Factors affecting participation of HIV positive mothers in the early infant diagnosis program in Fort Portal Regional Referral Hospital

Abstract

Introduction

Children infected with the Human Immunodeficiency Virus (HIV) have a high risk of death. In infants, these deaths can be avoided by Early Infant Diagnosis (EID) of HIV so that those who are found to be infected can receive early treatment with Antiretroviral therapy (ART). Uptake of Early Infant Diagnosis services is essential to child survival because it reduces child mortality and morbidity. We determined the factors affecting participation of HIV positive mothers attending ART clinic in the EID program in Fort Portal regional referral hospital in Kabarole district. Methods

We conducted a cross sectional survey among 342 HIV positive mothers attending the ART clinic in Fort Portal hospital. Key informant interviews were conducted among 8 key informants with knowledge in the subject matter. The HIV positive mothers who met the selection criteria were selected consecutively while Key informants were selected purposively. Quantitative data was analyzed using descriptive statistics and modified Poisson regression. Qualitative data was analyzed using thematic analysis. Written informed consent was sought from all participants.

Results

The proportion of HIV exposed children who participated in the EID program was 83.9 % (287/342). Of the 287 children, 16 children tested HIV positive at PCR 1, 5 children tested HIV positive at PCR 2 and a total of 266 children took all three tests. Mothers who were richer were less likely to participate in the EID program. In the qualitative analysis, health workers

reaffirmed that participation in the EID program was influenced by counseling in EMTCT, shortage of health workers and stigma and discrimination and health worker client interaction.

Conclusion

Mothers who were richer were less likely to participate in EID. Counseling in EMTCT, shortage of health workers and stigma and discrimination affected mothers’ participation in EID

Recommendations

A special package on EID attendance during EMTCT counseling and mother psychosocial support groups should be introduced. More research should be carried out to follow a cohort of all mothers who test positive during ANC and the association between wealth and participation.