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Long-Term Outcomes of HIV-Infected Women Receiving Antiretroviral Therapy After Transferring Out of an Integrated Maternal and Child Health Service in South Africa.
- Source :
-
Journal of acquired immune deficiency syndromes (1999) [J Acquir Immune Defic Syndr] 2020 Mar 01; Vol. 83 (3), pp. 202-209. - Publication Year :
- 2020
-
Abstract
- Background: Integrated maternal and child health (MCH) services improve women's postpartum antiretroviral therapy (ART) outcomes during breastfeeding; however, long-term outcomes after transfer to general ART services remain unknown.<br />Methods: The MCH-ART trial demonstrated that maternal retention and viral suppression at 12-months postpartum were improved significantly among women randomized to integrated MCH services continued in the antenatal clinic through cessation of breastfeeding (MCH-ART arm) compared with immediate transfer to general ART services postpartum (standard of care). We reviewed electronic health records for all women who participated in the MCH-ART trial to ascertain retention and gaps in care and invited all women for a study visit 36- to 60-months postpartum including viral load testing.<br />Results: Of 471 women in MCH-ART, 450 (96%) contributed electronic health record data and 353 (75%) completed the study visit (median 44-month postpartum). At this time, outcomes were identical in both trial arms: 67% retained in care (P = 0.994) and 56% with viral loads <50 copies/mL (P = 0.751). Experiencing a gap in care after delivery was delayed in the MCH-ART arm with 17%, 36%, and 45% of women experienced a gap in care by 12-, 24-, and 36-months postpartum compared with 35%, 48%, and 57% in the standard of care arm, respectively.<br />Conclusions: The benefits of integrated maternal HIV and child health care did not persist after transfer to general ART services. The transfer of women postpartum to routine adult care is a critical period requiring interventions to support continuity of HIV care.
- Subjects :
- Adult
Female
HIV Infections epidemiology
Humans
Medication Adherence
Postpartum Period
Pregnancy
Pregnancy Complications, Infectious drug therapy
South Africa epidemiology
Anti-HIV Agents administration & dosage
Anti-HIV Agents therapeutic use
HIV Infections drug therapy
Health Services Accessibility
Maternal-Child Health Services
Subjects
Details
- Language :
- English
- ISSN :
- 1944-7884
- Volume :
- 83
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- Journal of acquired immune deficiency syndromes (1999)
- Publication Type :
- Academic Journal
- Accession number :
- 31725060
- Full Text :
- https://doi.org/10.1097/QAI.0000000000002236