Open AccessFactors associated with access to HIV care and treatment in a prevention of mother to child transmission programme in urban Zimbabwe
Author(s) -
Muchedzi Auxilia,
Chandisarewa Winfreda,
Keatinge Jo,
StranixChibanda Lynda,
Woelk Godfrey,
Mbizvo Elizabeth,
Shetty Avinash K
Publication year - 2010
Publication title -
journal of the international aids society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.724
H-Index - 62
ISSN - 1758-2652
DOI - 10.1186/1758-2652-13-38
Subject(s) - medicine , referral , family medicine , multivariate analysis , transmission (telecommunications) , human immunodeficiency virus (hiv) , electrical engineering , engineering
Background This cross‐sectional study assessed factors affecting access to antiretroviral therapy (ART) among HIV‐positive women from the prevention of mother to child transmission HIV programme in Chitungwiza, Zimbabwe. Methods Data were collected between June and August 2008. HIV‐positive women attending antenatal clinics who had been referred to the national ART programme from January 2006 until December 2007 were surveyed. The questionnaire collected socio‐demographic data, treatment‐seeking behaviours, and positive or negative factors that affect access to HIV care and treatment. Results Of the 147 HIV‐positive women interviewed, 95 (65%) had registered with the ART programme. However, documentation of the referral was noted in only 23 (16%) of cases. Of the 95 registered women, 35 (37%) were receiving ART; 17 (18%) had not undergone CD4 testing. Multivariate analysis revealed that participants who understood the referral process were three times more likely to access HIV care and treatment (OR = 3.21, 95% CI 1.89‐11.65) and participants enrolled in an HIV support group were twice as likely to access care and treatment (OR = 2.34, 95% CI 1.13‐4.88). Those living with a male partner were 60% less likely to access care and treatment (OR = 0.40, 95% CI 0.16‐0.99). Participants who accessed HIV care and treatment faced several challenges, including long waiting times (46%), unreliable access to laboratory testing (35%) and high transport costs (12%). Of the 147 clients surveyed, 52 (35%) women did not access HIV care and treatment. Barriers included perceived long queues (50%), competing life priorities, such as seeking food or shelter (33%) and inadequate referral information (15%). Conclusions Despite many challenges, the majority of participants accessed HIV care. Development of referral tools and decentralization of CD4 testing to clinics will improve access to ART. Psychosocial support can be a successful entry point to encourage client referral to care and treatment programmes.