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Showing 1 - 10 of 10 Results for "Tanzania"

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Antenatal Care - Treatment
PMTCT-Plus (family-focused) HIV care can increase the numbers of women and their partners who access treatment and remain adherent. Note: This should not be implemented in any way that prejudices women who do not want to disclose to partners (see overview).
Antenatal Care - Treatment
4 studies Gray IIIa, IIIb PMTCT Plus, PMTCT-Plus, pregnancy, treatment Africa, Botswana, Côte d’Ivoire, South Africa, Tanzania, Uganda, Zambia
Interventions are needed to provide pregnant and breastfeeding women with more food security in order to increase viral suppression. A study found that food insecurity was associated with lower odds of sustained virological suppression.
Antenatal Care - Treatment
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
Promoting HIV testing for male and female adolescents prior to pregnancy or fatherhood may increase those on cART prior to pregnancy, thus decreasing viral load prior to pregnancy and increasing the likelihood of reduced risk of vertical transmission
Antenatal Care - Treatment
1 study
Strategies need to be identified to empower women to create demand for improved maternal health services and challenge violations of their rights in facility-based childbirth. This is a particularly acute need for women living with HIV. Studies show that HIV-related stigma may reduce the likelihood of delivering in a health facility
Antenatal Care - Treatment
1 study
Monitoring for drug resistance in low- and middle-income countries is needed during Option B+ scale up. Studies are finding drug resistance among women who are initiating cART or who have initiated cART
Antenatal Care - Treatment
1 study
Efforts are needed to effectively implement Option B+ in non-prejudicial ways. Women who were sex workers reported being denied care until delivery. Women who were not accompanied by husbands were denied any health services during pregnancy. A sign on health centers read: “Notice: all pregnant women are supposed to come with their husbands/partners at their first visit. You will not be given services without implementing this” (Beckham et al., 2015: 66).
Antenatal Care - Treatment
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
Strategies, including legal strategies, are needed to empower pregnant women living with HIV to ask questions, be properly informed and to challenge stigma, disrespect and abuse. [See also %{s:67}] Consequences for violating patient confidentiality, redress for women with HIV facing discrimination in facilities, and stigma reduction efforts are needed to increase adherence to cART, prior to, during and post pregnancy, including training for providers.
Antenatal Care - Treatment
1 study
Interventions are needed to sustain viral suppression and reduce loss to follow up once a woman has initiated Option B+, including affordable means of monitoring virological response and effective adherence counseling. Research is needed on how long is optimal to provide care within maternal health systems or when to transfer cART provision outside of maternal health systems. Compared to people who started cART for their own health, a study found that women who started cART while pregnant were 5 times less likely to return to the clinics after the initial visit. Women who started cART while breastfeeding were twice as likely to miss their first follow up appointment. On average, 17% of pregnant women who started ART under Option B+ dropped out of care in the first six months of ART and 22% dropped out within one year (Tenhathi et al., 2014). Systems are rarely in place to track mothers six weeks post-partum (Psaros et al., 2015; Waiswa, 2016). A survey found that ART retention was greatest in those facilities where newly diagnosed pregnant women living with HIV were referred from ANC to the ART clinic in the same facility for initiation and follow up or were referred to facilities serving as ART referral sites that did not provide ANC (van Lettow et al., 2014). A review noted that women found challenges in accessing cART either through maternal care systems, postpartum or through HIV care. Input from pregnant and postpartum women living with HIV is needed
Antenatal Care - Treatment
1 study