Maternal knowledge and attitude to early infant HIV diagnosis

Adeniyi, Vincent Oladele (2013-03)

Thesis (MPhil)--Stellenbosch University, 2013.

Thesis

ENGLISH ABSTRACT: The global targets of zero deaths from AIDS-related illness by the year 2015 can only be met if all HIV infected infants can be diagnosed and initiated on anti-retroviral therapy as early as four to six weeks. WHO/UNICEF reported in 2010 that only 8% of eligible infants were tested worldwide. There seems to be more attention directed towards service delivery and less attention on empowering mothers to make voluntary decision to access the services. The influence of maternal knowledge of infant HIV infection and the impact on the attitude towards knowing the status of their children so early in life remains uncertain. The aim of this study was to explore the knowledge and attitude of the HIV positive mothers to early infant diagnosis in order to make strategic recommendations to the health authorities on how to scale up the services in the various health facilities. A qualitative study was conducted in two health centres in King Sabata Dalindyebo Municipality of Eastern Cape Province, South Africa. This qualitative study drew in-depth interview with twenty-four HIV positive mothers/ exposed infants’ pair attending the immunization clinics. The results obtained were presented to two focus groups for discussion and validation of findings. Thematic analysis explored the emerging themes relevant to the objective of the study and health authorities. The study found that there is a high level of awareness about infant HIV infection. Majority of the participants were aware of MTCT of HIV and the timing of transmission (pregnancy, delivery and breastfeeding). Majority of the participants were aware about the protection offered by maternal exposure to ARVs however, only few participants knew about the risk of transmission despite ARV use. Majority of the participants did not know the right time to bring their infant for HIV test. Majority of the participants never thought about HIV test for their infant as early as six weeks. Majority of the mothers have fears about bringing their infants for HIV test so early. They have concerns about recommending early infant diagnosis to other children in their community due to the perceived disclosure of their own status. The study found that despite good knowledge of mothers about infant HIV infection and prevention methods, the knowledge about early infant diagnosis is lacking. The attitude of the mothers to knowing the status of their infant so early in life is challenging for them. The health authorities have more work to do to empower these mothers with knowledge about early infant diagnosis and early ART initiation to increase the chances of survival of HIV infected infants.

AFRIKAANSE OPSOMMING: Die internasionale mikpunt van geen sterftes weens vigsverwante siektes teen die jaar 2015 kan slegs bereik word as alle MIV-besmette babas reeds op vier tot ses weke gediagnoseer word en antiretrovirale terapie (ART) ontvang. Die WGO/UNICEF het in 2010 berig dat slegs 8% van babas wat getoets moet word, in werklikheid wêreldwyd getoets is. Dit blyk dat meer aandag aan dienslewering en minder aan die bemagtiging van moeders om die vrywillige besluit om van die dienste gebruik te maak, geskenk word. Die invloed van moeders se kennis op MIV-besmetting van babas en die impak op die houding teenoor kennis van die status van hul kinders op so ’n vroeë ouderdom is steeds onbekend. Die doel van hierdie studie was om die kennis en houding van MIV-positiewe moeders rakende vroeë diagnose van babas te ondersoek ten einde strategiese aanbevelings aan die gesondheidsowerhede te maak oor verbetering van die dienste in die onderskeie gesondheidsfasiliteite. ’n Kwalitatiewe studie is in twee gesondheidsentrums in King Sabata Dalindyebo-munisipaliteit in die provinsie Oos-Kaap, Suid-Afrika, onderneem. Dit het diepte-onderhoude met 24 MIV-positiewe moeders/blootgestelde babas wat die immuniseringsklinieke besoek het, behels. Die resultate is aan twee fokusgroepe vir bespreking en bekragtiging van die bevindings voorgelê. Tydens ’n tematiese ontleding is die temas wat aan die lig gekom het wat betrekking het op die doelstellings van die studie en gesondheidsowerhede ondersoek. Daar is gevind dat daar ’n hoë vlak bewustheid van MIV-besmetting van babas is. Die meerderheid van die deelnemers was bewus van moeder-na-kind-oordrag van MIV en die tydsberekening van oordrag (swangerskap, geboorte en borsvoeding). Die meerderheid van die deelnemers was ook bewus van die beskerming wat gebied word deur die moeder se blootstelling aan ART, maar net ’n paar deelnemers het egter geweet van die risiko van oordrag ongeag die gebruik van ART. Die meerderheid van die deelnemers het nie geweet wat die korrekte tyd is om hul baba vir ’n MIV-toets te bring nie. Die meerderheid het nog nooit ’n MIV-toets vir hul baba voor die ouderdom van ses weke oorweeg nie. Die meerderheid van die moeders was bang om hul babas so vroeg reeds vir MIV te laat toets. Hulle is begaan oor die aanbeveling van vroeë diagnose vir ander mense in hul gemeenskap weens die waargenome bekendmaking van hul eie status. Die studie het bevind dat ongeag moeders se grondige kennis van MIV-besmetting van babas en voorsorgmaatreëls, daar ’n gebrek aan kennis oor vroeë diagnose van babas is. Die houding van die moeders teenoor kennis van die status van hul baba op so ’n vroeë ouderdom hou vir hulle ’n uitdaging in. Die gesondheidsowerhede moet hulle daarop toespits om hierdie moeders sonder kennis oor vroeë diagnose van babas en vroeë nakoming van ART te bemagtig ten einde MIV-besmette babas se kanse op oorlewing te verhoog.

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