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Retention in care under universal antiretroviral therapy for HIV-infected pregnant and breastfeeding women (‘Option B+’) in Malawi
| Content Provider | Scilit |
|---|---|
| Author | Tenthani, Lyson Haas, Andreas D. Tweya, Hannock Jahn, Andreas Oosterhout, Joep J. Van Chimbwandira, Frank Chirwa, Zengani Ng’Ambi, Wingston Bakali, Alan Phiri, Sam Myer, Landon Valeri, Fabio Zwahlen, Marcel Wandeler, Gilles Keiser, Olivia |
| Copyright Year | 2014 |
| Description | Journal: Aids Objective: To explore the levels and determinants of loss to follow-up (LTF) under universal lifelong antiretroviral therapy (ART) for pregnant and breastfeeding women (‘Option B+’) in Malawi. Design, setting, and participants: We examined retention in care, from the date of ART initiation up to 6 months, for women in the Option B+ program. We analysed nationwide facility-level data on women who started ART at 540 facilities (n = 21 939), as well as individual-level data on patients who started ART at 19 large facilities (n = 11 534). Results: Of the women who started ART under Option B+ (n = 21 939), 17% appeared to be lost to follow-up 6 months after ART initiation. Most losses occurred in the first 3 months of therapy. Option B+ patients who started therapy during pregnancy were five times more likely than women who started ART in WHO stage 3/4 or with a CD4+ cell count 350 cells/μl or less, to never return after their initial clinic visit [odds ratio (OR) 5.0, 95% confidence interval (CI) 4.2–6.1]. Option B+ patients who started therapy while breastfeeding were twice as likely to miss their first follow-up visit (OR 2.2, 95% CI 1.8–2.8). LTF was highest in pregnant Option B+ patients who began ART at large clinics on the day they were diagnosed with HIV. LTF varied considerably between facilities, ranging from 0 to 58%. Conclusion: Decreasing LTF will improve the effectiveness of the Option B+ approach. Tailored interventions, like community or family-based models of care could improve its effectiveness. |
| Related Links | https://core.ac.uk/download/pdf/33068890.pdf https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4009400/pdf |
| Ending Page | 598 |
| Page Count | 10 |
| Starting Page | 589 |
| ISSN | 02699370 |
| e-ISSN | 14735571 |
| DOI | 10.1097/qad.0000000000000143 |
| Journal | Aids |
| Issue Number | 4 |
| Volume Number | 28 |
| Language | English |
| Publisher | Ovid Technologies (Wolters Kluwer Health) |
| Publisher Date | 2014-02-20 |
| Access Restriction | Open |
| Subject Keyword | Journal: Aids Health Policy and Services Antiretroviral Therapy, Loss To Follow-up, Option B+, Pregnancy, Prevention of Mother-to-child Transmission/vertical Transmission, Retention in Care |
| Content Type | Text |
| Resource Type | Article |
| Subject | Infectious Diseases Immunology and Allergy Immunology |
