Abstract:
Objective: The objective of this study was to assess trends over time using knowledge, attitude and practices (KAP)
among mothers living with HIV and rates of early infant diagnosis (EID) of human immunodeficiency virus type 1 (HIV-1)
in a hospital in Eastern Uganda, which is included in the National HIV Prevention Strategy (NHPS) in Uganda.
Methods: A thematic qualitative assessment was conducted using focus group discussions (FGDs) with pregnant
women, breastfeeding mothers and women attending the antiretroviral therapy (ART) clinic, all living with HIV. In
addition, we have performed key informant interviews (KIIs) in October 2011 (baseline) and November 2016 (follow-up)
at Mbale Regional Referral Hospital. Data were captured through customised source documents, written narratives and
voice recordings. Social scientists decoded, analysed and interpreted the qualitative data with quality control. Retrospective
data were obtained from EID registers for 2010 before and 2015 at the end of the NHPS, respectively. Supplementary
quantitative data from the same hospital regarding trends of HIV-1 vertical transmission rates were collected from EID
registers at baseline and at follow-up. Comparisons were made between HIV-1 transmission rates and KAP levels at
baseline and at follow-up.
Results: Three paired sets of FGD sessions, consisting of 8–10 participants for each of the groups of pregnant women,
breastfeeding mothers and women attending ART clinic, all living with HIV, were conducted at baseline and at follow-up.
Age ranged from 17 to 40 years. Two sets of paired KII interviews corresponding to the periods before and after the
NHPS were also held. All study FGDs and KIIs showed improvement in KAP on HIV-1 vertical transmission and lower
EID rates when comparing baseline to the follow-up period [9/69 (13.0%) and 14/336 (4.2%)], respectively (P = 0.004).
Conclusion: Improvement was noted in KAP on HIV-1 vertical transmission in pregnant women, breastfeeding mothers
and women attending ART clinic, all HIV positive, in a regional referral hospital in Eastern Uganda over a 5-year period
and was associated with a reduction in vertical transmission rates. Our data suggest that KAP is an effective type of
intervention with regard to the prevention of HIV-1 vertical transmission in this population in resource-limited settings.
