 01, 2018 | Cite this Article
Suryanti, P., Sari, K., Januraga, P., Lubis, D. 2018. Why do HIV-positive pregnant women discontinue with comprehensive PMTCT services? A qualitative study. Public Health and Preventive Medicine Archive 6(1): 73-78. DOI:10.15562/phpma.v6i1.13


Abstract

Background and purpose: Prevention of mother to child transmission (PMTCT) is a government program aimed at preventing mother-to-child transmission of HIV. A comprehensive PMTCT program involves the implementation of HIV testing up to antiretroviral (ARV) treatment for mothers with positive HIV test results. Coverage of comprehensive PMTCT remains low, with many HIV-positive pregnant women who discontinued ARV treatment. This study aims to explore the reasons of HIV-positive pregnant women to discontinue with the comprehensive PMTCT program.

Methods: A qualitative study was carried out in Badung District, Bali Province, with seven respondents: one HIV-positive pregnant woman who did not continue the ARV treatment, two HIV-positive women who gave birth the previous year and did not take ARV, three public health centre (PHC) providers, and one head of PHC. Respondents were selected using a purposive sampling technique. Data were collected through in-depth interviews and analyzed thematically. The results presented narratively to illustrate the reasons why HIV-positive pregnant women discontinued with the comprehensive PMTCT program.

Results: The emerging themes related to the reasons of HIV-positive pregnant women discontinued with the comprehensive PMTCT program included the lack of comprehensive PMTCT-related information, the lack of health provider assistance, and the high stigma towards people living with HIV (PLHIV). These barriers were affecting the willingness of HIV-positive pregnant women to continue with the program.

Conclusions: Lack of comprehensive PMTCT-related information, lack of assistance by health care providers, and high public stigma impacts upon HIV-positive pregnant women’s willingness to continue with comprehensive PMTCT program. There is a need for a minimum service standard in the implementation of comprehensive PMTCT services and comprehensive information on HIV infection in order to reduce the stigma towards PLHIV.

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