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HIV mother to child transmission

Martin Kuete, HongFang Yuan, Aude Laure Tchoua Kemayou, Emmanuel Ancel Songo, Fan Yang, XiuLan Ma, ChengLiang Xiong, HuiPing Zhang
BACKGROUND: Integration of family planning services (FPS) into human immunodeficiency virus (HIV) care for HIV-infected women is an important aspect of the global prevention of mother-to-child transmission (PMTCT) strategy. We assessed the integration of FPS into routine care of HIV-infected mothers by evaluating the uptake and barriers of contraception and PMTCT services. METHODS: We conducted an interventional study using the interrupted time series approach in the health care facilities located in Yaounde, Cameroon...
2016: Patient Preference and Adherence
Sergio Bautista-Arredondo, Sandra G Sosa-Rubí, Marjorie Opuni, David Contreras-Loya, Ada Kwan, Claire Chaumont, Abson Chompolola, Jeanine Condo, Omar Galárraga, Neil Martinson, Felix Masiye, Sabin Nsanzimana, Ivan Ochoa-Moreno, Richard Wamai, Joseph Wang'ombe
OBJECTIVE: We estimate facility-level average annual costs per client along the HIV testing and counselling (HTC) and prevention of mother-to-child transmission (PMTCT) service cascades. DESIGN: Data collected covered the period 2011-2012 in 230 HTC and 212 PMTCT facilities in Kenya, Rwanda, South Africa, and Zambia. METHODS: Input quantities and unit prices were collected, as were output data. Annual economic costs were estimated from the service providers' perspective using micro-costing...
October 23, 2016: AIDS
Emily L Tuthill, Jennifer A Pellowski, Sera L Young, Lisa M Butler
Exclusive breastfeeding (EBF) provides infants with optimal nutrition, and together with appropriate antiretroviral therapy has also been shown to decrease mother-to-child transmission of HIV from 45 to less than 1 %. However, rates of EBF are particularly low in South Africa, where rates of HIV are some of the highest in the world. Although perinatal depression has been identified as a potential barrier to EBF, little is known about its impact on EBF among HIV-infected women. A cohort study was conducted as part of a pilot randomized controlled trial (RCT) examining the effect of an Information, Motivation and Behavioral skills-based intervention promoting EBF among South African women living with HIV in their third trimester (28-42 weeks) of pregnancy...
October 17, 2016: AIDS and Behavior
Kristen M Little, Allan W Taylor, Craig B Borkowf, Maria C B Mendoza, Margaret A Lampe, Paul J Weidle, Steven R Nesheim
OBJECTIVE: Using published, nationally representative estimates, we calculated the total number of perinatally HIV-exposed and -infected infants born during 1978-2010, the number of perinatal HIV cases prevented by interventions designed for the prevention of mother-to-child transmission (PMTCT), and the number of infants exposed to antiretroviral drugs during the prenatal and intrapartum periods. DESIGN: We calculated the number of infants exposed to antiretroviral drugs since 1994, and the number of cases of mother-to-child HIV transmission prevented from 1994-2010 using published data...
September 30, 2016: Pediatric Infectious Disease Journal
Etienne Karita, Sabin Nsanzimana, Felix Ndagije, Kristin M Wall, Jeannine Mukamuyango, Placidie Mugwaneza, Eric Remera, Pratima L Raghunathan, Roger Bayingana, Kayitesi Kayitenkore, Brigitte Bekan-Homawoo, Amanda Tichacek, Susan Allen
BACKGROUND: Couples' voluntary HIV counseling and testing (CVCT) is a WHO-recommended intervention for prevention of heterosexual HIV transmission which very few African couples have received. We report the successful nationwide implementation of CVCT in Rwanda. METHODS: From 1988 to 1994 in Rwanda, pregnant and postpartum women were tested for HIV and requested testing for their husbands. Partner testing was associated with more condom use and lower HIV and sexually transmitted infection rates, particularly among HIV-discordant couples...
November 1, 2016: Journal of Acquired Immune Deficiency Syndromes: JAIDS
Stephane Helleringer
New HIV infections among children have declined significantly more slowly in West and central African countries (WCA) than in eastern and southern African countries between 2009 and 2015. Since adolescent fertility is particularly high in WCA countries, frequent mother-to-child transmission (MTCT) of HIV may in part be due to low coverage of HIV testing among adolescents during antenatal care (ANC). We investigated this adolescent gap in HIV testing using survey data from the demographic and health surveys and multiple indicators cluster surveys collected in 21 WCA countries since 2009...
October 12, 2016: AIDS and Behavior
Qian Wang, Linhong Wang, Liwen Fang, Ailing Wang, Xi Jin, Fang Wang, Xiaoyan Wang, Yaping Qiao, Sheena G Sullivan, Shannon Rutherford, Lei Zhang
This study investigates the improvement of the prevention of mother-to-child transmission (PMTCT) of Human Immunodeficiency Virus (HIV) in China during 2004-2011. A clinic-based prospective study was conducted among HIV-positive pregnant women and their children in eight counties across China. Associated factors of mother-to-child transmission were analyzed using regression analysis. A total of 1,387 HIV+ pregnant women and 1,377 HIV-exposed infants were enrolled. The proportion of pregnant women who received HIV testing increased significantly from 45...
October 10, 2016: Scientific Reports
Sophie Desmonde, Tessa Goetghebuer, Claire Thorne, Valériane Leroy
PURPOSE OF REVIEW: The number of HIV-exposed but uninfected (HEU) infants exposed to both HIV and multiple antiretroviral drugs in utero and during prolonged breastfeeding is increasing in low-income countries where HIV prevalence is the highest. We review recent evidence on the effects of perinatal/postnatal exposure to maternal HIV and combined antiretroviral therapy (cART) on health outcomes of HEU children (mitochondrial and metabolic toxicity, adverse pregnancy outcomes, neurodevelopment, growth, infectious morbidity, and mortality)...
September 2016: Current Opinion in HIV and AIDS
V Dorsamy, C Vallen, F Haffejee, J Moodley, T Naicker
OBJECTIVE: To compare expression of markers of HIV and associated receptors (p24, CD4, CCR5 and ICAM-2) in placentae and umbilical cords of HIV-associated and pre-eclamptic pregnancies to elucidate any association between these conditions in mother-to-child transmission. DESIGN: Cross-sectional immunohistochemical analysis of target receptor expression. SETTING: Laboratory-based study of primigravidae attending a district hospital in South Africa...
October 3, 2016: BJOG: An International Journal of Obstetrics and Gynaecology
Ameena E Goga, Thu-Ha Dinh, Debra J Jackson, Carl J Lombard, Adrian Puren, Gayle Sherman, Vundli Ramokolo, Selamawit Woldesenbet, Tanya Doherty, Nobuntu Noveve, Vuyolwethu Magasana, Yagespari Singh, Trisha Ramraj, Sanjana Bhardwaj, Yogan Pillay
BACKGROUND: Eliminating mother-to-child transmission of HIV (EMTCT), defined as ≤50 infant HIV infections per 100 000 live births, is a global priority. Since 2011 policies to prevent mother-to-child transmission of HIV (PMTCT) shifted from maternal antiretroviral (ARV) treatment or prophylaxis contingent on CD4 cell count to lifelong maternal ARV treatment (cART). We sought to measure progress with early (4-8 weeks postpartum) MTCT prevention and elimination, 2011-2013, at national and sub-national levels in South Africa, a high antenatal HIV prevalence setting ( ≈ 29%), where early MTCT was 3...
December 2016: Journal of Global Health
Edward Nicol, Lilian Dudley, Debbie Bradshaw
BACKGROUND: The prevention of mother-to-child transmission of HIV (PMTCT) is a key maternal and child-health intervention in the context of the HIV/AIDS pandemic in South Africa. Accordingly, the PMTCT programmes have been incorporated in the routine District Health Management Information System (DHMIS) which collects monthly facility-based data to support the management of public-health services. To date, there has been no comprehensive evaluation of the PMTCT information system. OBJECTIVES: This study seeks to evaluate the quality of output indicators for monitoring PMTCT interventions in two health districts with high HIV prevalence...
November 2016: International Journal of Medical Informatics
Doortje 't Hart, Merian Musinguzi, Richard Ochen, Juliet Katushabe, Joseph Rujumba
Inequities in access to HIV prevention and treatment for children remain a global challenge and a black spot to effective HIV prevention and response especially in many HIV endemic countries like Uganda. In Uganda while about 51% of the adults living with HIV are on antiretrovirals, only 39% of the children aged 0-14 years accessed the needed HIV care in 2014. In this article, it is argued that much focus on health system interventions with little regard to bridging the gap between health facilities, where much of the care is provided, and the communities, where children are conceived, born and cared for, contributes to and sustains this inequality...
July 2, 2016: Vulnerable Children and Youth Studies
Nikhil Gupte, Aarti Kinikar, Katherine N McIntire, Ramesh Bhosale, Sandesh Patil, Nishi Suryavanshi, Vidya Mave, Vandana Kulkarni, Robert C Bollinger, Amita Gupta
Latest World Health Organization guidelines recommend weight-based nevirapine prophylaxis for all HIV-exposed infants in resource-limited settings, yet low birth weight (LBW) infants (< 2500 g) have been understudied. Using data from the NIH-funded India six-week extended-dose nevirapine (SWEN) study, a randomized clinical trial of SWEN versus single-dose nevirapine (SD) for prevention of breast-milk HIV-1 transmission, we examined the relative impact of SWEN among 737 mother-infant pairs stratified by infant birth weight...
2016: PloS One
Walter Chingwaru, Jerneja Vidmar
Zimbabwe is going through a generalised acquired immunodeficiency syndrome (AIDS) epidemic. The first five years of the epidemic (1985-1990) were characterised by lack of medicines against human immunodeficiency virus (HIV), and an exponential increase in prevalence (65-fold) and incidence (13-fold), which were fuelled by high-risk sexual behaviour. The high HIV prevalence, mortality and stigma yielded great fear and panic in the population, which are thought to have led to confusion and hopelessness, and, in turn, increased risky sexual behaviour...
August 11, 2016: Global Public Health
L M Yee, A R Goldberger, P M Garcia, E S Miller
OBJECTIVE: To characterize pregnant patients' knowledge, attitudes and preferences regarding antenatal HIV testing for themselves and their sexual partners. STUDY DESIGN: Observational, mixed methods study of HIV-negative pregnant women from a university-based urban clinic. Participants completed an anonymous survey about HIV testing for themselves and their partners. Descriptive statistics, bivariable analyses, multivariable logistic regression and qualitative thematic analysis were utilized...
September 29, 2016: Journal of Perinatology: Official Journal of the California Perinatal Association
A L Slogrove, L Frigati, D M Gray
With improved prevention of mother to child transmission of HIV, paediatric HIV disease is less common. However, the number of HIV exposed but uninfected infants is growing. Exposure to maternal HIV impacts infant respiratory health through an increase in known risk factors such as increased preterm birth and low birth weight, suboptimal breastfeeding, increased psychosocial stressors and increased exposure to infective pathogens. Exposure to the HIV virus and altered maternal immune environment result in immunologic changes in the infant that may contribute to respiratory disease risk...
August 19, 2016: Paediatric Respiratory Reviews
Jennifer Cohn, Katherine Whitehouse, Julia Tuttle, Kristin Lueck, Trang Tran
BACKGROUND: Many HIV-positive children in low-income and middle-income countries remain undiagnosed. Although HIV testing in children at health facilities is recommended by WHO, it is not well implemented. This systematic review and meta-analysis examines the case-finding benefit of HIV screening in children aged 0-5 years in low-income and middle-income countries. METHODS: We did this systematic review and meta-analysis in accordance with an a-priori protocol. We searched PubMed, MEDLINE, WHO Global Index Medicus, Web of Science, Médecins Sans Frontières, Cochrane, Embase, CABS Abstracts, and LILACS databases for articles published between Jan 1, 2004, and April 30, 2016, that reported the quantitative prevalence of HIV detected through screening in four key contexts (paediatric inpatient settings, paediatric outpatient settings, nutrition centres, and expanded programme on immunisation centres) in paediatric populations in low-income and middle-income countries...
October 2016: Lancet HIV
Jodie Dionne-Odom, Courtney Massaro, Kristen M Jogerst, Zhongze Li, Marie-Marcelle Deschamps, Cleonas Junior Destine, Redouin Senecharles, Moleine Moles Aristhene, Joseph Yves Domercant, Vanessa Rouzier, Peter F Wright
Background. Preventing mother-to-child transmission of HIV relies on engagement in care during the prenatal, peripartum, and postpartum periods. Under PMTCT Option B, pregnant women with elevated CD4 counts are provided with antiretroviral prophylaxis until cessation of breastfeeding. Methods. Retrospective analysis of retention in care among HIV-infected pregnant women in Haiti was performed. Logistic regression was used to identify risk factors associated with loss to follow-up (LFU) defined as no medical visit for at least 6 months and Kaplan-Meier curves were created to show LFU timing...
2016: AIDS Research and Treatment
Pesona Grace Lucksom, Rekha Upadhya, Latha Kharka, Swati Dubey, Nishi Choudhary, Ruby Yadav
BACKGROUND: This study was conducted to determine whether antenatal mothers in Sikkim have adequate knowledge about awareness, attitude, and preventive practices regarding HIV infection. METHODS: Cross-sectional study using structured questionnaire. 220 Antenatal mothers attending the outpatient department of Central Referral Hospital of Sikkim were taken for the study for a period of 1 year from April 2011 to April 2012. Questionnaire form filled by pregnant women during their first antenatal visit was the source of data for this study...
October 2016: Journal of Obstetrics and Gynaecology of India
A M Hatcher, H Stöckl, N Christofides, N Woollett, C C Pallitto, C Garcia-Moreno, J M Turan
Prevention of mother-to-child transmission (PMTCT) can virtually eliminate HIV infection among infants, yet up to one-third of women miss PMTCT steps. Little is known about how partner dynamics such as intimate partner violence (IPV) influence pregnant and postpartum women's adherence to PMTCT. We conducted 32 qualitative interviews with HIV-positive pregnant and postpartum women in Johannesburg who experienced IPV. Trained researchers conducted in-depth interviews over the period of May 2014-Nov 2015 using narrative and social constructionist approaches...
November 2016: Social Science & Medicine
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