Initiatives to promote uptake and adherence to Option B+ program among rural pregnant women living with HIV in Malawi
Bibliographic record
Abstract
Abstract Background Malawi is the first country in the world to introduce Option B+, a test-and treat program for preventing vertical transmission of HIV from mothers to young children during pregnancy or breastfeeding. The program has significantly reduced the number of children that contract HIV from their mothers. Although this is the case, gaps remain as the program is marred with challenges such as clients opting out, low drug adherence, and default. This study examines the effectiveness of individual and community level approaches used to promote uptake of Option B+ program through reduction of intimate partner violence (IPV) in central Malawi. Methods A retrospective narrative qualitative research method was used to understand strategies that HIV positive pregnant women and community stakeholders used to improve uptake of Option B+ program. Twenty-five participants that were directly involved in Option B+ program as beneficiaries and service providers were interviewed. The interviews were audio recoded and transcribed verbatim. Data was manually coded to derive key themes and concepts. Results Prevalent forms of IPV against HIV pregnant mothers during initial stage of Option B+ program was identified. They include husband restricting women from taking Antiretroviral Therapy (ART), declining the use of condoms, and reducing family support. Various risk-taking behaviours was used to minimize IPV when some pregnant women were diagnosed HIV positive. These include opting out of the program, concealing the HIV serostatus and ART drugs. The integration of community based reproductive health initiatives such as expert clients, male championship, and safe motherhood into Option B+ program reduced cases of IPV and improved couple uptake of HIV testing. Conclusion Integration of Option B+ program with community based reproductive health promotion initiatives has a potential of reducing IPV against HIV positive pregnant women. The strategy can also increase the number of couples that can adopt Option B+ program in rural communities.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.005 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.003 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".