"It was my obligation as mother": 18-Month completion of Early Infant Diagnosis as identity control for mothers living with HIV in Kenya

Social Science & Medicine
Emily A HurleySarah Finocchario-Kessler

Abstract

Early Infant Diagnosis (EID) is critical to timely identification of HIV and rapid treatment initiation for infants found to be infected. Completing the EID cascade involves a series of age-specific tests between birth and 18 months and can be challenging for mother- infant pairs in low-resource settings. Even prior to recent increases in Kenya's testing recommendations, approximately 22% of mother-infant pairs enrolled in EID were lost to follow-up. As EID cascades become increasingly complex, identifying strategies to maximize retention becomes even more essential. Despite ongoing health system improvements, we still lack a framework for understanding the individual-level, psychosocial processes underlying EID completion-insight that could be essential for shaping strategies to support patients and close gaps in retention. Our objective was to explain individual-level processes that lead to EID completion among mothers who successfully completed the EID cascade. Using qualitative methods informed by grounded theory, we conducted 65 interviews with Kenyan mothers who completed EID. We identified three themes related to completion: (1) Negative motivation, from the consequences of infant infection, fear of postnatal transmissio...Continue Reading

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References

Jun 13, 2009·AIDS Education and Prevention : Official Publication of the International Society for AIDS Education·Amy MedleyMichael Sweat
Aug 4, 2010·Bulletin of the World Health Organization·Caitlin E KennedyKevin R O'Reilly
Jan 8, 2011·AIDS and Behavior·Amin S HassanJames A Berkley
Mar 14, 2012·BMJ : British Medical Journal·Karen McColl
Jul 15, 2015·Implementation Science : IS·Sarah Finocchario-KesslerVincent Okoth
Dec 7, 2017·Journal of the International AIDS Society·Carol S CamlinDiane V Havlir
Dec 30, 2017·Journal of Acquired Immune Deficiency Syndromes : JAIDS·Brandon A KnettelMelissa H Watt

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