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LFU Case Study

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Mothers who knew their and shared with their partner their HIV status before pregnancy were less likely to have their infant LTFU. Findings from studies done in Ethiopia and in other low HIV prevalence settings in Central Asia and Eastern Europe (30,31) showed that knowledge of maternal HIV prior to pregnancy allows HIV-infected mothers to be better prepared to receive their infants’ test results. It may be that they might have had adequate time to be taken through counseling and living positively with HIV, hence have a higher acceptance going forward.
There is a higher chance that mothers who knew their HIV status are more likely to have been better prepared psychologically, share their own HIV and HEI status with partners and family,
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It remains unknown what happens to HIV-exposed children LTFU within the household. Mother-HEI pairs might be using traditional home treatments. However, as a limitation, the study could not determine the magnitude on the use of home treatment among HEI. The use of home treatments puts HIV-exposed children at risk of progression of disease, malnutrition, illness and death, even if they are not HIV-infected. LTFU and the associated use of home treatment could be demonstrated by the four deaths that were recorded during this study. The four deaths had not been notified to the health facilities.
Households that had a family health insurance cover were more often compliant with mother-infant clinic appointments. This finding remains unclear since HIV services at our study sites were not charged. In addition, since June 2013, the Government of Kenya waived all maternity related fees (34). We did not expect cost-related factors to be a barrier to not seeking services. Having a health insurance cover could be a proxy indicator for other socio-economic determinants, or health-seeking behavioral differences. A systematic review of over 116 studies in SSA (35) suggests that social factors such as lack of income and being unemployed are associated with LTFU. Such social factors could explain a household’s ability to have a health insurance plan. A
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