HIV positive mothers likely to stop treatment after delivery

A new study has found that mothers living with HIV in South Africa often discontinue HIV care after their child is born and has tested negative for HIV, because they perceive their own health as unimportant. The study sought to understand the challenges facing HIV positive woman during the postpartum period, and why there is such a low retention of care. Although barriers for retention in care among HIV positive adults in sub-Saharan Africa are well known. Pregnant and postpartum women might face their own unique and additional barriers throughout the prevention of mother-to-child transmission (PMTCT) care cascade.

The study included 58 women in a residential area of Johannesburg, characterised by poverty, extensive migration, and high burdens of HIV and TB. Mothers living with HIV were asked why they did not return to the clinic after giving birth; the main reason indicated was the perception that some mothers care more about their babies’ health than their own. Other structural barriers were mentioned, such as a lack of money, clinic opening hours, having to take time off work and relocating after giving birth. Personal and social barriers also contributed to women dropping out of prevention programs, including the belief that the mother is cured of HIV, stigma and fear of disclosure.

This belief that the mother’s HIV care is unimportant, leading to the ceasing antiretroviral treatment (ART) after delivery threats the potential benefit of prevention programs. The study highlights the importance of coupling ART initiation with adherence counselling during pregnancy and after delivery. Calling for new interventions that address the importance of remaining in HIV care and adhering to treatment for the mother’s own health and the infant’s after delivery, particularly if breastfeeding.