Exploring socio-economic conditions and poor follow-up rates of HIV-exposed infants in Johannesburg, South Africa

Abstract

In 2002, more than 280,000 HIV-exposed babies were born in South Africa. According to international PMTCT guidelines, these children require follow-up to 12 months of age. Worldwide, the high loss to follow-up rates experienced by PMTCT programs precludes them from identifying and managing HIV-infected children. Socio-economic factors have been identified as potential contributors to poor follow-up. A small descriptive study to examine socio-economic circumstances of women attending the Coronation Women and Children's Hospital PMTCT program was undertaken. Cross-sectional data from 176 women, interviewed at their infants’ 12-month visit, was collected using a semi-structured questionnaire. Socio-economic factors such as poverty, geographical relocation and a lack of paternal support may affect the capacity of families to comply with the PMTCT follow-up program. Fifty-seven percent of mothers were unemployed, 25% of fathers did not support their children and only 58% of children remained resident in Johannesburg at the 12-month visit. The lack of follow-up of HIV-infected children denies them access to adequate medical care. Understanding the socio-economic factors that affect the ability of communities to comply with PMTCT programs will assist resource-poor countries in devising strategies to achieve follow-up of HIV-exposed infants.

Acknowledgments

We would like to thank Bristol Myers-Squibb Secure the Future Program and the Elizabeth Glaser Pediatric AIDS Foundationfor funding the Infant Diagnostic Study at Coronation Women and Children's Hospital.

The contribution of C. A. Varga to this paper constitutes an original contribution; its contents do not reflect the position of the MacArthur Foundation.