Making Sense of Mother-to-Child Transmission(MTCT)and Prevention of Mother-to-Child Transmission (PMTCT) of HIV: Social Representations in Written Narratives by African Youth from Five Countries in 1997, 2005, and 2014 Public

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

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School	Rollins School of Public Health
Department	Hubert Department of Global Health
Degree	MPH
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Public Health
Mot-clé	Social representations PMTCT Maternal and child health MTCT HIV/AIDS
Committee Chair / Thesis Advisor	Winskell Enger, Kate, Emory University
Committee Members	Sabben, Gaelle L., Emory University Singleton, Robyn , Emory University
Partnering Agencies	Emory University schools, faculty or affiliated programs

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