195 lines
6 KiB
YAML
195 lines
6 KiB
YAML
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abstract: 'Background
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The majority of HIV infection among children occurs through
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mother-to-child transmission. HIV exposed infants are recommended to
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have virological testing at birth or 4-6 weeks of age but challenges
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with centralized laboratory-based testing in Myanmar result in low
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testing rates and delays in result communication and treatment
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initiation. Decentralized point-of-care (POC) testing when integrated in
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prevention of mother-to-child transmission of HIV (PMTCT) services, can
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be an alternative to increase coverage of early infant diagnosis (EID)
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and timely engagement in HIV treatment and care.
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Aim
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This paper aims to explore experiences of caregivers of HIV-exposed
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infants enrolled in the PMTCT program in Myanmar and the perceived
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acceptability of point-of-care EID testing compared to conventional
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centralised laboratory-based testing.
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Methods
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This is a sub-study of the cluster randomised controlled stepped-wedge
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trial (Trial registration number: ACTRN12616000734460) that assessed the
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impact of near POC EID testing using Xpert HIV-1 Qual assay in four
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public hospitals in Myanmar. Caregivers of infants who were enrolled in
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the intervention phase of the main study, had been tested with both
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Xpert and standard of care tests and had received the results were
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eligible for this qualitative study. Semi-structured interviews were
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conducted with 23 caregivers. Interviews were audio recorded,
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transcribed verbatim and translated into English. Thematic data analysis
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was undertaken using NVivo 12 Software (QSR International).
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Results
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The majority of caregivers were satisfied with the quality of care
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provided by PMTCT services. However, they encountered social and
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financial access barriers to attend the PMTCT clinic regularly. Mothers
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had concerns about community stigma from the disclosure of their HIV
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status and the potential consequences for their infants. While medical
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care at the PMTCT clinics was free, caregivers sometimes experienced
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financial difficulties associated with out-of-pocket expenses for
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childbirth and transportation. Some caregivers had to choose not to
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attend work (impacting their income) or the adult antiretroviral clinic
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in order to attend the paediatric PMTCT clinic appointment. The
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acceptability of the Xpert testing process was high among the caregiver
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participants and more than half received the Xpert result on the same
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day as testing. Short turnaround time of the near POC EID testing
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enabled the caregivers to find out their infants'' HIV status quicker,
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thereby shortening the stressful waiting time for results.
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Conclusion
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Our study identified important access challenges facing caregivers of
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HIV exposed infants and high acceptability of near POC EID testing.
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Improving the retention rate in the PMTCT and EID programs necessitates
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careful attention of program managers and policy makers to these
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challenges, and POC EID represents a potential solution.'
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affiliation: 'Luchters, S (Corresponding Author), Burnet Inst, Melbourne, Vic, Australia.
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Luchters, S (Corresponding Author), Monash Univ, Sch Publ Hlth \& Prevent Med, Melbourne,
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Vic, Australia.
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Luchters, S (Corresponding Author), Aga Khan Univ, Dept Populat Hlth, Nairobi, Kenya.
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Luchters, S (Corresponding Author), Univ Ghent, Int Ctr Reprod Hlth ICRH, Dept Publ
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Hlth \& Primary Care, Ghent, Belgium.
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Yee, Win Lei; Than, Kyu Kyu; Htay, Hla, Burnet Inst, Yangon, Myanmar.
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Mohamed, Yasmin; Luchters, Stanley, Burnet Inst, Melbourne, Vic, Australia.
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Mohamed, Yasmin; Luchters, Stanley, Monash Univ, Sch Publ Hlth \& Prevent Med, Melbourne,
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Vic, Australia.
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Tin, Htay Htay; Thein, Win; Kyaw, Latt Latt; Yee, Win Win; Aye, Moe Myat, Minist
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Hlth \& Sports, Natl Hlth Lab, Yangon, Myanmar.
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Badman, Steven G.; Vallely, Andrew J.; Kelly-Hanku, Angela, UNSW Sydney, Kirby Inst
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Infect \& Immun Soc, Sydney, NSW, Australia.
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Vallely, Andrew J.; Kelly-Hanku, Angela, Papua New Guinea Inst Med Res, Sexual \&
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Reprod Hlth Unit, Goroka, Papua N Guinea.
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Luchters, Stanley, Aga Khan Univ, Dept Populat Hlth, Nairobi, Kenya.
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Luchters, Stanley, Univ Ghent, Int Ctr Reprod Hlth ICRH, Dept Publ Hlth \& Primary
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Care, Ghent, Belgium.'
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article-number: e0241245
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author: Yee, Win Lei and Than, Kyu Kyu and Mohamed, Yasmin and Htay, Hla and Tin,
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Htay Htay and Thein, Win and Kyaw, Latt Latt and Yee, Win Win and Aye, Moe Myat
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and Badman, Steven G. and Vallely, Andrew J. and Luchters, Stanley and Kelly-Hanku,
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Angela and Grp, AAMI Study
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author-email: stanley.luchters@aku.edu
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author_list:
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- family: Yee
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given: Win Lei
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- family: Than
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given: Kyu Kyu
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- family: Mohamed
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given: Yasmin
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- family: Htay
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given: Hla
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- family: Tin
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given: Htay Htay
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- family: Thein
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given: Win
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- family: Kyaw
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given: Latt Latt
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- family: Yee
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given: Win Win
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- family: Aye
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given: Moe Myat
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- family: Badman
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given: Steven G.
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- family: Vallely
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given: Andrew J.
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- family: Luchters
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given: Stanley
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- family: Kelly-Hanku
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given: Angela
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- family: Grp
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given: AAMI Study
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da: '2023-09-28'
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doi: 10.1371/journal.pone.0241245
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files: []
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issn: 1932-6203
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journal: PLOS ONE
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keywords-plus: CONCEPTUAL-FRAMEWORK; PREVENTION; STIGMA; DISCRIMINATION; TRANSMISSION
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language: English
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month: OCT 30
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number: '10'
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number-of-cited-references: '35'
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orcid-numbers: 'Vallely, Andrew/0000-0003-1558-4822
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Htay, Hla/0000-0003-1274-961X
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Anderson, David/0000-0002-9969-3905
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Luchters, Stanley/0000-0001-5235-5629
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Kelly-Hanku, Angela/0000-0003-0152-2954
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Yee, Win Lei/0000-0002-6387-9396'
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papis_id: a154d061ab33f87e6bbefc559c17dc79
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ref: Yee2020caregiverexperience
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times-cited: '2'
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title: 'Caregiver experience and perceived acceptability of a novel near point-of-care
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early infant HIV diagnostic test among caregivers enrolled in the PMTCT program,
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Myanmar: A qualitative study'
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type: Article
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unique-id: WOS:000588368900012
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usage-count-last-180-days: '1'
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usage-count-since-2013: '3'
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volume: '15'
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web-of-science-categories: Multidisciplinary Sciences
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year: '2020'
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