Cargando…
Optimal utilization of prevention of mother-to-child transmission of HIV services among adolescents under group versus focused antenatal care in Eastern Uganda
BACKGROUND: Group antenatal care (G-ANC), an alternative to focused ANC (F-ANC), involves grouping mothers by gestational and maternal age. In high-income countries, G-ANC has been associated with improved utilization of health care services like Prevention of Mother to Child Transmission (PMTCT) of...
Autores principales: | , , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2022
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9624396/ https://www.ncbi.nlm.nih.gov/pubmed/36318523 http://dx.doi.org/10.1371/journal.pone.0275905 |
_version_ | 1784822226274484224 |
---|---|
author | Akunzirwe, Rebecca Bakeera-Kitaka, Sabrina Kalyango, Joan N. Zalwango, Jane Frances Ssemasaazi, Judith Amutuhaire Okello, Tom Buhuguru, Remmy Kiguli, Sarah Mubuuke, Aloysius G. Ononge, Sam |
author_facet | Akunzirwe, Rebecca Bakeera-Kitaka, Sabrina Kalyango, Joan N. Zalwango, Jane Frances Ssemasaazi, Judith Amutuhaire Okello, Tom Buhuguru, Remmy Kiguli, Sarah Mubuuke, Aloysius G. Ononge, Sam |
author_sort | Akunzirwe, Rebecca |
collection | PubMed |
description | BACKGROUND: Group antenatal care (G-ANC), an alternative to focused ANC (F-ANC), involves grouping mothers by gestational and maternal age. In high-income countries, G-ANC has been associated with improved utilization of health care services like Prevention of Mother to Child Transmission (PMTCT) of HIV services. Some low-resource countries with poor utilization of health care services have piloted G-ANC. However, there is limited evidence of its efficiency. We, therefore, compared G-ANC versus F-ANC with regards to optimal utilization of PMTCT of HIV services and assessed associated factors thereof among adolescent mothers in eastern Uganda. We defined optimal utilization of PMTCT of HIV services as the adolescent being up to date with HIV counseling and testing. If found HIV negative, subsequent timely re-testing. If found HIV positive, initiation of antiretroviral therapy (ART) under option B plus for the mother. While for the infant, it entailed safe delivery, testing, feeding, and appropriate HIV chemotherapy. METHODS: From February to April 2020, we conducted a cross-sectional study among 528 adolescent mothers in four sites in eastern Uganda. We assessed the optimal utilization of PMTCT of HIV services among adolescent mothers that had attended G-ANC versus F-ANC at the post-natal care or immunization clinics. We also assessed the factors associated with optimal utilization of PMTCT of HIV services among these mothers. RESULTS: Optimal utilization of PMTCT was higher among those in G-ANC than in F-ANC (74.7% vs 41.2, p-0.0162). There was a statistically significant association between having attended G-ANC and optimal utilization of PMTCT [PR = 1.080, 95%CI (1.067–1.093)]. Other factors independently associated with optimal utilization were; having a partner that tested for HIV [PR = 1.075, 95%CI (1.048–1.103)], trimester of first ANC visit: second trimester [PR = 0.929, 95%CI (0.902–0.957)] and third trimester [PR = 0.725, 95%CI (0.616–0.853)], and the health facility attended: Bugembe HCIV [PR = 1.126, 95%CI (1.113–1.139)] and Jinja regional referral hospital [PR = 0.851, 95%CI (0.841–0.861] CONCLUSIONS: Adolescent mothers under G-ANC had significantly higher optimal utilization of PMTCT of HIV services compared to those under F-ANC. We recommend that the Ministry of Health considers widely implementing G-ANC, especially for adolescent mothers. |
format | Online Article Text |
id | pubmed-9624396 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-96243962022-11-02 Optimal utilization of prevention of mother-to-child transmission of HIV services among adolescents under group versus focused antenatal care in Eastern Uganda Akunzirwe, Rebecca Bakeera-Kitaka, Sabrina Kalyango, Joan N. Zalwango, Jane Frances Ssemasaazi, Judith Amutuhaire Okello, Tom Buhuguru, Remmy Kiguli, Sarah Mubuuke, Aloysius G. Ononge, Sam PLoS One Research Article BACKGROUND: Group antenatal care (G-ANC), an alternative to focused ANC (F-ANC), involves grouping mothers by gestational and maternal age. In high-income countries, G-ANC has been associated with improved utilization of health care services like Prevention of Mother to Child Transmission (PMTCT) of HIV services. Some low-resource countries with poor utilization of health care services have piloted G-ANC. However, there is limited evidence of its efficiency. We, therefore, compared G-ANC versus F-ANC with regards to optimal utilization of PMTCT of HIV services and assessed associated factors thereof among adolescent mothers in eastern Uganda. We defined optimal utilization of PMTCT of HIV services as the adolescent being up to date with HIV counseling and testing. If found HIV negative, subsequent timely re-testing. If found HIV positive, initiation of antiretroviral therapy (ART) under option B plus for the mother. While for the infant, it entailed safe delivery, testing, feeding, and appropriate HIV chemotherapy. METHODS: From February to April 2020, we conducted a cross-sectional study among 528 adolescent mothers in four sites in eastern Uganda. We assessed the optimal utilization of PMTCT of HIV services among adolescent mothers that had attended G-ANC versus F-ANC at the post-natal care or immunization clinics. We also assessed the factors associated with optimal utilization of PMTCT of HIV services among these mothers. RESULTS: Optimal utilization of PMTCT was higher among those in G-ANC than in F-ANC (74.7% vs 41.2, p-0.0162). There was a statistically significant association between having attended G-ANC and optimal utilization of PMTCT [PR = 1.080, 95%CI (1.067–1.093)]. Other factors independently associated with optimal utilization were; having a partner that tested for HIV [PR = 1.075, 95%CI (1.048–1.103)], trimester of first ANC visit: second trimester [PR = 0.929, 95%CI (0.902–0.957)] and third trimester [PR = 0.725, 95%CI (0.616–0.853)], and the health facility attended: Bugembe HCIV [PR = 1.126, 95%CI (1.113–1.139)] and Jinja regional referral hospital [PR = 0.851, 95%CI (0.841–0.861] CONCLUSIONS: Adolescent mothers under G-ANC had significantly higher optimal utilization of PMTCT of HIV services compared to those under F-ANC. We recommend that the Ministry of Health considers widely implementing G-ANC, especially for adolescent mothers. Public Library of Science 2022-11-01 /pmc/articles/PMC9624396/ /pubmed/36318523 http://dx.doi.org/10.1371/journal.pone.0275905 Text en © 2022 Akunzirwe et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Research Article Akunzirwe, Rebecca Bakeera-Kitaka, Sabrina Kalyango, Joan N. Zalwango, Jane Frances Ssemasaazi, Judith Amutuhaire Okello, Tom Buhuguru, Remmy Kiguli, Sarah Mubuuke, Aloysius G. Ononge, Sam Optimal utilization of prevention of mother-to-child transmission of HIV services among adolescents under group versus focused antenatal care in Eastern Uganda |
title | Optimal utilization of prevention of mother-to-child transmission of HIV services among adolescents under group versus focused antenatal care in Eastern Uganda |
title_full | Optimal utilization of prevention of mother-to-child transmission of HIV services among adolescents under group versus focused antenatal care in Eastern Uganda |
title_fullStr | Optimal utilization of prevention of mother-to-child transmission of HIV services among adolescents under group versus focused antenatal care in Eastern Uganda |
title_full_unstemmed | Optimal utilization of prevention of mother-to-child transmission of HIV services among adolescents under group versus focused antenatal care in Eastern Uganda |
title_short | Optimal utilization of prevention of mother-to-child transmission of HIV services among adolescents under group versus focused antenatal care in Eastern Uganda |
title_sort | optimal utilization of prevention of mother-to-child transmission of hiv services among adolescents under group versus focused antenatal care in eastern uganda |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9624396/ https://www.ncbi.nlm.nih.gov/pubmed/36318523 http://dx.doi.org/10.1371/journal.pone.0275905 |
work_keys_str_mv | AT akunzirwerebecca optimalutilizationofpreventionofmothertochildtransmissionofhivservicesamongadolescentsundergroupversusfocusedantenatalcareineasternuganda AT bakeerakitakasabrina optimalutilizationofpreventionofmothertochildtransmissionofhivservicesamongadolescentsundergroupversusfocusedantenatalcareineasternuganda AT kalyangojoann optimalutilizationofpreventionofmothertochildtransmissionofhivservicesamongadolescentsundergroupversusfocusedantenatalcareineasternuganda AT zalwangojanefrances optimalutilizationofpreventionofmothertochildtransmissionofhivservicesamongadolescentsundergroupversusfocusedantenatalcareineasternuganda AT ssemasaazijudithamutuhaire optimalutilizationofpreventionofmothertochildtransmissionofhivservicesamongadolescentsundergroupversusfocusedantenatalcareineasternuganda AT okellotom optimalutilizationofpreventionofmothertochildtransmissionofhivservicesamongadolescentsundergroupversusfocusedantenatalcareineasternuganda AT buhugururemmy optimalutilizationofpreventionofmothertochildtransmissionofhivservicesamongadolescentsundergroupversusfocusedantenatalcareineasternuganda AT kigulisarah optimalutilizationofpreventionofmothertochildtransmissionofhivservicesamongadolescentsundergroupversusfocusedantenatalcareineasternuganda AT mubuukealoysiusg optimalutilizationofpreventionofmothertochildtransmissionofhivservicesamongadolescentsundergroupversusfocusedantenatalcareineasternuganda AT onongesam optimalutilizationofpreventionofmothertochildtransmissionofhivservicesamongadolescentsundergroupversusfocusedantenatalcareineasternuganda |