Factors associated with access to HIV care and treatment in a prevention of mother to child transmission programme in urban Zimbabwe

Auxilia Muchedzi, Winfreda Chandisarewa, Jo Keatinge, Lynda Stranix-Chibanda, Godfrey Woelk, Elizabeth Mbizvo, Avinash K. Shetty

Research output: Contribution to journalArticle

31 Citations (Scopus)

Abstract

Background: This cross-sectional study assessed factors affecting access to antiretroviral therapy (ART) among HIVpositive women from the prevention of mother to child transmission HIV programme in Chitungwiza, Zimbabwe. Methods: Data were collected between June and August 2008. HIV-positive women attending antenatal clinics who had been referred to the national ART programme from January 2006 until December 2007 were surveyed. The questionnaire collected socio-demographic data, treatment-seeking behaviours, and positive or negative factors that affect access to HIV care and treatment. Results: Of the 147 HIV-positive women interviewed, 95 (65%) had registered with the ART programme. However, documentation of the referral was noted in only 23 (16%) of cases. Of the 95 registered women, 35 (37%) were receiving ART; 17 (18%) had not undergone CD4 testing. Multivariate analysis revealed that participants who understood the referral process were three times more likely to access HIV care and treatment (OR = 3.21, 95% CI 1.89-11.65) and participants enrolled in an HIV support group were twice as likely to access care and treatment (OR = 2.34, 95% CI 1.13-4.88). Those living with a male partner were 60% less likely to access care and treatment (OR = 0.40, 95% CI 0.16-0.99). Participants who accessed HIV care and treatment faced several challenges, including long waiting times (46%), unreliable access to laboratory testing (35%) and high transport costs (12%). Of the 147 clients surveyed, 52 (35%) women did not access HIV care and treatment. Barriers included perceived long queues (50%), competing life priorities, such as seeking food or shelter (33%) and inadequate referral information (15%). Conclusions: Despite many challenges, the majority of participants accessed HIV care. Development of referral tools and decentralization of CD4 testing to clinics will improve access to ART. Psychosocial support can be a successful entry point to encourage client referral to care and treatment programmes.

Original languageEnglish
Article number38
JournalJournal of the International AIDS Society
Volume13
Issue number1
DOIs
Publication statusPublished - 06-10-2010
Externally publishedYes

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Zimbabwe
Mothers
HIV
Referral and Consultation
Therapeutics
Self-Help Groups
Politics
Documentation

All Science Journal Classification (ASJC) codes

  • Public Health, Environmental and Occupational Health
  • Infectious Diseases

Cite this

Muchedzi, Auxilia ; Chandisarewa, Winfreda ; Keatinge, Jo ; Stranix-Chibanda, Lynda ; Woelk, Godfrey ; Mbizvo, Elizabeth ; Shetty, Avinash K. / Factors associated with access to HIV care and treatment in a prevention of mother to child transmission programme in urban Zimbabwe. In: Journal of the International AIDS Society. 2010 ; Vol. 13, No. 1.
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abstract = "Background: This cross-sectional study assessed factors affecting access to antiretroviral therapy (ART) among HIVpositive women from the prevention of mother to child transmission HIV programme in Chitungwiza, Zimbabwe. Methods: Data were collected between June and August 2008. HIV-positive women attending antenatal clinics who had been referred to the national ART programme from January 2006 until December 2007 were surveyed. The questionnaire collected socio-demographic data, treatment-seeking behaviours, and positive or negative factors that affect access to HIV care and treatment. Results: Of the 147 HIV-positive women interviewed, 95 (65{\%}) had registered with the ART programme. However, documentation of the referral was noted in only 23 (16{\%}) of cases. Of the 95 registered women, 35 (37{\%}) were receiving ART; 17 (18{\%}) had not undergone CD4 testing. Multivariate analysis revealed that participants who understood the referral process were three times more likely to access HIV care and treatment (OR = 3.21, 95{\%} CI 1.89-11.65) and participants enrolled in an HIV support group were twice as likely to access care and treatment (OR = 2.34, 95{\%} CI 1.13-4.88). Those living with a male partner were 60{\%} less likely to access care and treatment (OR = 0.40, 95{\%} CI 0.16-0.99). Participants who accessed HIV care and treatment faced several challenges, including long waiting times (46{\%}), unreliable access to laboratory testing (35{\%}) and high transport costs (12{\%}). Of the 147 clients surveyed, 52 (35{\%}) women did not access HIV care and treatment. Barriers included perceived long queues (50{\%}), competing life priorities, such as seeking food or shelter (33{\%}) and inadequate referral information (15{\%}). Conclusions: Despite many challenges, the majority of participants accessed HIV care. Development of referral tools and decentralization of CD4 testing to clinics will improve access to ART. Psychosocial support can be a successful entry point to encourage client referral to care and treatment programmes.",
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Factors associated with access to HIV care and treatment in a prevention of mother to child transmission programme in urban Zimbabwe. / Muchedzi, Auxilia; Chandisarewa, Winfreda; Keatinge, Jo; Stranix-Chibanda, Lynda; Woelk, Godfrey; Mbizvo, Elizabeth; Shetty, Avinash K.

In: Journal of the International AIDS Society, Vol. 13, No. 1, 38, 06.10.2010.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Factors associated with access to HIV care and treatment in a prevention of mother to child transmission programme in urban Zimbabwe

AU - Muchedzi, Auxilia

AU - Chandisarewa, Winfreda

AU - Keatinge, Jo

AU - Stranix-Chibanda, Lynda

AU - Woelk, Godfrey

AU - Mbizvo, Elizabeth

AU - Shetty, Avinash K.

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N2 - Background: This cross-sectional study assessed factors affecting access to antiretroviral therapy (ART) among HIVpositive women from the prevention of mother to child transmission HIV programme in Chitungwiza, Zimbabwe. Methods: Data were collected between June and August 2008. HIV-positive women attending antenatal clinics who had been referred to the national ART programme from January 2006 until December 2007 were surveyed. The questionnaire collected socio-demographic data, treatment-seeking behaviours, and positive or negative factors that affect access to HIV care and treatment. Results: Of the 147 HIV-positive women interviewed, 95 (65%) had registered with the ART programme. However, documentation of the referral was noted in only 23 (16%) of cases. Of the 95 registered women, 35 (37%) were receiving ART; 17 (18%) had not undergone CD4 testing. Multivariate analysis revealed that participants who understood the referral process were three times more likely to access HIV care and treatment (OR = 3.21, 95% CI 1.89-11.65) and participants enrolled in an HIV support group were twice as likely to access care and treatment (OR = 2.34, 95% CI 1.13-4.88). Those living with a male partner were 60% less likely to access care and treatment (OR = 0.40, 95% CI 0.16-0.99). Participants who accessed HIV care and treatment faced several challenges, including long waiting times (46%), unreliable access to laboratory testing (35%) and high transport costs (12%). Of the 147 clients surveyed, 52 (35%) women did not access HIV care and treatment. Barriers included perceived long queues (50%), competing life priorities, such as seeking food or shelter (33%) and inadequate referral information (15%). Conclusions: Despite many challenges, the majority of participants accessed HIV care. Development of referral tools and decentralization of CD4 testing to clinics will improve access to ART. Psychosocial support can be a successful entry point to encourage client referral to care and treatment programmes.

AB - Background: This cross-sectional study assessed factors affecting access to antiretroviral therapy (ART) among HIVpositive women from the prevention of mother to child transmission HIV programme in Chitungwiza, Zimbabwe. Methods: Data were collected between June and August 2008. HIV-positive women attending antenatal clinics who had been referred to the national ART programme from January 2006 until December 2007 were surveyed. The questionnaire collected socio-demographic data, treatment-seeking behaviours, and positive or negative factors that affect access to HIV care and treatment. Results: Of the 147 HIV-positive women interviewed, 95 (65%) had registered with the ART programme. However, documentation of the referral was noted in only 23 (16%) of cases. Of the 95 registered women, 35 (37%) were receiving ART; 17 (18%) had not undergone CD4 testing. Multivariate analysis revealed that participants who understood the referral process were three times more likely to access HIV care and treatment (OR = 3.21, 95% CI 1.89-11.65) and participants enrolled in an HIV support group were twice as likely to access care and treatment (OR = 2.34, 95% CI 1.13-4.88). Those living with a male partner were 60% less likely to access care and treatment (OR = 0.40, 95% CI 0.16-0.99). Participants who accessed HIV care and treatment faced several challenges, including long waiting times (46%), unreliable access to laboratory testing (35%) and high transport costs (12%). Of the 147 clients surveyed, 52 (35%) women did not access HIV care and treatment. Barriers included perceived long queues (50%), competing life priorities, such as seeking food or shelter (33%) and inadequate referral information (15%). Conclusions: Despite many challenges, the majority of participants accessed HIV care. Development of referral tools and decentralization of CD4 testing to clinics will improve access to ART. Psychosocial support can be a successful entry point to encourage client referral to care and treatment programmes.

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