Teshome Girum Sebsibie, Modiba Lebitsi Maud
School of Nursing and Midwifery, College of Health Science, Addis Ababa University, Addis Ababa, Ethiopia.
Department of Health Studies, University of South Africa, Pretoria, South Africa.
HIV AIDS (Auckl). 2020 Dec 2;12:821-837. doi: 10.2147/HIV.S277461. eCollection 2020.
Globally, nearly 38 million people are living with HIV, and 1.8 million are children. Each day approximately 5600 people acquire HIV. Since the emerging of HIV, 78 million people have been infected and close to 39 million have died. In developing countries, from all new HIV infections, half are because of mother-to-child transmission (MTCT). The aim of this study is to evaluate the effect of option B+ prevention of mother-to-child HIV transmission (PMTCT) and to develop strategies that contribute to eliminate MTCT in Addis Ababa, Ethiopia.
The study was conducted in three hospitals of Addis Ababa, Ethiopia, with a qualitative approach. Sixteen (16) in-depth interviews of HIV-positive mothers who had PMTCT follow-up and six focus group discussions with health professionals who work at a PMTCT unit were conducted. To analyse the data ATLAS.ti version 7 was used.
According to the findings of this study mother-to-child HIV transmission was associated with lack of HIV-discordant couples counselling guideline, lack of HIV disclosure strategy and counselling guidelines, unavailability of special PMTCT counselling guideline for HIV-positive commercial sex worker mothers and lack of HIV-free human breast milk (banked human breast milk) for PMTCT. Based on the study findings, a strategy that contributes to eliminate MTCT was developed.
Based on the research finding, the following four strategies were developed. Strategy 1: establish and use banked human breast milk for elimination of MTCT; Strategy 2: incorporate obligatory policy for discordant couple testing, counselling and disclosure with option B+ PMTCT; Strategy 3: develop disclosure policy and counselling guideline for PMTCT; and Strategy 4: formulate special PMTCT guideline for HIV-positive commercial sex worker mothers.
全球近3800万人感染了艾滋病毒,其中180万是儿童。每天约有5600人感染艾滋病毒。自艾滋病毒出现以来,已有7800万人感染,近3900万人死亡。在发展中国家,所有新增艾滋病毒感染病例中,一半是母婴传播所致。本研究旨在评估B+方案预防母婴艾滋病毒传播(PMTCT)的效果,并制定有助于在埃塞俄比亚亚的斯亚贝巴消除母婴传播的策略。
本研究在埃塞俄比亚亚的斯亚贝巴的三家医院采用定性研究方法进行。对16名接受过PMTCT随访的艾滋病毒阳性母亲进行了深入访谈,并与在PMTCT科室工作的卫生专业人员进行了6次焦点小组讨论。使用ATLAS.ti 7版本分析数据。
根据本研究结果,母婴艾滋病毒传播与缺乏艾滋病毒抗体不一致夫妇咨询指南、缺乏艾滋病毒披露策略和咨询指南、没有针对艾滋病毒阳性商业性工作者母亲的特殊PMTCT咨询指南以及缺乏用于PMTCT的无艾滋病毒人乳(储存人乳)有关。基于研究结果,制定了一项有助于消除母婴传播的策略。
基于研究结果,制定了以下四项策略。策略1:建立并使用储存人乳以消除母婴传播;策略2:将艾滋病毒抗体不一致夫妇检测、咨询和披露的强制性政策纳入B+方案PMTCT;策略3:制定PMTCT的披露政策和咨询指南;策略4:为艾滋病毒阳性商业性工作者母亲制定特殊的PMTCT指南。