I wanted to safeguard the baby: a qualitative study to understand the experiences of Option B+ for pregnant women and the potential implications for test-and-treat in four sub-Saharan African settings.

摘要: Objective To explore what influences on engagement with Option B+ in four sub-Saharan African settings. Methods In-depth interviews were conducted 2015, 22 HIV-positive women who had been pregnant since was available, and 15 healthcare workers (HCWs) involved HIV service delivery. Participants purposely selected from health demographic surveillance sites Malawi, Tanzania Uganda. A thematic content analysis to investigate influenced B+. Results Feeling ‘ready’ key accepting antiretroviral treatment (ART) the same day as diagnosis at antenatal clinic; this by previous knowledge of status, interactions HCWs relationship their partners. The desire protect unborn infant main issue that motivated initiate treatment, temporarily over-riding barriers starting ART. Many recognised pressurising into ART may lead them stop following However, own responsibility sometimes drove use strong persuasive techniques onto early possible, occasionally causing disengage. Conclusions Protecting baby superseded feelings unpreparedness for lifelong explain poor retention observed programmes. Women benefit more time accept counselling long-term value beyond pregnancy breastfeeding period. Strategies promote readiness same-day initiation are urgently needed, provide important lessons universal test-and-treat implementation.