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- Title
Assessing Option B+ retention and infant follow-up in Lilongwe, Malawi.
- Authors
Hauser, Blake M.; Ball, L. M.; Miller, William C.; Phiri, Sam; Hosseinipour, Mina C.; Hoffman, Irving F.; Rosenberg, Nora E.; Speight, Colin; Tweya, Hannock; Mtande, Tiwonge
- Abstract
Malawi launched Option B+, a program for all pregnant or breastfeeding HIV-positive women to begin lifelong combination antiretroviral therapy (cART), in July 2011. This study characterises a portion of the continuum of care within an antenatal setting in Lilongwe. Women testing HIV-positive and having a cART initiation record at Bwaila Antenatal Clinic from July 2013 to January 2014 were included. Using logistic regression models, we analysed relationships between maternal characteristics and return for infant testing. Among 490 HIV-positive women with a cART initiation record, 360 (73%) were retained at three months. Of these, 203 (56%) were adherent. Records of infant testing were located for 204 women (42%). Women who were not retained were less likely to have an early infant diagnosis record (aOR = 0.20; 95% CI: 0.10, 0.41). Among the women retained, there was a non-significant association between maternal adherence and infant testing (OR = 1.35; 95% CI: 0.89, 2.06). Women lost at earlier continuum stages, who are at higher risk for mother-to-child-transmission, were less likely to bring infants for testing. Even with a test-and-treat program, many women did not remain in care or bring their infant for testing. Facilitating strategies to improve these measures remains an important unmet need.
- Subjects
MALAWI; HIV-positive women; ANTIRETROVIRAL agents; VERTICAL transmission (Communicable diseases); INFANT health services; LOGISTIC regression analysis; MEDICAL care; HIV prevention; HIV infection transmission; ANTI-HIV agents; BREASTFEEDING; COMMUNICABLE diseases; COMPARATIVE studies; CONTINUUM of care; HIV infections; LONGITUDINAL method; RESEARCH methodology; EVALUATION of medical care; MEDICAL cooperation; PATIENT compliance; PREGNANCY complications; PRENATAL care; RESEARCH; RESEARCH funding; EVALUATION research; HUMAN research subjects; RETROSPECTIVE studies; HIV seroconversion; PATIENT dropouts; EVALUATION of human services programs; PSYCHOLOGY; PREVENTION
- Publication
International Journal of STD & AIDS, 2018, Vol 29, Issue 2, p185
- ISSN
0956-4624
- Publication type
journal article
- DOI
10.1177/0956462417721658