Exploring barriers to PMTCT: perceptions of HIV-positive pregnant women in western Kenya.

BACKGROUND

Kenya is among the six high-burden HIV/AIDS countries in Africa, with approximately 1.3 million people living with HIV as of 2024. This includes an estimated 62,000 children aged 0-14 years. Mother‒child transmission (MTCT) of HIV during pregnancy, labour, delivery, or breastfeeding significantly contributes to new infections among children. In the absence of prevention interventions, MTCT rates range from 15 to 45% but can be reduced to less than 5% with antiretroviral therapy. Women in Kenya have a higher HIV prevalence rate than men do, with 5.2% for women and 4.5% for men. Geographic disparities in HIV prevalence exist within the country and are influenced by cultural practices, sexual behavior, and economic activities. Despite efforts to increase knowledge about HIV prevention, gaps remain, particularly among young people, rural populations, and those with lower educational levels. The Kenya Demographic and Health Survey (KDHS) highlights significant knowledge gaps among HIV-positive pregnant women regarding MTCT and the benefits of antiretroviral drugs. Challenges in preventing MTCT in Kenya include limited knowledge, a lack of adherence to the PMTCT cascade, and barriers such as stigma, weak health systems, and socioeconomic factors.

METHODS

This study aims to determine the HIV knowledge and challenges faced by HIV-positive pregnant women in western Kenya regarding adherence to PMTCT protocols and to make recommendations to curb these challenges. Using a mixed-methods approach, including a survey and focus group discussions (FGDs), the study targeted HIV-positive pregnant women at Homa Bay County Referral and Teaching Hospital. Convenience sampling was used to select participants.

RESULTS

Key findings indicate that while awareness of MTCT exists, misconceptions and knowledge gaps persist. Themes from FGDs include viewing HIV as a curse, negative feelings about HIV status, fear of disclosure, comparisons with other diseases, and the importance of self-encouragement.

CONCLUSION

The study concludes that HIV-positive pregnant women in western Kenya face significant challenges in adhering to PMTCT protocols because of persistent myths, stigma, and socioeconomic barriers. Recommendations include enhancing education and support systems to improve adherence to PMTCT and reduce MTCT rates.