title: Qualitative assessment of the integration of HIV services with infant routine immunization visits in Tanzania.
abstract: BACKGROUND
  In 2009, a project was implemented in 8 primary health clinics throughout Tanzania to explore the feasibility of integrating pediatric HIV prevention services with routine infant immunization visits.
  
  
  METHODS
  We conducted interviews with 64 conveniently sampled mothers of infants who had received integrated HIV and immunization services and 16 providers who delivered the integrated services to qualitatively identify benefits and challenges of the intervention midway through project implementation.
  
  
  RESULTS
  Mothers' perceived benefits of the integrated services included time savings, opportunity to learn their child's HIV status and receive HIV treatment, if necessary. Providers' perceived benefits included reaching mothers who usually would not come for only HIV testing. Mothers and providers reported similar challenges, including mothers' fear of HIV testing, poor spousal support, perceived mandatory HIV testing, poor patient flow affecting confidentiality of service delivery, heavier provider workloads, and community stigma against HIV-infected persons; the latter a more frequent theme in rural compared with urban locations.
  
  
  CONCLUSIONS
  Future scale-up should ensure privacy of these integrated services received at clinics and community outreach to address stigma and perceived mandatory testing. Increasing human resources for health to address higher workloads and longer waiting times for proper patient flow is necessary in the long term.
authors: *Global Immunization Division, Centers for Disease Control and Prevention, Atlanta, GA; †Division of Global HIV/AIDS, Centers for Disease Control and Prevention, Dar es Salaam, Tanzania; ‡Expanded Programme on Immunizations, Ministry of Health and Social Welfare, Dar es Salaam, Tanzania; §Reproductive Child Health Services, Ministry of Health and Social Welfare, Dar es Salaam, Tanzania; ‖National AIDS Control Programme, Ministry of Health and Social Welfare, Dar es Salaam, Tanzania; and ¶Elizabeth Glaser Pediatric AIDS Foundation, Dar es Salaam, Tanzania.
authors: Aaron
authors: A
authors: Wallace
authors: Sajida
authors: S
authors: Kimambo
authors: Lyimo
authors: L
authors: Dafrossa
authors: Neema
authors: N
authors: Rusibamayila
authors: Anath
authors: A
authors: Rwebembera
authors: Juma
authors: J
authors: Songoro
authors: Gilly
authors: G
authors: Arthur
authors: Elizabeth
authors: E
authors: Luman
authors: Thomas
authors: T
authors: Finkbeiner
authors: James L
authors: JL
authors: Goodson
mesh_terms: D019033:Delivery of Health Care, Integrated / Q000458:organization & administration*; D015658:HIV Infections / Q000175:diagnosis* / Q000517:prevention & control*; D006801:Humans; D007115:Immunization Schedule; D007223:Infant; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control*; D007407:Interviews as Topic; D009035:Mothers; D013636:Tanzania