Prevention of mother-to-child transmission of HIV service interruptions amid COVID-19 pandemic

TL;DR

The study explores how the COVID-19 pandemic disrupted HIV prevention services for pregnant women and their infants in Tshwane, South Africa.

Contribution

This study provides insights into PMTCT service interruptions during the pandemic and highlights the need for community-based follow-up strategies.

Findings

PMTCT service interruptions led to non-adherence, high viral loads, and loss to follow-up.

Late antenatal bookings and delays in DNA-PCR testing were reported.

Healthcare providers faced stress and staff shortages due to pandemic-related reassignments.

Abstract

The coronavirus disease 2019 (COVID-19) caused global disruptions in healthcare service delivery. The prevention of mother-to-child transmission (PMTCT) of human immunodeficiency viruses (HIV) services were also interrupted, threatening the attainment of Sustainable Development Goal 3. This article describes the PMTCT service interruptions experienced during the COVID-19 pandemic in Tshwane healthcare facilities.

A descriptive phenomenological design was used to explore and describe the experiences of healthcare providers offering PMTCT services during COVID-19 in the Tshwane district, Gauteng province. Purposive sampling was used to recruit participants. Data were collected through in-depth interviews with 16 participants, and Colaizzi’s data analysis steps were followed in analysing the findings.

Participants reported interruptions in PMTCT service delivery during the pandemic. Non-adherence to scheduled visits resulted in patients defaulting or not adhering to treatment regimens, high viral loads and mother–infant pairs’ loss to follow-up. Other features of service disruption included late antenatal bookings, low client flow and delays in conducting deoxyribonucleic acid-polymerase chain reaction (DNA-PCR) testing in HIV-exposed babies. In addition, staff shortages occurred because of re-assignments to COVID-19-related activities. Study participants were psychologically affected by the fear of contracting COVID-19 and worked in a frustrating and stressful environment.

Improved community-based follow-up services are critical to enhance PMTCT service outcomes and prevent infant HIV infections.

The findings may influence policymakers in developing strategies to curb HIV infections among mothers and children during pandemics.