1. Initial Programmatic Implementation of WHO Option B in Botswana Associated With Increased Projected MTCT.
- Author
-
Dryden-Peterson, Scott, Lockman, Shahin, Zash, Rebecca, Quonhong Lei, Chen, Jennifer Y., Souda, Sajini, Petlo, Chipo, Dintwa, Eldah, Lebelonyane, Refeletswe, Mmalane, Mompati, and Shapiro, Roger L.
- Abstract
Botswana was one of the first African countries to transition from WHO Option A to Option B for prevention of mother-to-child HIV transmission (MTCT). We evaluated the impact of this transition on projected MTCT risk through review of 10,681 obstetric records of HIV-infected women delivering at 6 maternity wards. Compared with Option A, women receiving antenatal care under Option B were more likely to receive combination antiretroviral therapy (ART), adjusted odds ratio (aOR): 2.59 (95% confidence interval: 2.25 to 2.98), but they were also more likely to receive no antenatal antiretrovirals, aOR: 2.10 (95% confidence interval: 1.74 to 2.53). Consequently, initial implementation of Option B was associated with increased projected MTCT at 6 months of age, 3.79% under Option A and 4.69% under Option B (P, 0.001). Successful implementation of Option B or B+ may require that ART can be initiated within antenatal clinics, and novel strategies to remove barriers to rapid ART initiation. [ABSTRACT FROM AUTHOR]
- Published
- 2015
- Full Text
- View/download PDF