Acceptability and challenges of rapid ART initiation among pregnant women in a pilot programme, Cape Town, South Africa.
Identifieur interne : 002473 ( Ncbi/Curation ); précédent : 002472; suivant : 002474Acceptability and challenges of rapid ART initiation among pregnant women in a pilot programme, Cape Town, South Africa.
Auteurs : Samantha Black [Afrique du Sud] ; Rose Zulliger ; Rebecca Marcus ; Daniella Mark ; Landon Myer ; Linda-Gail BekkerSource :
- AIDS care [ 1360-0451 ] ; 2014.
Descripteurs français
- KwdFr :
- Acceptation des soins par le patient, Adulte, Agents antiVIH (administration et posologie), Assistance, Complications de la grossesse et maladies infectieuses (traitement médicamenteux), Facteurs socioéconomiques, Facteurs temps, Femelle, Grossesse, Humains, Infections à VIH (traitement médicamenteux), Infections à VIH (transmission), Jeune adulte, Numération des lymphocytes CD4, Prise en charge prénatale (organisation et administration), Projets pilotes, République d'Afrique du Sud, Résultat thérapeutique, Transmission verticale de maladie infectieuse ().
- MESH :
- administration et posologie : Agents antiVIH.
- organisation et administration : Prise en charge prénatale.
- traitement médicamenteux : Complications de la grossesse et maladies infectieuses, Infections à VIH.
- Acceptation des soins par le patient, Adulte, Assistance, Facteurs socioéconomiques, Facteurs temps, Femelle, Grossesse, Humains, Infections à VIH, Jeune adulte, Numération des lymphocytes CD4, Projets pilotes, République d'Afrique du Sud, Résultat thérapeutique, Transmission verticale de maladie infectieuse.
- Wicri :
- geographic : Afrique du Sud.
English descriptors
- KwdEn :
- Adult, Anti-HIV Agents (administration & dosage), CD4 Lymphocyte Count, Counseling, Female, HIV Infections (drug therapy), HIV Infections (transmission), Humans, Infectious Disease Transmission, Vertical (prevention & control), Patient Acceptance of Health Care, Pilot Projects, Pregnancy, Pregnancy Complications, Infectious (drug therapy), Prenatal Care (organization & administration), Socioeconomic Factors, South Africa, Time Factors, Treatment Outcome, Young Adult.
- MESH :
- chemical , administration & dosage : Anti-HIV Agents.
- geographic : South Africa.
- drug therapy : HIV Infections, Pregnancy Complications, Infectious.
- organization & administration : Prenatal Care.
- prevention & control : Infectious Disease Transmission, Vertical.
- transmission : HIV Infections.
- Adult, CD4 Lymphocyte Count, Counseling, Female, Humans, Patient Acceptance of Health Care, Pilot Projects, Pregnancy, Socioeconomic Factors, Time Factors, Treatment Outcome, Young Adult.
Abstract
Maternal antiretroviral therapy (ART) is a critical intervention in the prevention-of-mother-to child transmission (PMTCT) of HIV. In South Africa, many HIV-infected pregnant women commence ART late in pregnancy, and as a result, the duration of ART prior to delivery is often insufficient to prevent vertical transmission. To address this, we designed an intervention for the rapid initiation of ART in pregnancy (RAP), where patient's ART preparation occurred during rather than before treatment commencement. Here we report on the acceptability and the challenges of the RAP programme. We conducted 7 key informant and 27 semi-structured interviews with RAP participants. Participants were purposefully selected based on ART-eligibility and stage in the pregnancy to post-partum continuum. Interviews were conducted in participants' home language by trained fieldworkers, with key informant interviews conducted by the study investigators. The data were analysed using a framework analysis approach. Rapid initiation in pregnancy was acceptable to the majority of programme participants and protection of the woman's unborn child was the primary motivation for starting treatment. The key barrier was the limited time to accept the dual challenges of being diagnosed HIV-positive and eligible for life-long ART. Truncated time also limited the opportunity for disclosure to others. Despite these and other barriers, most women found the benefits of rapid ART commencement outweighed the challenges, with 91% of women initiated onto ART starting the same day treatment eligibility was determined. Many participants and key informants identified the importance of counseling and the need to make an informed, independent choice on the timing of ART initiation, based on individual circumstances. Acceptance of ART-eligibility improved with time on the programme, however, as women's principal reason for initiating ART was protection of the unborn child, monitoring and supporting adherence during the post-partum period will be critical.
DOI: 10.1080/09540121.2013.855300
PubMed: 24200029
Links toward previous steps (curation, corpus...)
- to stream PubMed, to step Corpus: Pour aller vers cette notice dans l'étape Curation :001405
- to stream PubMed, to step Curation: Pour aller vers cette notice dans l'étape Curation :001405
- to stream PubMed, to step Checkpoint: Pour aller vers cette notice dans l'étape Curation :001405
- to stream Ncbi, to step Merge: Pour aller vers cette notice dans l'étape Curation :002473
Links to Exploration step
pubmed:24200029Le document en format XML
<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Acceptability and challenges of rapid ART initiation among pregnant women in a pilot programme, Cape Town, South Africa.</title><author><name sortKey="Black, Samantha" sort="Black, Samantha" uniqKey="Black S" first="Samantha" last="Black">Samantha Black</name><affiliation wicri:level="1"><nlm:affiliation>a Desmond Tutu HIV Centre, Institute of Infectious Diseases & Molecular Medicine , University of Cape Town , Cape Town , South Africa.</nlm:affiliation><country xml:lang="fr">Afrique du Sud</country><wicri:regionArea>a Desmond Tutu HIV Centre, Institute of Infectious Diseases & Molecular Medicine , University of Cape Town , Cape Town </wicri:regionArea><wicri:noRegion>Cape Town </wicri:noRegion></affiliation></author><author><name sortKey="Zulliger, Rose" sort="Zulliger, Rose" uniqKey="Zulliger R" first="Rose" last="Zulliger">Rose Zulliger</name></author><author><name sortKey="Marcus, Rebecca" sort="Marcus, Rebecca" uniqKey="Marcus R" first="Rebecca" last="Marcus">Rebecca Marcus</name></author><author><name sortKey="Mark, Daniella" sort="Mark, Daniella" uniqKey="Mark D" first="Daniella" last="Mark">Daniella Mark</name></author><author><name sortKey="Myer, Landon" sort="Myer, Landon" uniqKey="Myer L" first="Landon" last="Myer">Landon Myer</name></author><author><name sortKey="Bekker, Linda Gail" sort="Bekker, Linda Gail" uniqKey="Bekker L" first="Linda-Gail" last="Bekker">Linda-Gail Bekker</name></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2014">2014</date><idno type="RBID">pubmed:24200029</idno><idno type="pmid">24200029</idno><idno type="doi">10.1080/09540121.2013.855300</idno><idno type="wicri:Area/PubMed/Corpus">001405</idno><idno type="wicri:explorRef" wicri:stream="PubMed" wicri:step="Corpus" wicri:corpus="PubMed">001405</idno><idno type="wicri:Area/PubMed/Curation">001405</idno><idno type="wicri:explorRef" wicri:stream="PubMed" wicri:step="Curation">001405</idno><idno type="wicri:Area/PubMed/Checkpoint">001405</idno><idno type="wicri:explorRef" wicri:stream="Checkpoint" wicri:step="PubMed">001405</idno><idno type="wicri:Area/Ncbi/Merge">002473</idno><idno type="wicri:Area/Ncbi/Curation">002473</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Acceptability and challenges of rapid ART initiation among pregnant women in a pilot programme, Cape Town, South Africa.</title><author><name sortKey="Black, Samantha" sort="Black, Samantha" uniqKey="Black S" first="Samantha" last="Black">Samantha Black</name><affiliation wicri:level="1"><nlm:affiliation>a Desmond Tutu HIV Centre, Institute of Infectious Diseases & Molecular Medicine , University of Cape Town , Cape Town , South Africa.</nlm:affiliation><country xml:lang="fr">Afrique du Sud</country><wicri:regionArea>a Desmond Tutu HIV Centre, Institute of Infectious Diseases & Molecular Medicine , University of Cape Town , Cape Town </wicri:regionArea><wicri:noRegion>Cape Town </wicri:noRegion></affiliation></author><author><name sortKey="Zulliger, Rose" sort="Zulliger, Rose" uniqKey="Zulliger R" first="Rose" last="Zulliger">Rose Zulliger</name></author><author><name sortKey="Marcus, Rebecca" sort="Marcus, Rebecca" uniqKey="Marcus R" first="Rebecca" last="Marcus">Rebecca Marcus</name></author><author><name sortKey="Mark, Daniella" sort="Mark, Daniella" uniqKey="Mark D" first="Daniella" last="Mark">Daniella Mark</name></author><author><name sortKey="Myer, Landon" sort="Myer, Landon" uniqKey="Myer L" first="Landon" last="Myer">Landon Myer</name></author><author><name sortKey="Bekker, Linda Gail" sort="Bekker, Linda Gail" uniqKey="Bekker L" first="Linda-Gail" last="Bekker">Linda-Gail Bekker</name></author></analytic><series><title level="j">AIDS care</title><idno type="eISSN">1360-0451</idno><imprint><date when="2014" type="published">2014</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adult</term><term>Anti-HIV Agents (administration & dosage)</term><term>CD4 Lymphocyte Count</term><term>Counseling</term><term>Female</term><term>HIV Infections (drug therapy)</term><term>HIV Infections (transmission)</term><term>Humans</term><term>Infectious Disease Transmission, Vertical (prevention & control)</term><term>Patient Acceptance of Health Care</term><term>Pilot Projects</term><term>Pregnancy</term><term>Pregnancy Complications, Infectious (drug therapy)</term><term>Prenatal Care (organization & administration)</term><term>Socioeconomic Factors</term><term>South Africa</term><term>Time Factors</term><term>Treatment Outcome</term><term>Young Adult</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Acceptation des soins par le patient</term><term>Adulte</term><term>Agents antiVIH (administration et posologie)</term><term>Assistance</term><term>Complications de la grossesse et maladies infectieuses (traitement médicamenteux)</term><term>Facteurs socioéconomiques</term><term>Facteurs temps</term><term>Femelle</term><term>Grossesse</term><term>Humains</term><term>Infections à VIH (traitement médicamenteux)</term><term>Infections à VIH (transmission)</term><term>Jeune adulte</term><term>Numération des lymphocytes CD4</term><term>Prise en charge prénatale (organisation et administration)</term><term>Projets pilotes</term><term>République d'Afrique du Sud</term><term>Résultat thérapeutique</term><term>Transmission verticale de maladie infectieuse ()</term></keywords><keywords scheme="MESH" type="chemical" qualifier="administration & dosage" xml:lang="en"><term>Anti-HIV Agents</term></keywords><keywords scheme="MESH" type="geographic" xml:lang="en"><term>South Africa</term></keywords><keywords scheme="MESH" qualifier="administration et posologie" xml:lang="fr"><term>Agents antiVIH</term></keywords><keywords scheme="MESH" qualifier="drug therapy" xml:lang="en"><term>HIV Infections</term><term>Pregnancy Complications, Infectious</term></keywords><keywords scheme="MESH" qualifier="organisation et administration" xml:lang="fr"><term>Prise en charge prénatale</term></keywords><keywords scheme="MESH" qualifier="organization & administration" xml:lang="en"><term>Prenatal Care</term></keywords><keywords scheme="MESH" qualifier="prevention & control" xml:lang="en"><term>Infectious Disease Transmission, Vertical</term></keywords><keywords scheme="MESH" qualifier="traitement médicamenteux" xml:lang="fr"><term>Complications de la grossesse et maladies infectieuses</term><term>Infections à VIH</term></keywords><keywords scheme="MESH" qualifier="transmission" xml:lang="en"><term>HIV Infections</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adult</term><term>CD4 Lymphocyte Count</term><term>Counseling</term><term>Female</term><term>Humans</term><term>Patient Acceptance of Health Care</term><term>Pilot Projects</term><term>Pregnancy</term><term>Socioeconomic Factors</term><term>Time Factors</term><term>Treatment Outcome</term><term>Young Adult</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Acceptation des soins par le patient</term><term>Adulte</term><term>Assistance</term><term>Facteurs socioéconomiques</term><term>Facteurs temps</term><term>Femelle</term><term>Grossesse</term><term>Humains</term><term>Infections à VIH</term><term>Jeune adulte</term><term>Numération des lymphocytes CD4</term><term>Projets pilotes</term><term>République d'Afrique du Sud</term><term>Résultat thérapeutique</term><term>Transmission verticale de maladie infectieuse</term></keywords><keywords scheme="Wicri" type="geographic" xml:lang="fr"><term>Afrique du Sud</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Maternal antiretroviral therapy (ART) is a critical intervention in the prevention-of-mother-to child transmission (PMTCT) of HIV. In South Africa, many HIV-infected pregnant women commence ART late in pregnancy, and as a result, the duration of ART prior to delivery is often insufficient to prevent vertical transmission. To address this, we designed an intervention for the rapid initiation of ART in pregnancy (RAP), where patient's ART preparation occurred during rather than before treatment commencement. Here we report on the acceptability and the challenges of the RAP programme. We conducted 7 key informant and 27 semi-structured interviews with RAP participants. Participants were purposefully selected based on ART-eligibility and stage in the pregnancy to post-partum continuum. Interviews were conducted in participants' home language by trained fieldworkers, with key informant interviews conducted by the study investigators. The data were analysed using a framework analysis approach. Rapid initiation in pregnancy was acceptable to the majority of programme participants and protection of the woman's unborn child was the primary motivation for starting treatment. The key barrier was the limited time to accept the dual challenges of being diagnosed HIV-positive and eligible for life-long ART. Truncated time also limited the opportunity for disclosure to others. Despite these and other barriers, most women found the benefits of rapid ART commencement outweighed the challenges, with 91% of women initiated onto ART starting the same day treatment eligibility was determined. Many participants and key informants identified the importance of counseling and the need to make an informed, independent choice on the timing of ART initiation, based on individual circumstances. Acceptance of ART-eligibility improved with time on the programme, however, as women's principal reason for initiating ART was protection of the unborn child, monitoring and supporting adherence during the post-partum period will be critical.</div></front></TEI></record>Pour manipuler ce document sous Unix (Dilib)
EXPLOR_STEP=$WICRI_ROOT/Wicri/Sante/explor/SidaSubSaharaV1/Data/Ncbi/Curation
HfdSelect -h $EXPLOR_STEP/biblio.hfd -nk 002473 | SxmlIndent | more
Ou
HfdSelect -h $EXPLOR_AREA/Data/Ncbi/Curation/biblio.hfd -nk 002473 | SxmlIndent | more
Pour mettre un lien sur cette page dans le réseau Wicri
{{Explor lien
|wiki= Wicri/Sante
|area= SidaSubSaharaV1
|flux= Ncbi
|étape= Curation
|type= RBID
|clé= pubmed:24200029
|texte= Acceptability and challenges of rapid ART initiation among pregnant women in a pilot programme, Cape Town, South Africa.
}}
Pour générer des pages wiki
HfdIndexSelect -h $EXPLOR_AREA/Data/Ncbi/Curation/RBID.i -Sk "pubmed:24200029" \
| HfdSelect -Kh $EXPLOR_AREA/Data/Ncbi/Curation/biblio.hfd \
| NlmPubMed2Wicri -a SidaSubSaharaV1
| This area was generated with Dilib version V0.6.32. |  |