Linkage to care, HIV + pregnant mothers, and Early Infant Diagnosis: A three years intervention towards the elimination of MTCT in Igbo-Eze North Local Government of Enugu State
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Abstract
A three-year research and advocacy programme aimed at establishing the degree of people living with HIV in rural community on one hand, and on the other hand, providing linkage services to the HIV treatment centres. We adopted a cross-sectional study carried out in pre-intervention, intervention and post-intervention phases and a total of 40 116 persons between the ages of <6 months to70 years received the HIV Treatment Services (HTS). This project empowered existing community congregational health structures to create demand for screening and referral for HIV and other chronic illnesses among pregnant and non-pregnant women during weekly church services and other congregational activities. The congregation health structures was supported with Treatment Linkage Specialist (TLS) to increase linkage to care of identified HIV positive clients and to overcome HIV-related stigma and discrimination in 25 rural communities of Enugu-Ezike, Enugu State. We used simple descriptive statistics to present HTS results. Our findings show that non-pregnant women represent the highest number (888 or 54.81%) of HIV positives, indicating 5.3538 prevalence rate over the three years of the survey. Adult males are the second highest (459 or 28.33%) HIV positives at a prevalence rate of 5.4127, pregnant women are reported as the third highest (122 or 7.53%) HIV positive with 1.7319 prevalence rate. Mother-to-child-transmission (MTCT) of HIV continuous to occur in the rural communities as children aged 5-9 years and less than 6 months – 4 years represent 2.6% and 2.3% of HIV positive persons respectively. The TLS strategy has, however, to a large extent reduced the poor linkage to care/treatment from the 41.4% linkages in 2018 to 91.8% and 98.3% in 2019 and 2020 respectively. This is a reflection of increased access to HIV testing services and the Treatment Linkage Specialists who bridge the gaps observed in the HIV care spectrum in Enugu-Ezike communities. Although preventing MTCT of HIV remains a difficult task in rural areas due to poverty and illiteracy, robust evidence shows that improved linkage services to care treatment centres will increase awareness level of PMTCT.