Mothers' experiences of barriers to the elimination of mother-to-child transmission of HIV in South Africa

Abstract

The prevalence of human immunodeficiency virus (HIV) infections in pregnant South African women is one of the highest in the world. Infants born to these women risk being exposed to and vertically infected with HIV. Since early 2001, the South African National Department of Health has made concerted efforts to prevent this mother-to-child transmission (MTCT) of HIV through its programme for the Prevention of mother-to-child transmission (PMTCT), in line with World Health Organization (WHO) and UNAIDS guidelines. The PMTCT program later translated to the elimination of mother-to-child transmission as the UNAIDS and UN bodies push for achieving the targets on ending HIV. (UNAIDS,2019) However, South Africa is yet to achieve the elimination target that the WHO set in 2011. The purpose of this qualitative study was therefore to investigate HIV-positive mothers’ experiences of the EMTCT programme, and the associated barriers, in Ehlanzeni district of Mpumalanga province, South Africa. An exploratory phenomenological research design was used with a purposive sample of 13 participants. The participants were mothers aged 18–35 whose infants had seroconverted before the age of 24 months after a negative birth PCR test. Qualitative data was collected through individual interviews with open ended questions and subjected to a thematic analysis. The study showed that the guidelines are not implemented consistently to provide a comprehensive standardised service to mothers. The findings were grouped into highlighted five thematic areas compared to current policy and guidelines worldwide, namely: access to PMTCT services, experiences with disclosure and support, sexual and reproductive health, knowledge of the risks of MTCT, and proposed improvements to the EMTCT programme. The following recommendations are proposed to strengthen South Africa’s EMTCT programme: Women need to be empowered by giving them the right information and providing quality of sexual and reproductive health care. Healthcare providers should be capacitated to provide family-centered approach where men are included and encouraged to participate constructively in the sexual and reproductive health processes and decisions. More studies, quantitative and mixed method studies, need to be done to understand the subject further.