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