Loss to Follow-Up Among HIV-Exposed Children in an HIV Clinic in Beira, Mozambique

Loss to follow-up contributes to the low coverage of HIV careinterventions among HIV-exposed infants in Beira, Mozambique. This qualitative studyexplores the perceptions of HIV-infected women and their health care providers regardingthe main obstacles preventing women from attending follow-up visits for HIV care, andfactors influencing women’s decisions about newborn care. Fifty-two in-depth interviewsand two focus group discussions were conducted; transcripts were coded and analyzedusing ATLAS.ti. Interviewees perceived three major barriers to follow-up: foodinsecurity, difficulties navigating the health system, and women’s familial roles andresponsibilities. Our findings unveil the complex context in which HIV-infected womenand their children live, and suggest that the structure and function of the HIV caresystem should be reviewed. Economic empowerment of women is crucial to achieving bettercompliance with medical care. Integration of mother and child services and moreefficient and culturally sensitive medical services may improve follow-up