Share this article on:

Qualitative Assessment of the Integration of HIV Services With Infant Routine Immunization Visits in Tanzania

Wallace, Aaron MPH, MBA*; Kimambo, Sajida MD, MPH; Dafrossa, Lyimo MD; Rusibamayila, Neema MD§; Rwebembera, Anath MD; Songoro, Juma MD; Arthur, Gilly MD; Luman, Elizabeth PhD*; Finkbeiner, Thomas MD; Goodson, James L. MPH*

JAIDS Journal of Acquired Immune Deficiency Syndromes: 1 May 2014 - Volume 66 - Issue 1 - p e8–e14
doi: 10.1097/QAI.0000000000000078
Implementation and Operational Research: Epidemiology and Prevention
IOR articles

Background: In 2009, a project was implemented in 8 primary health clinics throughout Tanzania to explore the feasibility of integrating pediatric HIV prevention services with routine infant immunization visits.

Methods: We conducted interviews with 64 conveniently sampled mothers of infants who had received integrated HIV and immunization services and 16 providers who delivered the integrated services to qualitatively identify benefits and challenges of the intervention midway through project implementation.

Findings: Mothers' perceived benefits of the integrated services included time savings, opportunity to learn their child's HIV status and receive HIV treatment, if necessary. Providers' perceived benefits included reaching mothers who usually would not come for only HIV testing. Mothers and providers reported similar challenges, including mothers' fear of HIV testing, poor spousal support, perceived mandatory HIV testing, poor patient flow affecting confidentiality of service delivery, heavier provider workloads, and community stigma against HIV-infected persons; the latter a more frequent theme in rural compared with urban locations.

Interpretation: Future scale-up should ensure privacy of these integrated services received at clinics and community outreach to address stigma and perceived mandatory testing. Increasing human resources for health to address higher workloads and longer waiting times for proper patient flow is necessary in the long term.

*Global Immunization Division, Centers for Disease Control and Prevention, Atlanta, GA;

Division of Global HIV/AIDS, Centers for Disease Control and Prevention, Dar es Salaam, Tanzania;

Expanded Programme on Immunizations, Ministry of Health and Social Welfare, Dar es Salaam, Tanzania;

§Reproductive Child Health Services, Ministry of Health and Social Welfare, Dar es Salaam, Tanzania;

National AIDS Control Programme, Ministry of Health and Social Welfare, Dar es Salaam, Tanzania; and

Elizabeth Glaser Pediatric AIDS Foundation, Dar es Salaam, Tanzania.

Correspondence to: Aaron Wallace, MPH, MBA, Global Immunization Division, Centers for Disease Control and Prevention, 1600 Clifton Road NE, Atlanta, GA MS-E05 (e-mail: awallace@cdc.gov).

Supported in part by the President's Emergency Plan for AIDS Relief (PEPFAR) through the US Centers for Disease Control and Prevention.

The authors have no conflicts of interest to disclose.

The findings and conclusions in this article are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.

Received November 21, 2013

Accepted November 21, 2013

© 2014 by Lippincott Williams & Wilkins