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Socio-demographic factors associated with loss to follow-up of HIV infected women attending a private sector PMTCT program in Maharashtra, India

Abstract : Currently 40 percent of HIV infected women enrolled in national PMTCT program in India are lost to follow-up (LTF) before they can receive single dose Nevirapine. To date no study from India has examined the reasons for inadequate utilization of PMTCT services. This study sought to examine the socio-demographic factors associated with LTF of HIV infected women enrolled during 2002 to 2008 in a large-scale private sector PMTCT project in Maharashtra, India. Data on HIV infected women who were enrolled during pregnancy (N= 734) and who reported live birth (N= 770) were used to analyze factors associated with LTF before delivery and after delivery respectively. Univariate and multivariate analyses were conducted to estimate the associations between being LTF and socio-demographic factors using generalized linear models. Eighty (10.9%) women were LTF before delivery and 151 (19.6%) women were LTF after delivery. Women with less than graduate level education (RR= 6.32), from a poor family (RR= 1.61), who were registered after 20 weeks of pregnancy (RR= 2.02) and whose partners were HIV non-infected or with unknown HIV status (RR=2.69) were more likely to be LTF before delivery. Similarly, the significant factors for LTF after delivery were less than graduate level education (RR=1.82), poor family (RR=1.42) and registration after 20 weeks of pregnancy (RR=1.75). This study highlights the need for innovative and effective counseling techniques for less educated women, economic empowerment of women, better strategies to increase up-take of partner's HIV testing and early registration of women in the program for preventing LTF in PMTCT programs. This need for innovative counseling techniques is even greater for PMTCT programs in the public health sector as the women accessing care in the public sector are likely to be less educated and economically more deprived.
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Mayuri Vijaykumar Panditrao, Shrinivas Satyanarayan Darak, Vinay Vaman Kulkarni, Sanjeevani Vinay Kulkarni, Ritu Shridhar Parchure. Socio-demographic factors associated with loss to follow-up of HIV infected women attending a private sector PMTCT program in Maharashtra, India. AIDS Care, Taylor & Francis (Routledge), 2011, 23 (05), pp.593-600. ⟨10.1080/09540121.2010.516348⟩. ⟨hal-00665441⟩

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