ArticleJournal of the International AIDS Society2018
"I will leave the baby with my mother": Long-distance travel and follow-up care among HIV-positive pregnant and postpartum women in South Africa.
Article in Journal of the International AIDS Society, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers.
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Who cites it
25 citing papers in PubMed.
- The Implementation of a GPS-Based Location-Tracking Smartphone App in South Africa to Improve Engagement in HIV Care: Randomized Controlled Trial.JMIR mHealth and uHealth · 2023Trial
- Cohort profile: CareConekta: a pilot study of a smartphone application to improve engagement in postpartum HIV care in South Africa.BMJ open · 2022Trial
- Pregnancy reporting and biases in under-five mortality in three African HDSSs.Population studies · 2025Article
- Routine Electronic Mother-Infant Data (REMInD): A proof-of-Concept Data to Care Study to Support Retention in Maternal HIV Treatment and Infant HIV Testing in Cape Town, South Africa.AIDS and behavior · 2025Article
- Guidelines for the transfer of people living with HIV attending primary healthcare facilities in South Africa: a scoping review.International health · 2025Article
- Outcomes After Loss to Follow-Up for Pregnant and Postpartum Women Living With HIV and Their Children in Kenya: A Prospective Cohort Study.Journal of acquired immune deficiency syndromes (1999) · 2024Article
- Peripartum mobility and maternal/child separation among women living with HIV in South Africa.AIDS care · 2024Article
- Mobility during the post-partum period and viraemia in women living with HIV in South Africa.International health · 2023Article
- Mobility and structural barriers in rural South Africa contribute to loss to follow up from HIV care.AIDS care · 2021Article
- Patient Transfers and Their Impact on Gaps in Clinical Care: Differences by Gender in a Large Cohort of Adults Living with HIV on Antiretroviral Therapy in South Africa.AIDS and behavior · 2021Article
- Attitudes Toward a Proposed GPS-Based Location Tracking Smartphone App for Improving Engagement in HIV Care Among Pregnant and Postpartum Women in South Africa: Focus Group and Interview Study.JMIR formative research · 2021Article
- Article
- The South African National HIV Pregnancy Cohort: evaluating continuity of care among women living with HIV.BMC public health · 2020Article
- Understanding mobility and sexual risk behaviour among women in fishing communities of Lake Victoria in East Africa: a qualitative study.BMC public health · 2020Article
- Qualitative exploration of perceived benefits of care and barriers influencing HIV care in trans Nzoia, Kenya.BMC health services research · 2020Article
- Article
- Migration and first-year maternal mortality among HIV-positive postpartum women: A population-based longitudinal study in rural South Africa.PLoS medicine · 2020Article
- "A way of escaping": a qualitative study exploring reasons for clinic transferring and its impact on engagement in care among women in Option B.AIDS care · 2020Article
- Mobility and its Effects on HIV Acquisition and Treatment Engagement: Recent Theoretical and Empirical Advances.Current HIV/AIDS reports · 2019Review
- Re-recruiting postpartum women living with HIV into a follow-up study in Cape Town, South Africa.BMC research notes · 2019Article
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Authors and funding
11 authors.
Funding
Abstract
introductionIt is common in urban African settings for postpartum women to temporarily return to family in distant settings. We sought to explore mobility among peripartum HIV-positive women to understand the timing and motivation of travel, particularly vis-à-vis delivery, and how it may affect healthcare access.
methodsUsing the same mobility measurements within three different studies, we examined long-distance travel of mother and infant before and after delivery in three diverse clinics within greater Johannesburg, South Africa (n = 150). Participants were interviewed prior to delivery at two sites (n = 125) and after delivery at one (n = 25). Quantitative and qualitative results are reported.
resultsAmong 150 women, median age was 29 years (IQR: 26 to 34) and 36.3% were employed. Overall, 76.7% of the participants were born in South Africa: 32.7% in Gauteng Province (Johannesburg area) and 44.0% in other South African provinces, but birthplace varied greatly by site. Almost half (44.0%) planned to travel around delivery; nearly all after delivery. Median duration of stay was 30 days (IQR: 24 to 90) overall, but varied from 60 days at two sites to just 7 days at another. Participants discussed travel to eight of South Africa's nine provinces and four countries. Travel most frequently was to visit family, typically to receive help with the new baby. Nearly all the employed participants planned to return to work in Johannesburg after delivery, sometimes leaving the infant in the care of family outside of Johannesburg. All expressed their intent to continue HIV care for themselves and their infant, but few planned to seek care at the destination site, and care for the infant was emphasized over care for the mother.
conclusionsWe identified frequent travel in the peripartum period with substantial differences in travel patterns by site. Participants more frequently discussed seeking care for the infant than for themselves. HIV-exposed children often were left in the care of family members in distant areas. Our results show the frequent mobility of women and infants in the peripartum period. This underscores the challenge of ensuring a continuity of HIV care in a fragmented healthcare system that is not adapted for a mobile population.
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