SEATTLE – Providing antiretroviral therapy to pregnant women in antenatal care settings has become commonplace in sub-Saharan African settings, but keeping these women in care after their babies are born has been challenging. Continuing antiretroviral treatment services for women in settings where postnatal services are provided to them and their infants is a “simple and highly effective strategy” for maintaining women in care during the post-partum period, according to Landon Myer from the University of Capetown who presented findings Tuesday morning from a study exploring this issue.
The study randomized 472 mothers from the Gugulethu settlement outside Cape Town to either continue to receive HIV treatment through the breast feeding period in an integrated HIV and maternal child health program after their babies were born, or to be referred to adult HIV clinical services for their own care and to routine “well baby” services for their newborns. The study aimed to evaluate both the level of continued maternal engagement in HIV care, and HIV viral suppression after 12 months. Some 80 percent of the women had started HIV treatment during pregnancy as part of the Option B plus approach of initiating antiretroviral therapy for all pregnant women identified as HIV-infected.
Researchers scheduled visits with the mothers at six weeks, and then three, six, and 12 months post-partum and assessed retention in care and HIV viral load from medical records.
Both groups had very low rates of HIV transmission to their infants. At twelve months, 77 percent of the women who received integrated services remained in care and achieved HIV viral suppression compared to 56 percent of the women who were referred to adult HIV clinics to continue their own care. Women in integrated care also breast fed longer, which provided additional health benefits to their infants.