Reducing Pmtct Attrition: Perspectives of Hiv+ Women on the Prevention of Mother-to-child Hiv Services in Addis Ababa, Ethiopia.

BACKGROUND Only 41% of eligible Ethiopian women completed (PMTCT) therapy in 2012, with MTCT rate of 20%. OBJECTIVE This study elicited the perspectives of HIV positive mothers on the situation and the unique beliefs, attitudes, cultural norms and individuals who have influence over them during their pregnancy. METHODS The mixed-methods parent study included community level surveys, focus groups and in-depth individual interviews of HIV positive women with a child at least one year of age in Addis Ababa, Ethiopia: only focus group and interview data are presented here. All tools were completed in Amharic with English translation. RESULTS 23 women completed in-depth interviews; 27 participated within 4 focus groups. The greatest barriers to PMTCT completion were: feelings of hopelessness and carelessness, lack of understanding of the efficacy of ARV, and negative religious influences. The advice to improve PMTCT adherence most frequently offered included increasing PLWHIV peer support and improving and extending current HIV educational efforts. Participants recommended that PLWHIV mothers be utilized in all PMTCT planning and interventions in the future. CONCLUSION Maintaining the motivation to adhere to the entire PMTCT cascade requires that a PLWHIV mother understands the validity of the steps she is taking and receives support for the many challenges she faces. Engaging PLWHIV peers as active members of the health care workforce and expanding their use as educators and counselors is important. Health officials can consider these findings to develop innovative and effective PMTCT interventions.