Objective

The objective of this study was to assess trends over time using knowledge, attitude and practices (KAP) among mothers living with HIV and rates of early infant diagnosis (EID) of human immunodeficiency virus type 1 (HIV-1) in a hospital in Eastern Uganda, which is included in the National HIV Prevention Strategy (NHPS) in Uganda.

Methods

A thematic qualitative assessment was conducted using focus group discussions (FGDs) with pregnant women, breastfeeding mothers and women attending the antiretroviral therapy (ART) clinic, all living with HIV. In addition, we have performed key informant interviews (KIIs) in October 2011 (baseline) and November 2016 (follow-up) at Mbale Regional Referral Hospital. Data were captured through customised source documents, written narratives and voice recordings. Social scientists decoded, analysed and interpreted the qualitative data with quality control. Retrospective data were obtained from EID registers for 2010 before and 2015 at the end of the NHPS, respectively. Supplementary quantitative data from the same hospital regarding trends of HIV-1 vertical transmission rates were collected from EID registers at baseline and at follow-up. Comparisons were made between HIV-1 transmission rates and KAP levels at baseline and at follow-up.

Results

Three paired sets of FGD sessions, consisting of 8–10 participants for each of the groups of pregnant women, breastfeeding mothers and women attending ART clinic, all living with HIV, were conducted at baseline and at follow-up. Age ranged from 17 to 40 years. Two sets of paired KII interviews corresponding to the periods before and after the NHPS were also held. All study FGDs and KIIs showed improvement in KAP on HIV-1 vertical transmission and lower EID rates when comparing baseline to the follow-up period [9/69 (13.0%) and 14/336 (4.2%)], respectively (P = 0.004).

Conclusion

Improvement was noted in KAP on HIV-1 vertical transmission in pregnant women, breastfeeding mothers and women attending ART clinic, all HIV positive, in a regional referral hospital in Eastern Uganda over a 5-year period and was associated with a reduction in vertical transmission rates. Our data suggest that KAP is an effective type of intervention with regard to the prevention of HIV-1 vertical transmission in this population in resource-limited settings.

中文翻译：

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乌干达东部地区使用知识，态度和实践预防HIV-1垂直传播并进行早期婴儿HIV-1诊断的结果的研究

目的

这项研究的目的是利用东部地区一家医院的HIV感染母亲的知识，态度和实践（KAP）以及随着时间推移的趋势，以及人类免疫缺陷病毒1型（HIV-1）的早期婴儿诊断率（EID）进行评估。乌干达，已被纳入乌干达国家艾滋病毒预防战略（NHPS）。

方法

通过与孕妇，母乳喂养的母亲和参加抗逆转录病毒疗法（ART）诊所且都患有艾滋病毒的妇女的焦点小组讨论（FGD），进行了主题定性评估。此外，我们分别于2011年10月（基准）和2016年11月（随访）对Mbale地区转诊医院进行了关键线人访谈（KII）。数据是通过定制的原始文档，书面叙述和语音记录捕获的。社会科学家通过质量控制对定性数据进行解码，分析和解释。回顾性数据分别来自于NHPS之前的2010年之前和2015年末的EID寄存器。在基线和随访时从EID登记处收集了同一家医院有关HIV-1垂直传播率趋势的补充定量数据。

结果

在基线和随访期间，进行了三对成对的FGD培训，每组分别为8-10名参与者，孕妇，哺乳母亲和参加ART诊所的所有感染艾滋病毒的妇女。年龄从17岁到40岁不等。还举行了与NHPS前后相对应的两组成对的KII访谈。与基线期和随访期相比，所有研究的FGD和KII均显示出HIV-1垂直传播的KAP改善和EID率降低[分别为9/69（13.0％）和14/336（4.2％）]（P  = 0.004）。

结论

KAP指出，在乌干达东部的一家地区转诊医院中，孕妇，母乳喂养的母亲和参加ART诊所的妇女中HIV-1垂直传播已有5年改善，所有艾滋病毒呈阳性，并且与垂直传播减少有关费率。我们的数据表明，在资源有限的情况下，KAP是预防该人群中HIV-1垂直传播的一种有效干预措施。