Abstract
Of the estimated 2.1 million new HIV infections in 2015, about
150,000 were in infants and children. Most occurred in sub-Saharan
Africa and were a result of Mother-to-Child-Transmission (MTCT).
MTCT can occur during pregnancy, at childbirth or through
breastfeeding, but methods for Prevention of
Mother-to-Child-Transmission (PMTCT) exist. However, information
and recommendations regarding breastfeeding and biomedical drugs
for PMTCT have changed over time. This study looks longitudinally
to understand how sub-Saharan African youth make sense of MTCT and
PMTCT in the context of changing recommendations. It also examines
how they represent barriers to PMTCT. Thematic analysis was
conducted on 47 written narratives submitted to the Global
Dialogues scriptwriting competitions by youth 10-24 years of age
from Burkina Faso, Kenya, South-East Nigeria, Senegal and Swaziland
in 1997, 2005, and 2014. PMTCT barriers identified in the
narratives include stigma in the form of mistreatment and lack of
support, not knowing one's HIV status, not accessing appropriate
medical care during childbirth, lack of monetary means, and
disclosure of HIV status. PMTCT facilitators include support from
family members and friends, HIV testing, knowledge of HIV status,
accessing and receiving proper medical care, receiving counseling
about HIV/AIDS from health professionals, and mothers' fear of
MTCT. 2014 narratives discussing breastfeeding state HIV positive
mothers should not breastfeed yet 2010 WHO recommendations
encouraged exclusive breastfeeding even if ARVs were not available
for PMTCT. EGPAF, UNAIDS and PEPFAR work towards eliminating
pediatric AIDS and new HIV infections among children. Programs
supported by these organizations particularly focus on improving
access to PMTCT services. Findings from this study demonstrate it
is not only about availability of PMTCT services, but also about
how the social and situational context informs mothers' abilities
to access PMTCT services. Family members, friends, and community
members should be informed about how they can contribute to PMTCT.
There is a need to prioritize addressing social contextual issues
influencing access to PMTCT services, improve communication about
PMTCT for mothers and community members, and improve how health
care workers are informed about PMTCT recommendations.
Table of Contents
TABLE OF CONTENTS
INTRODUCTION......................................................................................................1
LITERATURE
REVIEW................................................................................................5
METHODS.............................................................................................................15
RESULTS..............................................................................................................18
DISCUSSION.........................................................................................................40
CONCLUSION........................................................................................................43
PUBLIC HEALTH IMPLICATIONS &
RECOMMENDATIONS...................................................45
REFERENCES.........................................................................................................47
About this Master's Thesis
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