scholarly journals Adherence to Combination Antiretroviral Therapy among Pregnant Women Enrolled in a HIV Prevention Program in Rural North-central Nigeria

2020 ◽  
Vol 9 (1) ◽  
pp. 81-92
Author(s):  
Cedrina L. Calder ◽  
Heather O ◽  
Mohammad Tabatabai ◽  
Celia J. Maxwell ◽  
Salisha Marryshow ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Pregnant Women ◽  
Hiv Transmission ◽  
Secondary Analysis ◽  
Self Report ◽  
Hiv Positive ◽  
Combination Antiretroviral Therapy ◽  
North Central ◽  
Hiv Positive Women ◽  
Mother To Child

Objective: Adherence to combination antiretroviral therapy (ART) among pregnant women is essential to attaining the goal of eliminating mother-to-child HIV transmission. The objective of this study was to determine which factors affect adherence to ART among HIV-positive women enrolled in a large prevention of mother-to-child HIV transmission (PMTCT) trial in rural north-central Nigeria. Methods: The parent study included 372 HIV-positive pregnant women enrolled in a cluster-randomized control trial conducted at 12 health facilities in Nigeria between 2013 and 2015. This secondary analysis included HIV-positive women (and their infants) from the original trial with documented adherence data (n=210, 56.5%). The primary outcome was maternal adherence to ART, determined by self-report and based on the visual analogue scale (VAS) of a validated medication adherence tool. Participants with a VAS score of ? 95% were classified as adherent. We employed multivariate logistic regression to evaluate the predictors of maternal ART adherence in the study sample. Results: Approximately 61.0% of study participants (128/210) were adherent to ART. The majority of adherent participants (62.5%, 80/128) were enrolled in the trial intervention arm. The most common cited response for non-adherence was fear of status disclosure. Adherence to ART was associated with study arm (intervention arm vs. control arm, adjusted Odds Ratio (aOR) [95% CI]: 16.95 [5.30-54.23]), maternal ethnicity (Gwari vs. Other, aOR = 0.13 [0.05-0.38]), and partner HIV status (HIV-positive vs. unknown, aOR = 3.14 [1.22-8.07]). Conclusion and Global Health Implications: Adherence to ART among a cohort of pregnant women enrolled in a PMTCT trial in rural North-Central Nigeria was associated with trial arm, maternal self- reported ethnicity, and partner

scholarly journals Challenges in Assessing Outcomes among Infants of Pregnant HIV-Positive Women Receiving ART in Uganda

2017 ◽  
Vol 2017 ◽  
pp. 1-4
Author(s):  
Barbara Castelnuovo ◽  
Frank Mubiru ◽  
Ivan Kalule ◽  
Shadia Nakalema ◽  
Agnes Kiragga
Keyword(s):  
Clinical Trials ◽  
Pregnant Women ◽  
Median Time ◽  
Hiv Transmission ◽  
Cd4 Count ◽  
Hiv Positive ◽  
Hiv Positive Women

Since 2012, the WHO recommends lifelong ART with TDF+FTC/3TC+EFV for all HIV-positive pregnant and breastfeeding women (Option B-plus). In this analysis we describe the proportion of early and late transmission in mothers with high retention in Kampala, Uganda. We included 700 pregnant women from January 2012 to August 2014 with a follow-up extended to August 2016; the median age was 31 years (IQR: 26–35), 36.3% in WHO stage 3/4; median CD4 count was 447 cells/μL (IQR: 301–651) and 73.3% were already on ART for a median time of 28 (IQR: 10–57) months; 52% infants were male and median weight was 3.2 Kg (IQR: 2.5–3.5). Five hundred and sixty-five (80.7%) infants had at least one test for HIV; 22 (3.1%) infants died, all with unknown serostatus; 3 tested positive at week 6 and one additional at months 12 and 18. Two of the mothers of the 4 HIV-positive infants were ART-naïve at the time of pregnancy. We report very low documented HIV transmission comparable with those reported in clinical trials settings; however, demonstrating the efficacy of Option B-plus in terms of averted transmission in routine settings is challenging since high proportion of infants do not have documented HIV tests.

scholarly journals Prevention of mother-to-child HIV transmission program in Iran

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Parvin Afsar Kazeroni ◽  
Mohammad Mehdi Gouya ◽  
Mandana Tira ◽  
Maryam Sargolzaiie ◽  
Sana Eybpoosh ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Hiv Transmission ◽  
Comprehensive Evaluation ◽  
Control Program ◽  
Pilot Project ◽  
Hiv Positive ◽  
Pilot Phase ◽  
Viral Load Suppression ◽  
Barriers And Challenges ◽  
Mother To Child

Abstract Background The reproductive health and Prevention of Mother-to-Child Transmission (PMTCT) of HIV programs in Iran were integrated as a pilot project in September 2014. This study aims to provide a comprehensive evaluation and analysis of the PMTCT of HIV program in Iran. Methods The pilot phase of PMTCT of HIV was launched in early September 2014 in selected centers including 170 health centers and 40 hospitals affiliated to medical universities of 16 provinces of Iran. In each medical university, a researcher-made checklist was administered to all newly-diagnosed HIV-positive pregnant women by an AIDS expert. Data was analyzed using SPSS 19. Results Overall, 69.4% of eligible pregnant women were enrolled in the pilot phase. From 134 reactive cases, 76 (56.7%) were confirmed as HIV positive. ARV consumption was irregular in 10 (13.2%) of HIV positive pregnant women. Also, 82.5% had CD4 count more than 350 after treatment, with an average of 55.5% increase in the number of CD4 in comparison to the baseline, and 84.8% had viral load suppression (< 200 copies/ml). Counseling and testing was done for the husbands of 75% of the women that resulted in the identification of 15 (39.5%) new HIV cases among husbands. Among the tested individuals, 23 (60.5%) males already knew their HIV status and were registered as HIV patients. HIV was diagnosed in one (1.5%) newborn. Conclusion Implementation of rapid HIV testing and PMTCT in Iran is one of the strengths of the national HIV control program. To eliminate MTCT, it is necessary to understand and overcome the barriers and challenges to the program in the pilot phase.

scholarly journals Characteristics of HIV-positive pregnant women and HIV- and antiretroviral therapy-exposed fetuses: A case-control study

2020 ◽  
Vol 14 (08) ◽  
pp. 901-907
Author(s):  
Tung-Che Hung ◽  
Li-Cheng Lu ◽  
Mei-Hui Lin ◽  
Yu-Chia Hu ◽  
Chien-Yu Cheng ◽  
...  
Keyword(s):  
Body Weight ◽  
Antiretroviral Therapy ◽  
Pregnant Women ◽  
Case Control Study ◽  
Case Control ◽  
Hiv Positive ◽  
Positive Group ◽  
Hiv Positive Women ◽  
Control Study ◽  
Hiv Negative

Introduction: This study determined risk factors, obstetric comorbidities, and fetal conditions among HIV-positive mothers to improve their maternal care. Methodology: This retrospective case-control study included HIV-positive pregnant women 18 years of age or older and age-, parity-, and delivery method-matched HIV-negative controls between 2011 and 2018. Those who had stillbirth were excluded. Baseline demographics, labor process, CD4 count, plasma HIV viral load, and antiretroviral therapy (ART) regimen were recorded. Fetal conditions were recorded as well. Results: Forty HIV-positive women (45 parities; 22 via NSD, 23 via C/S) were included, with 45 HIV-negative parities as controls. Twenty-nine (72.5%) HIV-positive women had illicit drug use. In the HIV-positive group, 17% received ART prior to first perinatal visit, and 75.6% reached viral suppression pre-delivery. Zidovudine and ritonavir-boosted lopinavir were the majorly prescribed ART. Mild perineal lacerations via NSD were observed in HIV-positive women. Fetal body weight was lower in HIV- and ART-exposed fetuses (2665 vs 3010 g, p < 0.001). Preterm delivery PTB (28.9% vs 8.9%, p= 0.015) and small-for gestational age SGA (28.9% vs 8.8%, p = 0.003) rates were higher in the HIV-positive group. There was no vertical transmission of HIV. Conclusions: HIV-positive women tend to deliver fetuses with low body weight and have higher SGA and PTB rates. Given that most women received zidovudine and protease inhibitors, benefits of newer agents for HIV-positive pregnancies should be studied.

DOES KNOWLEDGE ABOUT ANTIRETROVIRAL THERAPY AND MOTHER-TO-CHILD TRANSMISSION AFFECT THE RELATIONSHIPS BETWEEN HIV STATUS AND FERTILITY PREFERENCES AND CONTRACEPTIVE USE? NEW EVIDENCE FROM NIGERIA AND ZAMBIA

2013 ◽  
Vol 46 (5) ◽  
pp. 580-599 ◽  
Author(s):  
AKINRINOLA BANKOLE ◽  
ANN E. BIDDLECOM ◽  
KUMBUTSO DZEKEDZEKE ◽  
JOSHUA O. AKINYEMI ◽  
OLUTOSIN AWOLUDE ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Contraceptive Use ◽  
Hiv Positive ◽  
Hiv Status ◽  
Child Transmission ◽  
Hiv Positive Women ◽  
Childbearing Desires ◽  
Living With Hiv ◽  
Mother To Child ◽  
Hiv Negative

SummaryThe increasing availability of antiretroviral therapy (ART) and drug regimens to prevent mother-to-child transmission (PMTCT) has probably changed the context of childbearing for people living with HIV. Using data from 2009–2010 community-based surveys in Nigeria and Zambia, this study explores whether women's knowledge about ART and PMTCT influences the relationship between HIV status and fertility preferences and contraceptive behaviour. The findings show that women living with HIV are more likely to want more children in Nigeria and to want to limit childbearing in Zambia compared with HIV-negative women. While there is no significant difference in contraceptive use by women's HIV status in the two countries, women who did not know their HIV status are less likely to use contraceptives relative to women who are HIV-negative. Knowledge about ART reduces the childbearing desires of HIV-positive women in Nigeria and knowledge about PMTCT increases desire for more children among HIV-positive women in Zambia, as well as contraceptive use among women who do not know their HIV status. The findings indicate that knowledge about HIV prevention and treatment services changes how living with HIV affects childbearing desires and, at least in Zambia, pregnancy prevention, and highlight the importance of access to accurate knowledge about ART and PMTCT services to assist women and men to make informed childbearing decisions. Knowledge about ART and PMTCT should be promoted not only through HIV treatment and maternal and newborn care facilities but also through family planning centres and the mass media.

Legal Barriers to Implementing Recommendations for Universal, Routine Prenatal HIV Testing

2004 ◽  
Vol 32 (1) ◽  
pp. 137-147 ◽  
Author(s):  
Leslie E. Wolf ◽  
Bernard Lo ◽  
Lawrence O. Gostin
Keyword(s):  
United States ◽  
Antiretroviral Therapy ◽  
Pregnant Women ◽  
Hiv Testing ◽  
Hiv Transmission ◽  
Perinatal Transmission ◽  
The United States ◽  
Hiv Status ◽  
Mother To Child ◽  
Legal Barriers

Administraation of antiretroviral therapy to women during pregnancy, labor and delivery, and to infants postnatally can dramatidy reduce mother-to- child HIV transmission (MTCT). However, pregnant women need to know that they are HIV-infected to take advantage of antiretroviral therapy, and many women do not know their HIV status. One-half of HIV-infected infants in the United States were bornto women who had not been tested for HIV or for whom the time of testing was not known. Although fewer than 400infants are infected perinatally in the United States each year, that number could be reduced even further through policies aimed at HIV testing during pregnancy.The reasons toadopt such a policy are strong: the pathophysiology of perinatal transmission is clear, prophylaxis is effective and safe, and the intended beneficiaries of the intervention - babies - cannot protect themselves.

scholarly journals HIV-Positive Women Taking Lifelong Antiretroviral Therapy Report Better Adherence Than Women Taking Short-Course Prophylaxis During and After Pregnancy Under PMTCT Program Option A in Lusaka, Zambia

2017 ◽  
Vol 6 (1) ◽  
pp. 27 ◽  
Author(s):  
Karen Marie Hampanda, PhD, MPH ◽  
Lisa L. Abuogi, MD, MS ◽  
Yusuf Ahmed, MPH, BM
Keyword(s):  
Antiretroviral Therapy ◽  
Sub Saharan Africa ◽  
Hiv Positive ◽  
Mother To Child Transmission ◽  
Child Transmission ◽  
Cross Sectional ◽  
Therapy Regimen ◽  
Hiv Positive Women ◽  
Short Course ◽  
Mother To Child

Background and Objectives: HIV-positive women’s adherence to antiretrovirals is critical for prevention of mother-to-child transmission. We aimed to establish if mothers taking triple lifelong antiretroviral therapy report higher adherence compared to mothers taking short-course prophylaxis under Option A in Lusaka, Zambia.Methods: In this clinic-based cross-sectional study, we interviewed 320 HIV-positive mothers at a large public health facility in Lusaka in 2014. Participants reported adherence using a visual analog scale. Multiple logistic regression models were used to determine the adjusted odds of adherence by mother’s prescribed regimen.Results: Women taking lifelong triple antiretroviral therapy report higher adjusted odds of adherence during pregnancy, postpartum, and to giving the infant prophylaxis compared to women to women taking short-course prophylaxis.Discussion: Women on lifelong therapy may have better adherence compared to women on short course prophylaxis because they knew their positive status for longer or were symptomatic with HIV-related disease. The lifelong therapy regimen may be easier for women to follow, particularly because they are required to give the infant prophylaxis for a shorter duration of time.Conclusions and Global Health Implications: Our results indicate that lifelong triple antiretroviral therapy has the potential to promote better drug adherence during and after pregnancy among women living with HIV in sub-Saharan Africa, compared to short-course antiretroviral regimens.Key words: HIV-positive Women • Prevention of Mother-to-Child Transmission • Antiretroviral Therapy • Adherence • Zambia • Option A • PMTCT • ARTCopyright © 2017 Hampanda et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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