| As of 2009, an estimated 2.1 million children worldwide were living with the human immunodeficiency virus/acquired immunodeficiency syndrome, the majority of whom acquired the disease from their HIV-positive mothers. In Rwanda an estimated 19,000 children under the age of 15 are living with HIV and account for nearly 13% of all infections nationwide. Rapid disease progression and high mortality in prenatally infected infants underlines the importance of pediatric follow-up care. However, due to high loss to follow-up, prevention-of-mother-to-child-transmission (PMTCT) programs have been unsuccessful in ensuring continued care of HIV-exposed infants. The purpose of this study was to identify the barriers to access and utilization of pediatric follow-up care of HIV-exposed infants in Rwanda. This dissertation analyzed 2007 data from HIV-positive Rwandan women collected as part of a national PMTCT program evaluation. World Health Organization guidelines were used to determine adherence/nonadherence status to follow-up care. Results indicated that women were less likely to report nonadherence to pediatric follow up guidelines if they were unmarried, had reported the death of a previous child, or had displayed mother/infant adherence to single-dose nevirapine prophylaxis to prevent mother-to-child transmission of HIV. Findings of this study may inform Rwandan national policy and identify reasons for nonadherence to pediatric follow-up care and reduce morbidity and mortality among HIV-exposed infants. |
