A model of prevention of mother-to-child transmission and health management team for improving adverse outcomes of pregnancy syphilis in Ningxia, China.

Regional variations exist in the implementation of Syphilis Mother-to-Child Transmission Prevention (PMTCT). Thus, it is crucial to assess the effectiveness of this model in the Ningxia region and explore the supplementary role of Health Management Teams (HMT). This study established the PMTCT + HMT model and examined its impact on adverse outcomes in pregnant women with syphilis infection. The majority of participants were urban residents, married, had a minimum high school education, and held public positions; 36.7% and 26.7% were from minority ethnic groups. The PMTCT + HMT model enhanced participants' knowledge, rates of voluntary counseling, and testing. The incidence of adverse pregnancy outcomes (miscarriages, preterm births, stillbirths) significantly decreased, and adverse neonatal outcomes (low birth weight, neonatal mortality, congenital syphilis) were notably reduced. Simultaneously, we identified factors associated with adverse outcomes, including non-residency, unmarried status, lower educational attainment, minority ethnicity, primary syphilis, and positive titers. Thus, HMT may be an effective intervention to enhance the effect of PMTCT for syphilis. The unique population structure in Ningxia is closely linked to adverse outcomes, highlighting the significance of providing equitable treatment for vulnerable populations.

Uptake of early infant HIV diagnosis and its associated factors in Tanzania: an analytical cross-sectional study.

The uptake of early infant HIV diagnosis services is crucial for preventing mother to child transmission of virus, and timely management. However, the uptake of the services remains a global challenge, despite major advances in HIV testing. This study investigated the uptake of early infant HIV diagnosis and its associated factors among mothersof exposed infants. The results showed that the uptake of early infant HIV diagnosis was 76%. Factors associated with the uptake are caregivers being married, have higher income level and having adequate knowledge on early infant HIV diagnosis.

Costs and benefits of allomaternal care to mothers and others in wild Phayre's leaf monkeys.

OBJECTIVES: Allomaternal care (AMC) is suggested to be energetically beneficial to mothers and costly to allomothers. However, among primates, AMC is a heterogeneous phenomenon and its implications are less clear especially in female dispersal species. Here, we investigated infant care in a female dispersal species, Phayre's leaf monkeys (Trachypithecus phayrei crepusculus), to evaluate whether mothers were constrained by infant care and benefitted energetically from AMC, whether AMC was energetically costly for allomothers and how maternal experience was associated with AMC. MATERIALS AND METHODS: Data were collected via instantaneous focal animal sampling between 2004 and 2005 for juvenile and adult females (N = 18) from two groups at the Phu Khieo Wildlife Sanctuary, Thailand (440 h). We used generalized linear mixed models to determine how infant care during the first month after birth affected the time mothers and allomothers spent feeding, socializing, resting, and locomoting and how AMC varied. RESULTS: In the first month, infants spent 26% of their time with an allomother. We found no differences in mothers' overall activity before versus after birth, although mothers fed significantly more and rested less when without their infant. Allomothers fed and rested less when with an infant. AMC varied between 0.0% and 20.5%, with immature females being most active. DISCUSSION: Mothers appear to benefit energetically from AMC such that their overall activity after birth remained unchanged. Costs and benefits for allomothers seem to be variable. Some very active immature females may be benefitting from learning-to-mother. The overall low cost of AMC may facilitate a reciprocal social network among unrelated females.

Intimate Partner Violence Among Adolescent Mothers Living With and Without HIV: A Pre- and During-COVID-19 South African Cohort Analysis.

PURPOSE: Adolescent mothers face heightened economic and social vulnerabilities, which can place them at increased risk of intimate partner violence (IPV), prepandemic, and during COVID-19. However, few studies examine this population, and even less disaggregate findings by HIV status. METHODS: We analyzed data from 834 South African adolescent mothers, 35% living with HIV (LHIV), who reported on physical, psychological, and sexual IPV exposure at two interviews: 2018-2019 (prepandemic) and 2021-2022 (during COVID-19). We estimated lifetime prevalence of IPV, disaggregating by HIV status. We used inverse weighted probability multivariate mixed-effects logistic regression to examine changes in IPV between the two periods and if changes in IPV differed by HIV status. RESULTS: A quarter of adolescent mothers had experienced any IPV during COVID-19, quadruple prepandemic levels (24.7% vs. 6.0%). The increase was driven by surges in physical (+15.7%) and psychological (+11.2%) IPV. In both periods, psychosocial and physical IPV were the most prevalent forms and the most common combination among those who had experienced multiple forms of IPV. Exposure to any IPV was significantly more prevalent among those LHIV compared to those without HIV, prepandemic (9.5% vs. 4.1%, p = .026) and during COVID-19 (31.8% vs. 20.6%, p < .001). Adjusted models revealed an 18.2% significant increase in the average predicted probability of reporting IPV during COVID-19 compared to prepandemic, with no differential effect by HIV status. DISCUSSION: Adolescent mothers experienced a significantly higher burden of IPV during COVID-19 than prepandemic, with those LHIV experiencing the highest level. Initiatives to reduce IPV need to reach adolescent mothers, particularly those living with HIV.

Impact of the mother's voice on sedation need and stress during cardiologic examination of children (SMUSS study): a prospective, interventional, randomised, controlled, monocentric study.

INTRODUCTION: Cardiac catheterisation is crucial for diagnosing and treating paediatric heart diseases, but it is poorly tolerated by small children, infants, and newborns without sedation. This study investigated whether maternal voice during sedation could lower stress and pain in children undergoing cardiac catheterisation and also assessed mothers' stress levels before and after the procedure. METHODS: This was a prospective, monocentric, randomised, controlled interventional study at the University Hospital Bonn. Children aged 4 years or younger scheduled for elective cardiac catheterisation under procedural sedation and American Society of Anaesthesiologists class between 1 and 3 were eligible. RESULTS: At the end of cardiac catheterisation, the intervention group showed a higher Newborn Infant Parasympathetic Evaluation index with an adjusted mean difference of 9.5 (± 4.2) (p = 0.026) and a lower median Children's and Infants Postoperative Pain Scale score of 2.0 (IQR: 0.0-5.0) versus 4.5 (IQR: 3.0-6.0) than the control group (p = 0.027). No difference in the children's cortisol level was found (p = 0.424). The mothers in the intervention group had a lower cortisol level than those in the control group before cardiac catheterisation (adjusted mean difference: -4.5 nmol/l (± 1.8 nmol/l), p = 0.011). CONCLUSION: Listening to the maternal voice during cardiac catheterisation could lead to less postoperative pain and significantly lower stress and discomfort level in children. Less pain could reduce the incidence of postoperative delirium.Additionally, mothers perceived involvement as positive. A reduced stress level of mothers can positively influence children and possibly reduce pain and anxiety.

Idiosyncratic gesture use in a mother-infant dyad in chimpanzees (Pan troglodytes schweinfurthii) in the wild.

One promising method to tackle the question, "In which modality did language evolve?" is by studying the ontogenetic trajectory of signals in human's closest living relatives, including chimpanzees (Pan troglodytes). Concerning gestures, current debates centre on four different hypotheses: "phylogenetic ritualization", "social transmission through imitation", "ontogenetic ritualization", and "social negotiation". These differ in their predictions regarding idiosyncratic gestures, making such occurrences a crucial area of investigation. Here, we describe a novel and potential idiosyncratic behaviour - 'hand-on-eye' - which was initially observed in one mother-infant dyad in a community of chimpanzees living in the wild. We systematically investigated the form, sequential organisation, intentionality, usage, function, and distribution of the behaviour over a five-year period. The results showed that 'hand-on-eye' was nearly exclusively deployed in a single mother-infant dyad, was accompanied by hallmarks of intentionality, and served to initiate or resume joint dorsal travel. Although the behaviour was observed once in each of three other mother-infant dyads, these lacked the same frequency and hallmarks of intentionality. 'Hand-on-eye' thus qualifies as an idiosyncratic gesture. The proposed developmental pathway gives support to both the "ontogenetic ritualization" and "social negotiation" hypotheses. It also stresses the crucial need for longitudinal approaches to tackle developmental processes that are triggered by unique circumstances and unfold over relatively long time windows.

Development of the Culturally Affirming and Responsive Experiences (CARE) Measure: Observing Responsiveness and Ethnic-Racial Cultural Socialization in Mother-Child Interactions.

The existing literature on the importance of maternal responsiveness and the growing body of literature supporting early ethnic-racial cultural socialization highlight the need for an observational measure of how they co-occur during mother-child interactions. This study presents the development and initial validation of the Culturally Affirming and Responsive Experiences (CARE) measure, an observational measure of the presence and quality of responsiveness and ethnic-racial cultural socialization within early mother-child interactions. Pilot study results with 103 racially and ethnically diverse mother-child dyads demonstrated initial reliability and validity of the CARE measure. Implications of applying the CARE measure to early mother-child interactions to assess quality of responsiveness and ethnic-racial cultural socializations are discussed.

Effects of kangaroo mother care combined with nurse-assisted mindfulness training for reducing stress among mothers of preterm infants hospitalized in the NICU: a randomized controlled trial.

BACKGROUND: Kangaroo mother care (KMC) can have a positive effect on the mental well-being of a mother. However, there are specific challenges associated with the process that may contribute to increased anxiety for the mother. By integrating nurse-assisted mindfulness training alongside KMC guidance, nurses may effectively alleviate maternal stress to a greater extent. METHODS: A single-centre randomized controlled trial was conducted to investigate the effects of KMC combined with nurse-assisted mindfulness training. The study included preterm infants with a gestational age of less than 32 weeks or a birth weight of less than 1500 g and their mothers, who were randomly divided into two groups. The intervention group consisted of mothers who received KMC combined with nurse-assisted mindfulness training for 14 days. The control group comprised mothers who received only KMC for 14 days. Data from both groups were collected and compared for analysis. RESULTS: Forty-seven infants and their mothers were included in the intervention group, whereas 44 pairs were included in the control group. After the intervention, the parental stressor scale scores for the neonatal intensive care unit (PSS: NICU) (3), PSS: NICU (4), and Hospital Anxiety and Depression Scale (HADS) scores for the intervention group were lower than those for the control group, whereas the Five Facet Mindfulness Questionnaire (FFMQ) (1), FFMQ (4), and FFMQ (5) scores for the intervention group were higher. The degree of change in the PSS: NICU and HADS scores was inversely correlated with the degree of change in the FFMQ score. The breast milk feed rate and weight gain rate were greater in the intervention group than in the control group. No adverse reactions were observed in either group. CONCLUSIONS: Kangaroo mother care combined with nurse-assisted mindfulness training is an acceptable, feasible, and effective procedure for reducing anxiety in mothers of preterm infants in the NICU, with potential benefits for the short-term prognosis of these infants. TRIAL REGISTRATION: Chinese Clinical Trial Registry, ChiCTR1900023697, registered on June 8, 2019, retrospectively registered.

Explaining maternal antenatal attachment by psychological, clinical and sociodemographic factors: a path analysis study.

BACKGROUND: Antenatal attachment is a fundamental concept relative to human transition to parenthood and may be influenced by several factors. The aim of this study is to find the best model to explain maternal antenatal attachment based on the interaction among sociodemographic, clinical, and psychological variables. METHODS: Pregnant women (N = 407) were interviewed during the second trimester of pregnancy while waiting for medical consultations. A sociodemographic, obstetric, and psychometric protocol was used. STATISTICAL ANALYSES: path analysis. INDEPENDENT VARIABLES: psychopathological symptomatology, depression, anxiety, stress, occupational stress, attitudes about pregnancy and motherhood, coping styles, marital satisfaction, sociodemographic, and clinical variables. DEPENDENT VARIABLES: maternal antenatal attachment in its several dimensions; quality of attachment (QA), intensity of preoccupation (IP), and global attachment (GA). RESULTS: Depression, anxiety, attitudes, and marital satisfaction explained 37% of maternal antenatal QA. Age, depression, anxiety, attitudes, and marital satisfaction explained 26% of maternal antenatal IP. Age, depression, anxiety, attitudes, and marital satisfaction explained 34% of the statistical variance of maternal antenatal GA. CONCLUSIONS: Factors like emotional states (depression and anxiety), attitudes towards pregnancy and motherhood, marital satisfaction, and a sociodemographic variable (age) contribute significantly for the explanation of maternal antenatal attachment.

Development of a breastfeeding support scale in the workplace and psychometric properties of Turkish version: a validity and reliability.

The purpose of this study was to develop a workplace breastfeeding support scale for working mothers and examine their psychometric properties. This methodological research was conducted between February and April 2022. This study included 325 mothers who continued breastfeeding while working. The tool development stages included item generation, expert review for content validity testing, and psychometric testing. The data were collected through face-to-face interviews between February and April 2022. In data analysis, for explanatory factor analysis, the direct oblimin technique and scree plot test were performed. Structural equation modeling was performed for confirmatory factor analysis. Two sub-dimensions (manager support, environmental support) and a nine-item workplace breastfeeding support scale showed good validity and reliability. The Cronbach's alpha value of the total scale and sub-dimensions of the scale were greater than 0.70. Confirmatory factor analysis showed that the model fit indices were acceptable (χ2 = 68.658, χ2/df = 2.64, CFI = 0.94, GFI = 0.96, AGFI = 0.92, and RMSEA = 0.07). The total variance explained by the scale was 54.32 percent. This newly developed 9-item and 2-dimensional version is a valid and reliable tool for measuring the working mothers' perception of workplace breastfeeding support. This tool is recommended to be verified in other low, middle, and high-income countries.

Microclimatic effects of tree shelters on the early establishment and resilience of seeded acorns vs. outplanted seedlings.

Little is known about the effects of tree shelters on the early response of oak seedlings produced by acorn seeding. In this paper, we explore the effects on holm oak (Quercus ilex L. subsp. ballota (Desf.) Samp.) seedlings of the microenvironment created by the tree shelters and the restoration method (seeding vs. outplanting) in terms of emergence, survival, growth, and resilience after harvesting. For this purpose, seedling height [H], root collar diameter [RCD], number of leaves, and aerial biomass were monitored. We made two sowings of acorns in February 2017 and February 2018, together with a seedling outplanting in February 2018 in a common garden site in semiarid SE Spain. In total, 600 acorns were randomly sowed and 300 nursery-grown seedlings were outplanted and studied until 2022. Mother tree and initial acorn mass were also monitored as additional variables in the analyses. Tree shelters consisted of closed plastic Tubes, Mixed tubes, Cork shelters, Tiles, and a Control with no shelter. Emergence rate was positively influenced by the Tube shelter (86%) as compared to the Control (64%), and especially by the initial acorn mass. By contrast, mother tree or year of sowing seemed to have no effect. The survival rate for the emerged acorns (88%) was statistically similar to that of outplanted seedlings (91%), and was unaffected by mother tree, tree shelter, or acorn mass. In terms of growth, the slenderness ratio (H:RCD) was considerably higher in seedlings from directly seeded acorns than for those that were outplanted. With the exception of Tile, all the shelters showed a higher slenderness ratio than the Control, especially the Tube shelter, which also showed a lower number of leaves and a lower aboveground dry biomass than the Control, Cork, and Tile shelters. Virtually no interactions were observed between the mother tree and the tree shelter. At harvesting, all the growth-related parameters were still strongly dependent on the acorn mass and the initial seedling features recorded after the first growing season. Resprouting rate and growth were also highly dependent on the acorn mass and the plant features at the beginning of the experiment and at harvesting. In summary, we did not find evidence to support tree shelters to improve the microclimate of holm oak seedlings both seeded or outplanted. Direct acorn seeding can be as successful as outplanting of nursery-grown seedlings. Selection of heavy acorns from mothers with a high germination and emergence rate is highly advisable.

Exploring the relationship between social media use, sharenting practices, and maternal psychological well-being.

BACKGROUND: This study examined the correlation between social media usage, sharenting practices (sharing parenting-related content on social media), and psychological well-being among 130 mothers whose children visited Baskent University Hospital between April 2020 and January 2021. METHODS: The participants completed an online questionnaire that assessed their social media usage, sharenting practices on Instagram, as well as their levels of depression, life satisfaction, and psychological resilience. Additionally, the researchers created an Instagram account and followed the mothers' social media activities. RESULTS: The findings revealed that Instagram was the most commonly used social media platform, with mothers using it an average of 5.8 times per day and spending an average of 75 min per day on the platform. Sharing privacy-violating photos of their children was positively correlated with the mothers' own depressive symptoms (r = 0.285, p < 0.01) and negatively correlated with their life satisfaction (r=-0.274, p < 0.01). Similarly, sharing children's photos containing identifiable information was positively correlated with mothers' depressive symptoms (r = 0.373, p < 0.01) and negatively correlated with their life satisfaction (r=-0.282, p = 0.001). CONCLUSION: These findings indicate a significant relationship between social media usage, sharenting practices, and the psychological well-being of mothers. The study underscores the importance of raising awareness about the potential risks associated with social media use, particularly among mothers who engage in sharenting practices.

Mother Phubbing and Child Problematic Media Use: The Role of Mother-Child Relationship and Paternal Coparenting.

Purpose: This study investigates the relationship between mother phubbing and preschoolers' problematic media use, examining the mediating role of the mother-child relationship and the moderating effects of paternal coparenting. Drawing on the Interactive Theory of Childhood Problematic Media Use and family system theory, we aim to identify key family dynamics that influence early childhood media habits. The findings could provide insights into mitigating the negative impacts of parental phubbing on children's media habits and inform targeted interventions to promote healthier media use among young children. Methods: The study examined 1008 mothers (Mage = 35.58 years, SD = 3.90) with preschool-aged children (Mage = 4.59 years, SD = 0.92) who completed self-report questionnaires. Path analysis with bootstrap sampling was executed to assess the moderated mediation model. Results: Mother phubbing was positively associated with preschoolers' problematic media use, with this relationship mediated by the mother-child relationship. Paternal coparenting moderated both the direct and indirect pathways in this relationship. Specifically, paternal coparenting directly mitigated the impact of mother phubbing on child problematic media use. Additionally, it alleviated the negative influence of mother phubbing on the mother-child relationship, thereby indirectly reducing its adverse effect on preschoolers' problematic media use. Overall, paternal coparenting demonstrated a protective function against the negative consequences of mother phubbing. Conclusion: The findings significantly contribute to our understanding of how mother phubbing might increase the risk of problematic media use among preschoolers and underscore the potential importance of reducing mother phubbing and increasing paternal coparenting as integral steps to prevent preschoolers' problematic media use.

A Mobile Gaming App to Train Teenage Mothers on Appropriate Child Feeding Practices: Development and Validation Study.

BACKGROUND: Undernutrition is an underlying factor in nearly 50% of 1 million estimated annual deaths among Nigerian children aged <5 years. Inappropriate maternal infant and young child feeding (IYCF) practices are basic contributors to child undernutrition. Teenage motherhood exacerbates the problem of inadequate child feeding. One possible intervention method to improve IYCF knowledge and practices of teenage mothers is the use of mobile gaming technologies. Despite extreme poverty in low- and middle-income countries, a ubiquity of mobile phone networks exists. OBJECTIVE: This study aims to develop and validate a mobile gaming app, called BabyThrive, to train Nigerian teenage mothers on appropriate IYCF practices. METHODS: To identify gaps in current IYCF practices in northern Nigeria, we conducted an extensive search of the literature and held 2 focus group interviews with 16 teenage mothers with low-income status. An initial app content design was then created, and content validity was established by 10 nutrition experts. Next, we developed an app prototype, which was assessed for quality by 7 nutrition and mobile gaming experts and evaluated for usability by 90 teenage mothers from rural areas in Abuja, the country's capital. The final app, BabyThrive, is a 2D mobile game that is fully functional offline and available in English as well as Hausa, which is commonly spoken in northern Nigeria. The efficacy of the BabyThrive app was assessed using IYCF knowledge scores obtained from the administration of the validated Teen Moms Child Feeding Questionnaire for Sub-Saharan Africa. Construct validity was established via crossover design by comparing the total IYCF knowledge scores of the teenage mothers obtained after a verbal training program and BabyThrive app use. RESULTS: Large proportions of the study participants were married (53/90, 59%) and had no personal income (63/90, 70%). The mean quality rating for the BabyThrive app was 4.3 (SD 0.39) out of 5.0. High levels (>80%) of usability and user satisfaction were documented. Knowledge of exclusive breastfeeding (P<.001) and total knowledge scores (P=.002) were significantly higher in the BabyThrive group than in the verbal training group. The IYCF knowledge scores obtained from both groups showed coherence, with a statistically significant Spearman correlation coefficient of 0.50 (P<.001). CONCLUSIONS: This research developed and validated a novel, offline mobile gaming app. It will be an easy, effective, and acceptable method to disseminate critical knowledge on IYCF practices to teenage mothers in rural Nigeria.

Factors Associated with Birth-Related Post-Traumatic Stress Disorder Symptoms and the Subsequent Impact of Traumatic Birth on Mother-Infant Relationship Quality.

This study aimed to investigate factors associated with birth-related PTSD symptoms and the subsequent impact on mother-infant relationship quality, exploring what women felt they needed to be different about their birth process to further understand the problem. Participants were recruited using social media advertising. A multi-method approach, using qualitative and quantitative analyses, was employed. The study included 142 pregnant women residing in Australia aged between 19 and 42 years (M = 31.24; SD = 4.70). High extraversion significantly predicted greater birth-related PTSD symptoms. There was a significant relationship between birth-related PTSD symptoms and poorer mother-infant relationship quality. The content analysis of the responses from women who reported a desire for a different or improved birth experience generated four themes: (1) less intrusive intervention, (2) better communication, (3) access to more supportive intervention, and (4) better post-birth care. The findings highlight the importance of supporting women's choices during birth by promoting informed and respectful woman-centred care. Postnatally, the screening and assessment of women should go beyond mood screening and include an assessment of the woman's response to her birth experience.

Effect of maternal knowledge of asthma management on quality of life and asthma control among children with asthma: a cross-sectional study.

OBJECTIVE: This study aimed to evaluate the effect of mothers' knowledge about asthma management on quality of life and asthma control among children with asthma in Palestine. METHODS: This cross-sectional study was carried out by mothers of children with asthma in Palestine in four major public hospitals. Mothers of a total of 220 were selected randomly via a computerized system. Data were collected using Pediatric Asthma Quality of Life (PAQLQ), an Asthma Control Test (ACT), and the mothers' Self-Practices and Knowledge (SPK) of asthma management questionnaire. Statistical analysis was performed using SPSS (V25). RESULTS: A total of 220 mothers of children with asthma were randomly selected and invited to participate but 182 agreed to participate, with a response rate of 83%. The mean age of participant children was 9.7 ± 2.72 years, and the mean age of mothers was 34.5 ± 9.6 years. The mean score of the QoL was 3.91(SD ± 1.61) out of 7. Most participant children had uncontrolled asthma with a total mean score of 14.13(SD ± 5.23) on the ACT. The mean score of mothers' SPK level was 2.12(SD ± 0.83) with a total mean score of 42.13 ± 3.68 out of 68, which indicated a moderate level of knowledge and there was a strong correlation between mothers' SPK and children's QoL. CONCLUSIONS: The investigation showed that mothers of children with asthma had moderate SPK, and the children had uncontrolled asthma with poor QoL. These findings suggest developing educational initiatives to enhance parents' asthma-related knowledge and skills to improve their children's asthma-related quality of life and asthma control.

Topical review: Lactation and use of DMTs in women with MS.

One in three females with multiple sclerosis (MS) becomes pregnant after diagnosis. In the postpartum period, there is a risk of rebound inflammatory activity. This risk can likely be reduced with breastfeeding, as well as with early initiation of effective therapies that have low therapeutic lag. To guide patients in their choices surrounding breastfeeding and MS therapies, clinicians must be familiar with how best to protect against relapses, to ensure infant safety, and to support breastfeeding choices. This topical review provides a broad framework on lactation in women with MS. It seeks to reframe guidelines around caring for the maternal-infant dyad, and for diverse populations living with MS. It also provides updated data on the effects of lactation in women with MS and the limited data on transfer of disease-modifying therapies (DMTs) into breastmilk. The ultimate goal is to support informed shared decision-making between clinicians and patients regarding breastfeeding during the high-risk postpartum period.

Bolstering Access to HIV-Related Health care in Zimbabwe Among Young Mothers Living With HIV: Lessons Learned on HIV Health Promotion From Zvandiri's Young Mentor Mother Program.

HIV disproportionately affects adolescent girls and young women living in Southern Africa. Rates of perinatal HIV transmission are high in this population, emphasizing the need for targeted health promotion and public health programming to improve the health of young mothers living with HIV. Zvandiri, a non-profit organization in Zimbabwe, created the Young Mentor Mother (YMM) program in response to this issue. This health promotion program uses peer-led service delivery conducted by trained young mothers living with HIV, called YMMs. We conducted semi-structured virtual interviews (N = 29) among Zvandiri staff and YMMs to identify benefits and challenges, and to inform future program scaling. We applied thematic analyses to the transcriptions. Participant narratives revealed several themes, including three key benefits from the YMM program: (1) peer support, (2) holistic care, and (3) women's empowerment. Participants also shared barriers to the success of the program, reflecting two overarching dimensions: (1) barriers related to scaling up the YMM program and (2) challenges related to addressing socio-structural factors. Barriers to scale-up included limited funds and resources, and food insecurity. Socio-structural challenges included HIV-related stigma, cultural and geographic differences, and intimate partner violence (IPV). These challenges align with the social-ecological model, whereby structural factors (lack of funding, food insecurity), community factors (HIV-related stigma, socio-cultural differences in accepting HIV care), and interpersonal factors (IPV) affect the implementation and scale-up of the program. We recommend future adopters of the YMM program to tailor the model for their community, prioritize peer supporter's well-being, foster women's empowerment, and adopt a holistic care approach.