Lusaka Mildred, Crowley Talitha
Department of Nursing and Midwifery, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.
South Afr J HIV Med. 2021 Jan 27;22(1):1183. doi: 10.4102/sajhivmed.v22i1.1183. eCollection 2021.
Mothers living with human immunodeficiency virus (HIV) should be guided to practise safe childbirth, provide appropriate infant feeding, return infants for repeat HIV testing and administer for the required period, protective antiretroviral (ARV) medication (post-exposure prophylaxis [PEP]) to their infants. Although several studies have explored challenges related to the prevention of mother-to-child transmission (PMTCT), no studies were found that focused specifically on the mother and PEP.
To explore and understand the challenges experienced by mothers in Lusaka, Zambia, whilst providing their children with PEP.
This study utilised a qualitative methodology and a descriptive design. Fifteen semi-structured individual interviews were conducted with mothers who gave PEP to their infants. Study evaluation made use of Creswell's six steps of data analysis.
Women experienced numerous challenges. Challenges of an individual and social nature included 'negative' emotions, misconceptions and a lack of understanding of PEP. Post-exposure prophylaxis was sometimes burdensome and partner involvement often limited. Cultural, religious practices and stigma deterred some women from continuing PEP. Healthcare challenges included time-consuming appointments and protracted waiting periods. Clinic organisation was often inefficient and complicated by stock-outs of essential medication such as nevirapine. Healthcare workers were at times stigmatising towards mothers living with HIV and their infants. The counselling support provided by the healthcare workers was felt to be inadequate in the face of the burden of PEP.
Post-exposure prophylaxis as part of the PMTCT programme is key to eliminating mother-to-child transmission of HIV. Postnatal support for women administering PEP to their children can be enhanced through counselling that is person- and family-centred is culturally sensitive and offers differentiated services that include PEP, integrated mother-and-child healthcare and access to support groups.
感染人类免疫缺陷病毒（HIV）的母亲应得到指导，以实施安全分娩、提供适当的婴儿喂养、带婴儿返回进行重复HIV检测，并在所需期间为婴儿服用预防性抗逆转录病毒（ARV）药物（暴露后预防 [PEP]）。尽管有几项研究探讨了与预防母婴传播（PMTCT）相关的挑战，但未发现专门针对母亲和PEP的研究。
探讨并了解赞比亚卢萨卡的母亲在为其子女提供PEP时所面临的挑战。
本研究采用定性方法和描述性设计。对为婴儿提供PEP的母亲进行了15次半结构化的个人访谈。研究评估采用了克雷斯韦尔的数据分析六个步骤。
女性面临着诸多挑战。个人和社会性质的挑战包括“负面”情绪、误解以及对PEP缺乏了解。暴露后预防有时负担沉重，伴侣的参与往往有限。文化、宗教习俗和耻辱感使一些女性不愿继续进行PEP。医疗保健方面的挑战包括预约耗时和等待时间过长。诊所组织往往效率低下，因奈韦拉平之类的基本药物缺货而变得复杂。医护人员有时会歧视感染HIV的母亲及其婴儿。面对PEP的负担，医护人员提供的咨询支持被认为不足。
作为PMTCT计划一部分的暴露后预防是消除HIV母婴传播的关键。通过以个人和家庭为中心、具有文化敏感性并提供包括PEP、母婴综合医疗保健和支持小组在内的差异化服务的咨询，可以加强对为子女提供PEP的妇女的产后支持。
