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Early HIV treatment: mothers say they need time to think
Carole Leach-Lemens, 2016-07-26 15:50:00
Findings from the first
randomised controlled trial to date evaluating postpartum antiretroviral
therapy (ART) for women with high CD4 cell counts (over 400 cells/mm3)
highlight a critical need to increase treatment acceptance in this population. The research was presented at the 21st International AIDS Conference (AIDS 2016) in Durban, South Africa.
Despite counselling and prior
exposure to intense ART education and HIV monitoring within a highly-resourced
clinical trial setting over a third of women declined ART when the offer of
treatment was extended to all women in the study, needing more time to consider
the benefits for their own health.
Effective implementation of
the World Health Organization’s recommended “treat all” approach requires
addressing the significant challenges these findings raise.
The findings come from the
Promoting Maternal and Infant Survival Everywhere (PROMISE 1077HS) study,
carried out at 52 clinical research sites in Argentina, Botswana, Brazil,
China, Haiti, Peru, Thailand and the United States.
The study was conducted
between January 2010 and November 2014 to determine if health over the long
term is better served by continuing or stopping ART after delivery among
non-breastfeeding women with high CD4 cell counts who did not meet local criteria
for starting ART.