Conversations with mothers: exploring reasons for prevention of mother-to-child transmission (PMTCT) failures in the era of programmatic scale-up in Soweto, South Africa

AIDS Behav. 2012 Jan;16(1):91-8. doi: 10.1007/s10461-010-9875-9.


Reasons for incident cases of vertical HIV transmission in the era of free access to PMTCT in South Africa were investigated. This mixed-methods study was conducted in Soweto, South Africa from June-August, 2009. Birthmothers of HIV-infected infants born after 1 December 2008 were eligible. All participants completed an interviewer-administered questionnaire. Women also participated in a focus group (n = 10) or individual structured interview (n = 35). Mean age of participants (n = 45) was 28.7 years (SD = 5.4). Major findings are: (i) failure of per-guideline prescription of ARV strategies for infants (31%) and/or mothers (57%); (ii) maternal refusal of treatment (n = 5); (iii) preterm delivery (31%); (iv) delayed ANC attendance because of facility-related barriers and maternal apprehension around HIV testing; (v) fear of stigma; (vi) maternal difficulty with administering infant AZT (n = 9) and (vii) maternal confusion about infant feeding. A variety of individual, social, and structural factors must be addressed to optimize PMTCT service delivery in South Africa.

Publication types

  • Evaluation Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Anti-Retroviral Agents / administration & dosage*
  • Female
  • Focus Groups
  • HIV Infections / prevention & control*
  • HIV Infections / transmission
  • Health Knowledge, Attitudes, Practice
  • Health Services Accessibility
  • Humans
  • Infant, Newborn
  • Infectious Disease Transmission, Vertical / prevention & control*
  • Maternal Health Services / organization & administration
  • Mothers / psychology*
  • Mothers / statistics & numerical data
  • Patient Acceptance of Health Care
  • Pregnancy
  • Pregnancy Complications, Infectious / prevention & control*
  • Prejudice
  • Qualitative Research
  • Socioeconomic Factors
  • South Africa
  • Surveys and Questionnaires


  • Anti-Retroviral Agents