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Conversations With Mothers: Exploring Reasons for Prevention of Mother-to-Child Transmission (PMTCT) Failures in the Era of Programmatic Scale-Up in Soweto, South Africa

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Abstract

Reasons for incident cases of vertical HIV transmission in the era of free access to PMTCT in South Africa were investigated. This mixed-methods study was conducted in Soweto, South Africa from June–August, 2009. Birthmothers of HIV-infected infants born after 1 December 2008 were eligible. All participants completed an interviewer-administered questionnaire. Women also participated in a focus group (n = 10) or individual structured interview (n = 35). Mean age of participants (n = 45) was 28.7 years (SD = 5.4). Major findings are: (i) failure of per-guideline prescription of ARV strategies for infants (31%) and/or mothers (57%); (ii) maternal refusal of treatment (n = 5); (iii) preterm delivery (31%); (iv) delayed ANC attendance because of facility-related barriers and maternal apprehension around HIV testing; (v) fear of stigma; (vi) maternal difficulty with administering infant AZT (n = 9) and (vii) maternal confusion about infant feeding. A variety of individual, social, and structural factors must be addressed to optimize PMTCT service delivery in South Africa.

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Acknowledgments

We thank the participants, PHRU staff, and our group moderator Lindelwa Sikakane. Paediatric Wellness Clinic is funded by USAID-PEPFAR. Partial study funding was through a grant provided by the Social Sciences and Humanities Research Council (SSHRC) of Canada and a Simon Fraser University Graduate Travel & Minor Research award.

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Authors and Affiliations

  1. Perinatal HIV Research Unit, University of the Witwatersrand, Diepkloof, Soweto, P.O. Box 114, Johannesburg, 1864, South Africa

    Fatima Laher, Erica Lazarus, Matamela Makongoza & Glenda Gray

  2. Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada

    Angela Cescon, Angela Kaida, Robert S. Hogg & Cari L. Miller

  3. British Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC, Canada

    Angela Cescon, Angela Kaida & Robert S. Hogg

  4. School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada

    Christine N. Soon

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  1. Fatima Laher
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  2. Angela Cescon
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  3. Erica Lazarus
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  9. Glenda Gray
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Correspondence to Fatima Laher.

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Laher, F., Cescon, A., Lazarus, E. et al. Conversations With Mothers: Exploring Reasons for Prevention of Mother-to-Child Transmission (PMTCT) Failures in the Era of Programmatic Scale-Up in Soweto, South Africa. AIDS Behav 16, 91–98 (2012). https://doi.org/10.1007/s10461-010-9875-9

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