PMID- 25361205
OWN - NLM
STAT- MEDLINE
DCOM- 20150126
LR  - 20181113
IS  - 1557-7449 (Electronic)
IS  - 1087-2914 (Print)
IS  - 1087-2914 (Linking)
VI  - 28
IP  - 12
DP  - 2014 Dec
TI  - Shame, guilt, and stress: Community perceptions of barriers to engaging in 
      prevention of mother to child transmission (PMTCT) programs in western Kenya.
PG  - 643-51
LID - 10.1089/apc.2014.0171 [doi]
AB  - While global scale-up of prevention of mother-to-child transmission of HIV 
      (PMTCT) services has been expansive, only half of HIV-infected pregnant women 
      receive antiretroviral regimens for PMTCT in sub-Saharan Africa. To evaluate 
      social factors influencing uptake of PMTCT in rural Kenya, we conducted a 
      community-based, cross-sectional survey of mothers residing in the KEMRI/CDC 
      Health and Demographic Surveillance System (HDSS) area. Factors included 
      referrals and acceptability, HIV-related stigma, observed discrimination, and 
      knowledge of violence. Chi-squared tests and multivariate regression analyses 
      were used to detect stigma domains associated with uptake of PMTCT services. Most 
      HIV-positive women (89%) reported blame or judgment of people with HIV, and 46% 
      reported they would feel shame if they were associated with someone with HIV. In 
      multivariate analyses, shame was significantly associated with decreased 
      likelihood of maternal HIV testing (Prevalence Ratio 0.91, 95% Confidence 
      Interval 0.84-0.99), a complete course of maternal antiretrovirals (ARVs) (PR 
      0.73, 95% CI 0.55-0.97), and infant HIV testing (PR 0.86, 95% CI 0.75-0.99). 
      Community perceptions of why women may be unwilling to take ARVs included stigma, 
      guilt, lack of knowledge, denial, stress, and despair or futility. Interventions 
      that seek to decrease maternal depression and internalization of stigma may 
      facilitate uptake of PMTCT.
FAU - Kohler, Pamela K
AU  - Kohler PK
AD  - 1 Department of Global Health, University of Washington , Seattle, Washington.
FAU - Ondenge, Kenneth
AU  - Ondenge K
FAU - Mills, Lisa A
AU  - Mills LA
FAU - Okanda, John
AU  - Okanda J
FAU - Kinuthia, John
AU  - Kinuthia J
FAU - Olilo, George
AU  - Olilo G
FAU - Odhiambo, Frank
AU  - Odhiambo F
FAU - Laserson, Kayla F
AU  - Laserson KF
FAU - Zierler, Brenda
AU  - Zierler B
FAU - Voss, Joachim
AU  - Voss J
FAU - John-Stewart, Grace
AU  - John-Stewart G
LA  - eng
GR  - K24 HD054314/HD/NICHD NIH HHS/United States
GR  - P30 AI027757/AI/NIAID NIH HHS/United States
GR  - R24 HD056799/HD/NICHD NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PL  - United States
TA  - AIDS Patient Care STDS
JT  - AIDS patient care and STDs
JID - 9607225
RN  - 0 (Anti-HIV Agents)
SB  - IM
MH  - Adult
MH  - Anti-HIV Agents/*therapeutic use
MH  - Community-Based Participatory Research
MH  - Cross-Sectional Studies
MH  - Female
MH  - *Guilt
MH  - HIV Infections/drug therapy/*prevention & control/psychology
MH  - Health Services Accessibility
MH  - Humans
MH  - Infant
MH  - Infant, Newborn
MH  - Infectious Disease Transmission, Vertical/*prevention & control
MH  - Interviews as Topic
MH  - Kenya
MH  - Mothers/*psychology
MH  - Multivariate Analysis
MH  - Patient Acceptance of Health Care/*statistics & numerical data
MH  - Perception
MH  - Pregnancy
MH  - Pregnancy Complications, Infectious/epidemiology/*prevention & control
MH  - Program Evaluation
MH  - Regression Analysis
MH  - Rural Population
MH  - Social Stigma
MH  - Stress, Psychological/*psychology
PMC - PMC4250952
EDAT- 2014/11/02 06:00
MHDA- 2015/01/27 06:00
PMCR- 2015/12/01
CRDT- 2014/11/01 06:00
PHST- 2014/11/01 06:00 [entrez]
PHST- 2014/11/02 06:00 [pubmed]
PHST- 2015/01/27 06:00 [medline]
PHST- 2015/12/01 00:00 [pmc-release]
AID - 10.1089/apc.2014.0171 [pii]
AID - 10.1089/apc.2014.0171 [doi]
PST - ppublish
SO  - AIDS Patient Care STDS. 2014 Dec;28(12):643-51. doi: 10.1089/apc.2014.0171.