ArticleJournal of acquired immune deficiency syndromes (1999)2015
Implementation and Operational Research: Distance From Household to Clinic and Its Association With the Uptake of Prevention of Mother-to-Child HIV Transmission Regimens in Rural Zambia.
Article in Journal of acquired immune deficiency syndromes (1999), 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers.
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Who cites it
17 citing papers in PubMed.
- Trial
- Predictors of HIV infection: a prospective HIV screening study in a Ugandan refugee settlement.BMC infectious diseases · 2016Trial
- Uptake and retention in HIV care among pregnant and postpartum women living with HIV under different eras of vertical transmission prevention policies in sub-Saharan Africa: a systematic review and meta-analysis.medRxiv : the preprint server for health sciences · 2026Article
- Predictors of HIV Vertical Transmission in Exposed Infants in Northwest, Ethiopia: A Retrospective Cohort Study.Health science reports · 2026Article
- HIV infection during pregnancy in the state of Rio de Janeiro, Brazil, 2021-2023.Revista brasileira de epidemiologia = Brazilian journal of epidemiology · 2025Article
- Associations between treatment burden, self-reported treatment qualities, antiretroviral therapy obtainment, and health-related quality of life among Ugandan PLWH.Cost effectiveness and resource allocation : C/E · 2023Article
- From Option B+ to Universal "Test and Treat" in Cameroon: Identification and Evaluation of District-level Factors Associated with Retention in Care.International journal of MCH and AIDS · 2023Article
- Attrition in HIV care following HIV diagnosis: a comparison of the pre-UTT and UTT eras in South Africa.Journal of the International AIDS Society · 2021Article
- Accelerating progress towards the elimination of mother-to-child transmission of HIV: a narrative review.Journal of the International AIDS Society · 2020Review
- A root cause analysis of sub-optimal uptake and compliance to iron and folic acid supplementation in pregnancy in 7 districts of Zambia.BMC pregnancy and childbirth · 2020Article
- Long-term survival outcomes of HIV infected children receiving antiretroviral therapy: an observational study from Zambia (2003-2015).BMC public health · 2019Observational
- Geographic Information Systems, spatial analysis, and HIV in Africa: A scoping review.PloS one · 2019Article
- Travel to farms in the lowlands and inadequate malaria information significantly predict malaria in villages around Lake Tana, northwest Ethiopia: a matched case-control study.Malaria journal · 2018Article
- Women's decision-making and uptake of services to prevent mother-to-child HIV transmission in Zambia.AIDS care · 2018Article
- HIV-1 transmission and survival according to feeding options in infants born to HIV-infected women in Yaoundé, Cameroon.BMC pediatrics · 2018Article
- Factors Affecting Uptake of PMTCT Services, Lodwar County Referral Hospital, Turkana County, Kenya, 2015 to 2016.Journal of the International Association of Providers of AIDS CareArticle
- Distance to HIV and Antenatal Care: A Geospatial Analysis in Siaya County, Kenya.The Journal of the Association of Nurses in AIDS Care : JANACArticle
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Authors and funding
10 authors.
Funding
Abstract
backgroundIn rural settings, HIV-infected pregnant women often live significant distances from facilities that provide prevention of mother-to-child transmission (PMTCT) services.
methodsWe offered universal maternal combination antiretroviral regimens in 4 pilot sites in rural Zambia. To evaluate the impact of services, we conducted a household survey in communities surrounding each facility. We collected information about HIV status and antenatal service utilization from women who delivered in the past 2 years. Using household Global Positioning System coordinates collected in the survey, we measured Euclidean (i.e., straight line) distance between individual households and clinics. Multivariable logistic regression and predicted probabilities were used to determine associations between distance and uptake of PMTCT regimens.
resultsFrom March to December 2011, 390 HIV-infected mothers were surveyed across four communities. Of these, 254 (65%) had household geographical coordinates documented. One hundred sixty-eight women reported use of a PMTCT regimen during pregnancy including 102 who initiated a combination antiretroviral regimen. The probability of PMTCT regimen initiation was the highest within 1.9 km of the facility and gradually declined. Overall, 103 of 145 (71%) who lived within 1.9 km of the facility initiated PMTCT versus 65 of 109 (60%) who lived farther away. For every kilometer increase, the association with PMTCT regimen uptake (adjusted odds ratio: 0.90, 95% confidence interval: 0.82 to 0.99) and combination antiretroviral regimen uptake (adjusted odds ratio: 0.88, 95% confidence interval: 0.80 to 0.97) decreased.
conclusionsIn this rural African setting, uptake of PMTCT regimens was influenced by distance to health facility. Program models that further decentralize care into remote communities are urgently needed.
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