Assessing Option B+ retention and infant follow-up in Lilongwe, Malawi

Option Bþ, a programme for pregnant or breastfeeding HIV-positive women to begin combination antiretroviral therapy

Abstract

Malawi launched Option Bþ, a program for all pregnant or breastfeeding HIV-positive women to begin lifelong combination antiretroviral therapy (cART), in July 2011.

This study characterises a portion of the continuum of care within an antenatal setting in Lilongwe. Women testing HIV-positive and having a cART initiation record at Bwaila Antenatal Clinic from July 2013 to January 2014 were included. Using logistic regression models, the authors analysed relationships between maternal characteristics and return for infant testing. Among 490 HIV-positive women with a cART initiation record, 360 (73%) were retained at three months. Of these, 203 (56%) were adherent. Records of infant testing were located for 204 women (42%). Women who were not retained were less likely to have an early infant diagnosis record (aOR¼0.20; 95% CI: 0.10, 0.41). Among the women retained, there was a non-significant association between maternal adherence and infant testing (OR¼1.35; 95% CI: 0.89, 2.06). Women lost at earlier continuum stages, who are at higher risk for mother-to-child-transmission, were less likely to bring infants for testing. Even with a test-and-treat program, many women did not remain in care or bring their infant for testing. Facilitating strategies to improve these measures remains an important unmet need.

This research was supported by the UK Department for International Development’s Operational Research Capacity Building Programme led by the International Union Against TB and Lung Disease (The Union)

Citation

Hauser BM, Miller WC, Tweya H, Speight C, Mtande T, Phiri S, Ball LM, Hosseinipour MC, Hoffman IF, Rosenberg NE. Assessing Option B þ retention and infant follow-up in Lilongwe , Malawi. International Journal of STD and AIDS. 2017;e95646241772165.

Assessing Option B+ retention and infant follow-up in Lilongwe, Malawi

Published 27 July 2017