How Can the Health System Retain Women in HIV Treatment for a Lifetime? A Discrete Choice Experiment in Ethiopia and Mozambique.
INTRODUCTION:Option B+, an approach that involves provision of antiretroviral therapy (ART) to all HIV-infected pregnant women for life, is the preferred strategy for prevention of mother to child transmission of HIV. Lifelong retention in care is essential to its success. We conducted a discrete ch...
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| Format: | Article |
| Language: | English |
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Public Library of Science (PLoS)
2016-01-01
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| Series: | PLoS ONE |
| Online Access: | http://europepmc.org/articles/PMC4994936?pdf=render |
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| author | Margaret E Kruk Patricia L Riley Anton M Palma Sweta Adhikari Laurence Ahoua Carlos Arnaldo Dercio F Belo Serena Brusamento Luisa I G Cumba Eric J Dziuban Wafaa M El-Sadr Yoseph Gutema Zelalem Habtamu Thomas Heller Aklilu Kidanu Judite Langa Epifanio Mahagaja Carey F McCarthy Zenebe Melaku Daniel Shodell Fatima Tsiouris Paul R Young Miriam Rabkin |
| author_facet | Margaret E Kruk Patricia L Riley Anton M Palma Sweta Adhikari Laurence Ahoua Carlos Arnaldo Dercio F Belo Serena Brusamento Luisa I G Cumba Eric J Dziuban Wafaa M El-Sadr Yoseph Gutema Zelalem Habtamu Thomas Heller Aklilu Kidanu Judite Langa Epifanio Mahagaja Carey F McCarthy Zenebe Melaku Daniel Shodell Fatima Tsiouris Paul R Young Miriam Rabkin |
| author_sort | Margaret E Kruk |
| collection | DOAJ |
| description | INTRODUCTION:Option B+, an approach that involves provision of antiretroviral therapy (ART) to all HIV-infected pregnant women for life, is the preferred strategy for prevention of mother to child transmission of HIV. Lifelong retention in care is essential to its success. We conducted a discrete choice experiment in Ethiopia and Mozambique to identify health system characteristics preferred by HIV-infected women to promote continuity of care. METHODS:Women living with HIV and receiving care at hospitals in Oromia Region, Ethiopia and Zambézia Province, Mozambique were shown nine choice cards and asked to select one of two hypothetical health facilities, each with six varying characteristics related to the delivery of HIV services for long term treatment. Mixed logit models were used to estimate the influence of six health service attributes on choice of clinics. RESULTS:2,033 women participated in the study (response rate 97.8% in Ethiopia and 94.7% in Mozambique). Among the various attributes of structure and content of lifelong ART services, the most important attributes identified in both countries were respectful provider attitude and ability to obtain non-HIV health services during HIV-related visits. Availability of counseling support services was also a driver of choice. Facility type, i.e., hospital versus health center, was substantially less important. CONCLUSIONS:Efforts to enhance retention in HIV care and treatment for pregnant women should focus on promoting respectful care by providers and integrating access to non-HIV health services in the same visit, as well as continuing to strengthen counseling. |
| first_indexed | 2024-12-19T10:30:24Z |
| format | Article |
| id | doaj.art-57d7e7a9edf3484face432e78e685b35 |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-12-19T10:30:24Z |
| publishDate | 2016-01-01 |
| publisher | Public Library of Science (PLoS) |
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| series | PLoS ONE |
| spelling | doaj.art-57d7e7a9edf3484face432e78e685b352022-12-21T20:25:46ZengPublic Library of Science (PLoS)PLoS ONE1932-62032016-01-01118e016076410.1371/journal.pone.0160764How Can the Health System Retain Women in HIV Treatment for a Lifetime? A Discrete Choice Experiment in Ethiopia and Mozambique.Margaret E KrukPatricia L RileyAnton M PalmaSweta AdhikariLaurence AhouaCarlos ArnaldoDercio F BeloSerena BrusamentoLuisa I G CumbaEric J DziubanWafaa M El-SadrYoseph GutemaZelalem HabtamuThomas HellerAklilu KidanuJudite LangaEpifanio MahagajaCarey F McCarthyZenebe MelakuDaniel ShodellFatima TsiourisPaul R YoungMiriam RabkinINTRODUCTION:Option B+, an approach that involves provision of antiretroviral therapy (ART) to all HIV-infected pregnant women for life, is the preferred strategy for prevention of mother to child transmission of HIV. Lifelong retention in care is essential to its success. We conducted a discrete choice experiment in Ethiopia and Mozambique to identify health system characteristics preferred by HIV-infected women to promote continuity of care. METHODS:Women living with HIV and receiving care at hospitals in Oromia Region, Ethiopia and Zambézia Province, Mozambique were shown nine choice cards and asked to select one of two hypothetical health facilities, each with six varying characteristics related to the delivery of HIV services for long term treatment. Mixed logit models were used to estimate the influence of six health service attributes on choice of clinics. RESULTS:2,033 women participated in the study (response rate 97.8% in Ethiopia and 94.7% in Mozambique). Among the various attributes of structure and content of lifelong ART services, the most important attributes identified in both countries were respectful provider attitude and ability to obtain non-HIV health services during HIV-related visits. Availability of counseling support services was also a driver of choice. Facility type, i.e., hospital versus health center, was substantially less important. CONCLUSIONS:Efforts to enhance retention in HIV care and treatment for pregnant women should focus on promoting respectful care by providers and integrating access to non-HIV health services in the same visit, as well as continuing to strengthen counseling.http://europepmc.org/articles/PMC4994936?pdf=render |
| spellingShingle | Margaret E Kruk Patricia L Riley Anton M Palma Sweta Adhikari Laurence Ahoua Carlos Arnaldo Dercio F Belo Serena Brusamento Luisa I G Cumba Eric J Dziuban Wafaa M El-Sadr Yoseph Gutema Zelalem Habtamu Thomas Heller Aklilu Kidanu Judite Langa Epifanio Mahagaja Carey F McCarthy Zenebe Melaku Daniel Shodell Fatima Tsiouris Paul R Young Miriam Rabkin How Can the Health System Retain Women in HIV Treatment for a Lifetime? A Discrete Choice Experiment in Ethiopia and Mozambique. PLoS ONE |
| title | How Can the Health System Retain Women in HIV Treatment for a Lifetime? A Discrete Choice Experiment in Ethiopia and Mozambique. |
| title_full | How Can the Health System Retain Women in HIV Treatment for a Lifetime? A Discrete Choice Experiment in Ethiopia and Mozambique. |
| title_fullStr | How Can the Health System Retain Women in HIV Treatment for a Lifetime? A Discrete Choice Experiment in Ethiopia and Mozambique. |
| title_full_unstemmed | How Can the Health System Retain Women in HIV Treatment for a Lifetime? A Discrete Choice Experiment in Ethiopia and Mozambique. |
| title_short | How Can the Health System Retain Women in HIV Treatment for a Lifetime? A Discrete Choice Experiment in Ethiopia and Mozambique. |
| title_sort | how can the health system retain women in hiv treatment for a lifetime a discrete choice experiment in ethiopia and mozambique |
| url | http://europepmc.org/articles/PMC4994936?pdf=render |
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