Patient and provider perspectives on improving the linkage of HIV-positive pregnant women to long-term HIV care and treatment in eastern Uganda

  • Haneefa Saleem
  • Robert Kyeyagalire
  • Sarah Smith Lunsford


Despite strong evidence that antiretroviral therapy (ART) reduces the risk of mother-to-child transmission of HIV and improves the health of HIV-positive mothers, many HIV-positive pregnant women do not enrol into long-term HIV care and treatment. This study examined barriers and facilitators to the linkage of HIV-positive pregnant women from antenatal care (ANC) to long-term HIV care from patient and provider perspectives, following the implementation of a collaborative quality improvement project in Eastern Uganda. It also solicited recommendations for improving linkages to HIV care. Structured interviews were conducted with 11 health providers and 48 HIV-positive mothers enrolled in HIV care. Facilitators to linking HIV-positive pregnant women to long-term HIV care identified included support from expert clients, escorted referrals, same-day HIV care registration, and coordination between ANC and HIV services. Barriers reported included shortages in HIV testing kits and fear of social, physical and medical consequences. Participants recommended integration of ANC and HIV services, reduction in waiting times, HIV counselling by expert clients, and community-based approaches for improving linkages to HIV care. Linking HIV-positive pregnant women to HIV care can be improved through deliberate implementation of quality improvement interventions in facilities to address barriers to access and provide stronger support and community mobilisation.

Keywords: long-term HIV care and treatment, linkage to care, antenatal care, quality improvement

African Journal of AIDS Research 2014, 13(1): 45–51

Author Biographies

Haneefa Saleem
Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe Street, Baltimore, Maryland 21205-2103, USA
Robert Kyeyagalire
Nuffield Department of Population Health, University of Oxford, Roosevelt Drive OX3 7LF, Oxford, United Kingdom
Sarah Smith Lunsford
EnCompass, LLC, 7200 Wisconsin Avenue, Suite 500, Bethesda, Maryland 20814-4811, USA

Journal Identifiers

eISSN: 1608-5906
print ISSN: 1727-9445