Showing 1 - 12 of 12 Results for "PMTCT"

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More effective and timely translation of new PMTCT policy into standard practice is needed.
Antenatal Care - Treatment
1 study
Efforts are needed to ensure that providing family-focused HIV care within maternal and child health programs doesn’t discourage men from seeking HIV services. A study found that men were excluded from PMTCT programs.
Structuring Health Services to Meet Women’s Needs
1 study
Policy guidelines, including service delivery guidelines, need to specify how contraception should be addressed in HIV prevention, treatment and care. Studies found that many guidelines did not explicitly address family planning in VCT and PMTCT guidelines and that providers and policymakers felt they had insufficient knowledge.
Meeting the Sexual and Reproductive Health Needs of Women Living With HIV
1 study
Further interventions are needed to incorporate violence prevention, screening and counseling services into PMTCT testing and counseling. [See also %{s:59}] Studies found high rates of violence, sexual coercion and abuse among HIV-positive pregnant women, particularly when accessing HIV testing or during disclosure.
Antenatal Care - Testing and Counseling
1 study
Multiple strategies are needed to promote male involvement in ways that meet pregnant women’s needs. Studies found that some women found their partners’ involvement controlling and/or violent and other women wanted more autonomy in health decision-making. Studies also found men lacked information on vertical transmission and felt excluded from PMTCT programs. Other studies found that women indicated that they could not discuss their HIV serostatus with their husbands.
Antenatal Care - Testing and Counseling
1 study
Interventions, including community based distribution of cART and/or funds for transport, are needed to reach pregnant women living with HIV who do not access ANC, postpartum care or cART. “Restrictions on women’s mobility and lack of access to transportation and financial resources may limit their ability to seek PMTCT services” (Ghanotakis et al., 2012: table 2).
Antenatal Care - Treatment
1 study
Programs must adhere to the longstanding international agreement to voluntarism, informed consent, and ensuring the right of individuals and couples to decide freely and responsibly the number and spacing of their children. Studies found that women living with HIV had been sterilized against their will, were pressured by providers to terminate a pregnancy, or were stigmatized for becoming pregnant. Studies also found that provision of antiretroviral therapy was conditional on using certain types of contraception. Litigation is currently being undertaken. A study found that HIV-positive women who accessed contraceptive services were not informed of the benefits of PMTCT programs in reducing vertical transmission.
Meeting the Sexual and Reproductive Health Needs of Women Living With HIV
1 study
Interventions are needed for male involvement that do not such reinforce harmful gender norms or increase risk for violence, stigma or discrimination. “Evidence for effectiveness of male involvement in PMTCT programs is scant” (Beckham et al., 2015: 67). One study only evaluated male involvement as accompanying their pregnant partner to ANC care with no HIV related outcomes listed and tasking the woman to require her male partner to come to ANC (Nyondo et al., 2015). Most approaches only reach men through their pregnant spouse, with no services for men beyond HIV testing and use men as an instrument solely to increase access to services by women. Men have been denied involvement in antenatal care, birth and delivery even if the couple so chooses.
Antenatal Care - Treatment
1 study
Efforts are needed to reform laws that criminalize drug use and/or drug possession for personal use and to eliminate compulsory drug detention and instead, provide people who use drugs with access to HIV and health services, including harm reduction, and voluntary, effective evidence-based drug dependency treatment. Detention centers are administered by police, military or other national government public security authorities and operate outside the formal criminal justice system with detainees held without trial or right of appeal; those detained are not allowed to leave voluntarily (Wolfe, 2012). Studies found that female IDU were not given reproductive health services, including PMTCT services in compulsory detention and/or prison settings. Detoxification programs were substandard and ineffective. Despite high rates of HIV, antiretroviral treatment is largely unavailable in compulsory drug detention centers. IDUs who have started antiretroviral treatment should be able to continue treatment in prison with access to medical supervision. [See also %{s:11}]
Advancing Human Rights and Access to Justice for Women and Girls
1 study
Efforts are needed to eliminate compulsory drug detention and instead, provide PWID with HIV prevention and testing services and effective drug dependency treatment by medical professionals. Detention centers are administered by police, military or other national government public security authorities and operate outside the form criminal justice system with detainees held without trial or right of appeal and those detained do not allow people to leave voluntarily (Wolfe, 2012). Studies found that women who use drugs were not given reproductive health services, including PMTCT services in compulsory detention and/or prison settings. Detoxification programs were substandard and ineffective. Despite high rates of HIV, antiretroviral treatment is largely unavailable in compulsory drug detention centers. One study found high rates of injecting drug use within prison and high rates of syringe sharing within prisons plus incarceration was not associated with reduction in drug use, with over a quarter of these female drug users. PWID in and out of prison who have started antiretroviral treatment should be able to continue treatment with access to medical supervision. Treatment in compulsory drug detention takes the form of sanction rather than therapy, with high relapse rates.
Women Who Use Drugs and Female Partners of Men Who Use Drugs
1 study
Additional efforts are needed to provide postpartum women with contraception information and methods so they may space or prevent their next pregnancy and use condoms to reduce the likelihood of HIV transmission upon resumption of sexual activity. [See also %{c:15}] Studies found that women were not given contraceptive counseling or contraceptives postpartum and that transport costs restricted their ability to gain access to their contraceptive method of choice. Studies also found an unmet need for postpartum contraception among women living with HIV. Studies found that sexuality and condom use need to be addressed when sexual activity resumes postpartum. Family planning services are most often not provided postpartum in PMTCT programs. Providers and women did not know that clinically well HIV-positive women can use IUDs. Women lacked the full range of available contraception. No study to date has measured pregnancy intention prospectively in an HIV-discordant couple cohort and measured the effect of desired pregnancy on HIV transmission.
Postpartum
1 study
Further interventions are needed to reduce barriers to HIV testing. Studies found that fear of partner notification, risk of domestic violence, the unreliability of rapid HIV tests, test availability, long waiting times at the clinic, costs for transport, lack of childcare and the need for partner consent were barriers to HIV testing. The impact of rapid testing during labor and delivery for HIV-positive women has yet to be assessed and HIV test results were not provided prior to delivery.
Antenatal Care - Testing and Counseling
1 study