Providing HIV Prevention of Mother to Child Transmission (PMTCT) Services to Migrants During the COVID-19 Pandemic in South Africa: Insights of Healthcare Providers

'Condoms are hard to get by': access to HIV prevention methods during lockdown of the COVID-19 epidemic in eastern Zimbabwe

BACKGROUND

In the early phase of the coronavirus disease 2019 (COVID-19) pandemic, health services were disrupted worldwide, including HIV prevention services. While some studies have begun to document the effects of COVID-19 on HIV prevention, little has been done to qualitatively examine how lockdown measures were experienced and perceived to affect access to HIV prevention methods in sub-Saharan Africa.

OBJECTIVES

To explore how the COVID-19 pandemic was perceived to affect access to HIV prevention methods in eastern Zimbabwe.

METHOD

This article draws on qualitative data from the first three data collection points (involving telephone interviews, group discussions, and photography) of a telephone and WhatsApp-enabled digital ethnography. Data were collected from 11 adolescent girls and young women and five men over a 5-month period (March-July 2021). The data were analysed thematically.

RESULTS

Participants reported widespread interruption to their condom supply when beerhalls were shut down as part of a nationwide lockdown. Restrictions in movement meant that participants who could afford to buy condoms from larger supermarkets or pharmacies were unable to. Additionally, the police reportedly refused to issue letters granting permission to travel for the purpose of accessing HIV prevention services. The COVID-19 pandemic was also described to obstruct the demand (fear of COVID-19, movement restrictions) and supply (de-prioritised, stock-outs) for HIV prevention services. Nonetheless, under certain formal and informal circumstances, such as accessing other and more prioritised health services, or 'knowing the right people', some participants were able to access HIV prevention methods.

CONCLUSION

People at risk of HIV experienced the COVID-19 epidemic in Zimbabwe as disruptive to access to HIV prevention methods. While the disruptions were temporary, they were long enough to catalyse local responses, and to highlight the need for future pandemic response capacities to circumvent a reversal of hard-won gains in HIV prevention.

Addressing the migrant gap: maternal healthcare perspectives on utilising prevention of mother to child transmission (PMTCT) services during the COVID-19 pandemic, South Africa

BACKGROUND

The COVID-19 pandemic has interrupted the prevention of mother-to-child transmission of HIV (PMTCT) programming in South Africa. In 2020, it was estimated that there were 4 million cross-border migrants in South Africa, some of whom are women living with HIV (WLWH), who are highly mobile and located within peripheral and urban areas of Johannesburg. Little is known about the mobility typologies of these women associated with different movement patterns, the impact of the COVID-19 pandemic on mobility typologies of women utilising PMTCT services and on how changes to services might have affected adherence.

OBJECTIVE

To qualitatively explore experiences of different mobility typologies of migrant women utilising PMTCT services in a high mobility context of Johannesburg and how belonging to a specific typology might have affected the health care received and their overall experiences during the COVID-19 pandemic.

METHODS

Qualitative semi-structured interviews with 40 pregnant migrant WLWH were conducted from June 2020-June 2021. Participants were recruited through purposive sampling at a public hospital in Johannesburg. A thematic approach was used to analyse interviews.

RESULTS

Forty interviews were conducted with 22 cross-border and 18 internal migrants. Women in cross-border migration patterns compared to interprovincial and intraregional mobility experienced barriers of documentation, language availability, mistreatment, education and counselling. Due to border closures, they were unable to receive ART interrupting adherence and relied on SMS reminders to adhere to ART during the pandemic. All 40 women struggled to understand the importance of adherence because of the lack of infrastructure to support social distancing protocols and to provide PMTCT education.

CONCLUSIONS

COVID-19 amplified existing challenges for cross-border migrant women to utilise PMTCT services. Future pandemic preparedness should be addressed with differentiated service delivery including multi-month dispensing of ARVs, virtual educational care, and language-sensitive information, responsive to the needs of mobile women to alleviate the burden on the healthcare system.

The Burden of HIV Infection among Pregnant Women Attending Antenatal Care in Jimma University Specialized Hospital in Ethiopia: A Retrospective Observational Study

Background

The HIV (human immunodeficiency virus) epidemic enters its fifth decade amid a global pandemic. Nearly 61% of the people newly infected with HIV live in sub-Saharan Africa (SSA). The virus is transmitted from mother to child during pregnancy, labour, delivery, and breastfeeding, warranting routine counselling at antenatal care (ANC). Hence, this study aimed to determine the prevalence and trend of HIV infection among pregnant women on ANC follow-up at Jimma University Specialized Hospital (JUSH) in Ethiopia from November 2018 to 2021.

Methods

A retrospective cross-sectional study was conducted from June 25, 2021, to November 30, 2021. A total of 634 mothers were sampled by systematic random sampling, and the data were analyzed by descriptive statistics package of SPSS software. A chi-square test was employed to assess an association between variables. Analyses outputs were summarized and presented in tables and figures.

Results

Among the sampled women (634), 96.1% received counselling services on the prevention of maternal-to-child transmission of HIV/AIDS. Around 83.1% of the mothers refused to consult their partners and were unable to persuade their surrogate or afraid to discuss HIV serostatus tests. The overall prevalence of HIV infection among pregnant mothers was 7.1% and no significant decrease in the trends of HIV prevalence over the three years study period (p value >0.05). The seroprevalence is high in urban residents (4.4%) and age group of 25–29 years (38.9%) (p value <0.05). Residence, level of education attained, and marital status of women were significantly associated (p value <0.05) with seropositivity.

Conclusion

HIV burden among ANC attendees in JUSH is high as compared to the national figure and its trend over three years is steady. Accordingly, mandatory early screening tests and community-based education are mandatory for all women and adolescent girls in the reproductive age group.