Exploring the lived experiences of HIV-positive women on PMTCT option B+ strategy in a selected district hospital in Malawi.
In July 2011, The Malawi government started implementing an innovative PMTCT policy known as Option B+ strategy that provides universal lifelong ART for all HIV-infected pregnant and breastfeeding women regardless of clinical or immunological stage. Even though Option B+ strategy is a good choice for Malawi, there is fear that the programme may be affected by poor access, utilisation, adherence and retention. Aim: The aim of this study was to explore the lived experiences of HIV-positive women on Option B+ strategy in a selected district hospital in Malawi. Methodology: A Hermeneutics phenomenological approach was used in this study to explore the lived experiences of HIV-positive women on Option B+ strategy through in-depth interviews of five purposely sampled information rich sources. Interviews were audio-taped and transcribed, then manual data analysis using Giorgi’s approach was employed to identify meaningful segments and develop categories, themes and sub-themes. Results: The lifelong commitment was described as the most challenging aspect of Option B+ strategy. Participants demonstrated lack of knowledge and understanding of Option B+ strategy and its implications which rendered them poorly prepared and unready for the task. The un optional Opt-out HIV testing resulted in participants feeling left out in their own care, as health professionals dominated the care from HIV testing throughout the process. The importance of male involvement in PMTCT was revealed in promoting partner HIV testing, disclosure, support, and prevention of further HIV spread. Barriers to participation were described in terms of attitudes of health care workers, stigma and discrimination. Despite the overemphasised need for women to be supported on Option B+ strategy participants were not willing to seek available sources of formal support.
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