Factors contributing to low follow–up of babies born to HIV positive mothers

Abstract

Since the implementation of the prevention of mother–to–child transmission of HIV program in South Africa in 2001, infant deaths due to HIV and AIDS have still remained high. HIV–exposed infants need to be taken for follow–up, schedule at six weeks, for PCR HIV testing. When the infant is found to be HIV–positive, the antiretroviral treatment is commenced for life (DOH, 2010). This benefits them in that the earlier they start treatment, the higher their quality of life and their life expectancy will be. Health workers face a problem in that there are still mothers of HIV–exposed infants who do not return their babies for the 6 weeks of age follow–up schedule and their babies therefore do not benefit from the treatment and care. The study looked at the reasons for the low follow–up of babies born to HIV–positive mothers according to HIV–positive mothers and nurses and counsellors and what strategies can be used by nurses and counsellors to encourage the mothers to bring their babies for follow–up. To answer these questions, qualitative, exploratory and contextual design was used. Purposive sampling was done with participants who had knowledge about the research problem. HIV–positive mothers were individually interviewed and nurses and counsellors were interviewed in a focus group. Five individual interviews and three focus group interviews were conducted. The focus groups were interviewed twice for each question mentioned. Responses were satisfactory with the following categories emerging from the findings: fear about disclosure, denial of status, insufficient knowledge about HIV, accusations about who is the actual “giver” of HIV and incongruent health education on HIV and AIDS and the management thereof in the case of babies with HIV, with specific reference to incorrect and/or insufficient information. Recommendations are made concerning these issues, so as to effect an increase in the follow–up of babies born to HIV–positive mothers.