Patterns of HIV Care Clinic Attendance and Adherence to Antiretroviral Therapy Among Pregnant and Breastfeeding Women Living With HIV in the Context of Option B+ in Zimbabwe

Journal of Acquired Immune Deficiency Syndromes : JAIDS
Alison S ErlwangerAlexio-Zambezi Mangwiro

Abstract

Consistent use of antiretroviral therapy (ART) during pregnancy and breastfeeding reduces the likelihood of mother-to-child HIV transmission. All pregnant and breastfeeding women living with HIV in Zimbabwe are offered ART with same-day initiation regardless of CD4 count (Option B+). We investigated patterns of clinic attendance and adherence to ART among HIV-infected pregnant women in Zimbabwe. The Evidence for Elimination cluster-randomized trial evaluating point-of-care CD4 testing included 1150 HIV-infected ART-naive women attending antenatal care between January 2014 and June 2015. Thirty-two primary care facilities were randomized between 2 arms. In this secondary analysis of Evidence for Elimination data collected from routine clinic records, we classified women by number of pills dispensed, and estimated adherence from the ratio of pills to days since ART initiation (Medication Possession Ratio, adherent if ≥95%) or the period when they stopped receiving medication. Two-thirds (67.7%) were still receiving medication 1 year after initiation; less than half of the cohort (39.1%) were adherent. Younger women, newly diagnosed with HIV, and/or first presenting to antenatal care in their third trimester were more likely to dr...Continue Reading

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Citations

Dec 30, 2017·Journal of Acquired Immune Deficiency Syndromes : JAIDS·Brandon A KnettelMelissa H Watt
Jun 23, 2018·Current HIV/AIDS Reports·Grace John-Stewart
Jul 22, 2018·Journal of the International AIDS Society·Tamsin K PhillipsLandon Myer
Jun 27, 2019·Health Care for Women International·Sara ChandyMaria L Ekstrand
Oct 28, 2019·Journal of Acquired Immune Deficiency Syndromes : JAIDS·Risa M HoffmanUNKNOWN PROMISE 1077HS Team
Feb 14, 2021·International Journal of Environmental Research and Public Health·Steven MasianoMaria Kim

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