Dynamics and Constraints of Early Infant Diagnosis of HIV Infection in Rural Kenya

• Published in: AIDS and behavior Vol. 16; no. 1; pp. 5 - 12
• Main Authors: Hassan, Amin S., Sakwa, Erick M., Nabwera, Helen M., Taegtmeyer, Miriam M., Kimutai, Robert M., Sanders, Eduard J., Awuondo, Ken K., Mutinda, Maureen N., Molyneux, Catherine S., Berkley, James A.
• Format: Journal Article
• Language: English
• Published: Boston Springer US 01.01.2012; Springer Nature B.V
• Subjects: Acquired Immune Deficiency Syndrome; Adult; Attitudes; Babies; Cohort Studies; Early Diagnosis; Elderly; Female; Follow-Up Studies; Health Care Services; Health Knowledge, Attitudes, Practice; Health Psychology; Health Services Accessibility; HIV; HIV Infections - diagnosis; HIV-1 - isolation & purification; Human immunodeficiency virus; Humans; Infant; Infant, Newborn; Infants; Infectious Disease Transmission, Vertical - prevention & control; Infectious Diseases; Interviews as Topic; Kenya; Knowledge; Male; Maternal Age; Medical screening; Medicine; Medicine & Public Health; Mothers; Original Paper; Polymerase Chain Reaction; Public Health; Rural Areas; Rural Population; Social Support; Socioeconomic Factors; Kenya; Vertical transmission; Prevention of mother to child transmission; PCR; Infant diagnosis; Retention in care
• ISSN: 1090-7165; 1573-3254
• DOI: 10.1007/s10461-010-9877-7

A cohort design was used to determine uptake and drop out of 213 HIV-exposed infants eligible for Early Infant Diagnosis (EID) of HIV. To explore service providers and care givers knowledge, attitudes and perceptions of the EID process, observations and in-depth interviews were conducted. 145 (68%) infants enrolled after 2 months of age. 139 (65%) dropped out before follow up to 18 months old. 60 (43%) drop outs occurred within 2 months of enrolment. Maternal factors associated with infant drop out were maternal loss to follow up (48 [68%] vs. 8 [20%], P  < 0.001) and younger maternal age (27.2 vs. 30.1 years, P  = 0.033). Service providers and caregivers had inadequate training, knowledge and understanding of EID. Poverty and lack of social support were challenges in accessing EID services. EID should be more closely aligned within PMTCT services, integrated with routine mother and child health (MCH) activities and its implementation more closely monitored.