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Studies probe retention in HIV care for women who start antiretroviral treatment during pregnancy
Carole Leach-Lemens, 2016-03-01 14:30:00
counsellors to provide a combination package of evidence-based interventions in
Nyanza, Kenya and addressing partner disclosure, as well as pre-treatment education
about the benefits of antiretroviral therapy (ART) for maternal and child health in Malawi’s Option B+ programme,
improved retention in care and reduced loss to follow-up of mothers with HIV
and their infants, studies presented last week at the Conference on
Retroviruses and Opportunistic Infections (CROI 2016) in Boston show.
in care of mothers with HIV and their infants across the prevention of
mother-to-child transmission (PMTCT)/paediatric care continuum continues to
undermine what is otherwise a remarkable success. If retention is not
adequately addressed, programme success and maternal and infant health are
resource-poor settings, studies have shown 17% of pregnant women with HIV
initiated on ART do not return after their first antenatal care visit; one
third of women with HIV who give birth in a clinic are lost to follow-up
three months after delivery.
Reports have described
the unique needs – including treatment literacy of postpartum
women with HIV – to be addressed if they are to return to and/or be retained in care.
of PMTCT services and adoption of Option B+ (the availability of lifelong
treatment regardless of CD4 count for pregnant and breastfeeding
women with HIV) in many countries, notably Malawi, have had extraordinary success in
significantly reducing the number of vertical (from mother to child) transmissions.
However, loss to follow-up (LTFU) among women enrolled onto treatment as a
result of Option B+ in Malawi is as high as 29% after a year.
Several studies presented at CROI 2016 looked at reasons for loss to follow-up among mothers enrolled on antiretroviral treatment, and interventions to improve retention.