“If my husband leaves me, I will go home and suffer, so better cling to him and hide this thing”: The influence of gender on Option B+ prevention of mother-to-child transmission participation in Malawi and Uganda

Globally, countries are working toward achieving the goal of having 90% of people diagnosed with HIV on sustained antiretroviral therapy (ART). This has been difficult to achieve in PMTCT programs in sub-Saharan Africa owing to a variety of factors and while enrollment in PMTCT has increased under Option B+, which initiates all HIV-positive pregnant or breastfeeding women on lifelong ART at diagnosis, estimates of losses to follow-up vary widely.  This qualitative study at examined the interplay of gender and individual, interpersonal, health system, and community factors that contribute to PMTCT participation in Malawi and Uganda.  The findings point to the role of gender dynamics as a barrier to women accessing and continuing treatment.