title: Women's reasons for not participating in follow up visits before starting short course antiretroviral prophylaxis for prevention of mother to child transmission of HIV: qualitative interview study.
abstract: OBJECTIVE
  To find out why pregnant women who receive HIV-1 positive test results and are offered short course antiretroviral prophylaxis to prevent transmission of HIV from mother to child do not participate in necessary follow up visits before starting prophylaxis.
  
  
  METHODS
  Qualitative interview study.
  
  
  METHODS
  A programme aiming to prevent transmission of HIV from mother to child at a public antenatal clinic in Abidjan, Côte d'Ivoire.
  
  
  METHODS
  Purposive sample of 27 women who had received HIV-1 positive test results and were invited to return for monthly follow up visits before starting prophylaxis with zidovudine at 36 weeks' gestation, but who had either refused or discontinued the visits. None of the women started prophylaxis.
  
  
  RESULTS
  Most of the women explained their non-participation in follow up visits by referring to negative experiences that they had had while interacting with programme staff or to their views about the programme. Additional reasons concerned their disbelief of HIV positive test results and personal factors.
  
  
  CONCLUSIONS
  Difficulties experienced by women during their contacts with staff working on the prevention programme and negative views that they have about the programme can contribute to their non-participation in prophylaxis. Training and supervision of programme staff may increase the likelihood of positive interactions between staff and clients, thereby facilitating women's participation in preventing transmission of HIV from mother to child. Outreach and mobilisation in communities that are served by prevention programmes may complement these measures at programme level by contributing to increased social support for women's efforts to prevent transmission of HIV from mother to child.
authors.affiliation: Division of HIV/AIDS Prevention, National Center for HIV, STD and TB Prevention, Centers for Disease Control and Prevention, 1600 Clifton Road, NE, Mail stop E-37, Atlanta, Georgia 30333, USA. tcp2@cdc.gov
authors.forename: Thomas M
authors.initials: TM
authors.lastname: Painter
authors.forename: Kassamba L
authors.initials: KL
authors.lastname: Diaby
authors.forename: Danielle M
authors.initials: DM
authors.lastname: Matia
authors.forename: Lillian S
authors.initials: LS
authors.lastname: Lin
authors.forename: Toussaint S
authors.initials: TS
authors.lastname: Sibailly
authors.forename: Moïse K
authors.initials: MK
authors.lastname: Kouassi
authors.forename: Ehounou R
authors.initials: ER
authors.lastname: Ekpini
authors.forename: Thierry H
authors.initials: TH
authors.lastname: Roels
authors.forename: Stefan Z
authors.initials: SZ
authors.lastname: Wiktor
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D044966:Anti-Retroviral Agents / Q000627:therapeutic use; D001294:Attitude to Health; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000523:psychology / Q000635:transmission; D015497:HIV-1; D006801:Humans; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000188:drug therapy* / Q000523:psychology; D011369:Professional-Patient Relations; D016312:Treatment Refusal
chemical_list: D019380:Anti-HIV Agents; D044966:Anti-Retroviral Agents