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Open Access 01-12-2018 | Research article

Experiences of HIV-positive postpartum women and health workers involved with community-based antiretroviral therapy adherence clubs in Cape Town, South Africa

Authors: Zara Trafford, Yolanda Gomba, Christopher J. Colvin, Victoria O. Iyun, Tamsin K. Phillips, Kirsty Brittain, Landon Myer, Elaine J. Abrams, Allison Zerbe

Published in: BMC Public Health | Issue 1/2018

Abstract

Background

The rollout of universal, lifelong treatment for all HIV-positive pregnant and breastfeeding women (“Option B+”) has rapidly increased the number of women initiating antiretroviral treatment (ART) and requiring ART care postpartum. In a pilot project in South Africa, eligible postpartum women were offered the choice of referral to the standard of care, a local primary health care clinic, or a community-based model of differentiated ART services, the adherence club (AC). ACs have typically enrolled only non-pregnant and non-postpartum adults; postpartum women had not previously been referred directly from antenatal care. There is little evidence regarding postpartum women’s preferences for and experiences of differentiated models of care, or the capacity of this particular model to cater to their specific needs. This qualitative paper reports on feedback from both postpartum women and health workers who care for them on their respective experiences of the AC.

Methods

One-on-one in-depth qualitative interviews were conducted with 19 (23%) of the 84 postpartum women who selected the AC and were retained at approximately 12 months postpartum, and 9 health workers who staff the AC. Data were transcribed and thematically analysed using NVivo 11.

Results

Postpartum women’s inclusion in the AC was acceptable for both participants and health workers. Health workers were welcoming of postpartum women but expressed concerns about prospects for longer term adherence and retention, and raised logistical issues they felt might compromise trust with AC members in general.

Conclusions

Enrolling postpartum women in mixed groups with the general adult population is feasible and acceptable. Preliminary recommendations are offered and may assist in supporting the specific needs of postpartum women transitioning from antenatal ART care.

Trial registration

Number NCT02417675 clinicaltrials.gov/ct2/show/record/NCT02417675 (retrospective reg.)

Due to the continued risk of MTCT during breastfeeding, one of the sub-objectives of the core quantitative study was to investigate maternal viral suppression before, during and after breastfeeding. The quantitative cohort thus comprised breastfeeding women, and our sample for qualitative research was drawn from the larger cohort.

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Title: Experiences of HIV-positive postpartum women and health workers involved with community-based antiretroviral therapy adherence clubs in Cape Town, South Africa
Authors: Zara Trafford
Yolanda Gomba
Christopher J. Colvin
Victoria O. Iyun
Tamsin K. Phillips
Kirsty Brittain
Landon Myer
Elaine J. Abrams
Allison Zerbe
Publication date: 01-12-2018
Publisher: BioMed Central
Published in: BMC Public Health / Issue 1/2018
Electronic ISSN: 1471-2458
DOI: https://doi.org/10.1186/s12889-018-5836-4

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Experiences of HIV-positive postpartum women and health workers involved with community-based antiretroviral therapy adherence clubs in Cape Town, South Africa

Abstract

Background

Methods

Results

Conclusions

Trial registration

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Trial registration

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