ArticleSexually transmitted infections2017
'I wanted to safeguard the baby': a qualitative study to understand the experiences of Option B+ for pregnant women and the potential implications for 'test-and-treat' in four sub-Saharan African settings.
Article in Sexually transmitted infections, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 33 papers, 2 of them syntheses that pooled it.
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Who cites it
33 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Being HIV positive and staying on antiretroviral therapy in Africa: A qualitative systematic review and theoretical model.PloS one · 2019Pooled it
- Retention in HIV Care During Pregnancy and the Postpartum Period in the Option B+ Era: Systematic Review and Meta-Analysis of Studies in Africa.Journal of acquired immune deficiency syndromes (1999) · 2018Pooled it
- Predictors of Viremia in Postpartum Women on Antiretroviral Therapy.Journal of acquired immune deficiency syndromes (1999) · 2020Trial
- Slow Acceptance of Universal Antiretroviral Therapy (ART) Among Mothers Enrolled in IMPAACT PROMISE Studies Across the Globe.AIDS and behavior · 2019Trial
- Barriers and facilitators to the uptake of Test and Treat in Mozambique: A qualitative study on patient and provider perceptions.PloS one · 2018Trial
- Clinical outcomes and survival of HIV exposed children at 18 months in post-conflict region: insight from the Panzi Interdisciplinary PMTCT cohort (Panzi IPC) study.BMC infectious diseases · 2026Article
- Long-term retention on antiretroviral treatment after enrolment in prevention of vertical HIV transmission services: a prospective cohort study in Dar es Salaam, Tanzania.Journal of the International AIDS Society · 2024Article
- The Psychosocial Profile of Women Who Defaulted Option B+ HIV Treatment: An Interpretive Phenomenological Analysis Study.HIV/AIDS (Auckland, N.Z.) · 2023Article
- Eliminating mother-to-child transmission of HIV in Tanzania calls for efforts to address factors associated with a low confirmatory test.PLOS global public health · 2023Article
- Perceptions of barriers and facilitators to implement programs for prevention of mother-to-child transmission of HIV-Mozambique.Revista da Escola de Enfermagem da U S P · 2022Article
- Understanding factors influencing utilization of HIV prevention and treatment services among patients and providers in a heterogeneous setting: A qualitative study from South Africa.PLOS global public health · 2022Article
- Patterns of engagement in HIV care during pregnancy and breastfeeding: findings from a cohort study in North-Eastern South Africa.BMC public health · 2021Article
- Understanding the influence of health systems on women's experiences of Option B+: A meta-ethnography of qualitative research from sub-Saharan Africa.Global public health · 2021Article
- Implementation and experiences of integrated prevention of mother-to-child transmission services in Tanzania, Malawi and South Africa: A mixed methods study.Global public health · 2021Article
- Testing for saturation in qualitative evidence syntheses: An update of HIV adherence in Africa.PloS one · 2021Article
- Article
- The development of Maisha, a video-assisted counseling intervention to address HIV stigma at entry into antenatal care in Tanzania.Evaluation and program planning · 2020Article
- "BMJ global health · 2020Article
- "At home, no one knows": A qualitative study of retention challenges among women living with HIV in Tanzania.PloS one · 2020Article
- Optimizing Test and Treat in Malawi: health care worker perspectives on barriers and facilitators to ART initiation among HIV-infected clients who feel healthy.Global health action · 2020Article
Corrections and comments
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Authors and funding
8 authors.
Funding
Abstract
objectiveTo explore what influences on engagement with Option B+ in four sub-Saharan African settings.
methodsIn-depth interviews were conducted in 2015, with 22 HIV-positive women who had been pregnant since Option B+ was available, and 15 healthcare workers (HCWs) involved in HIV service delivery. Participants were purposely selected from four health and demographic surveillance sites in Malawi, Tanzania and Uganda. A thematic content analysis was conducted to investigate what influenced engagement with Option B+.
resultsFeeling 'ready' was key to pregnant women accepting antiretroviral treatment (ART) on the same day as diagnosis at antenatal clinic; this was influenced by previous knowledge of HIV-positive status, interactions with HCWs and relationship with their partners. The desire to protect their unborn infant was the main issue that motivated women to initiate treatment, temporarily over-riding barriers to starting ART. Many HCWs recognised that pressurising women into starting ART may lead them to stop treatment following delivery. However, their own responsibility to protect the infant sometimes drove HCWs to use strong persuasive techniques to initiate pregnant women onto ART as early as possible, occasionally causing women to disengage.
conclusionsProtecting the baby superseded feelings of unpreparedness for lifelong ART and may explain poor retention observed in Option B+ programmes. Women may benefit from more time to accept their status, and counselling on the long-term value of ART beyond the pregnancy and breastfeeding period. Strategies to promote readiness for same-day initiation of lifelong treatment are urgently needed, and may provide important lessons for universal test-and-treat implementation.
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