Amsterdam 2015
Menu
AIDSImpact.com
Conference Details
Authors
International Committee
Plenary Speakers
Presenting Speakers
Programme
Sessions
Scientific Committee
Acknowledgements
| Abstract #2255 - Pregnancy and HIV | ||||
|
Session: 14.5: Pregnancy and HIV (Symposium) on Wednesday @ 14.30-16.00 in C103 Chaired by Sibylle Niderost, Sandra Van Den Eynde Authors: Presenting Author: Dr Geoffrey Fatti - KhethImpilo, South Africa |
||||
| Additional Authors: | ||||
| Aim: Community-based adherence support (CBAS) workers are employed in antiretroviral treatment (ART) programs to improve adherence and long-term patient retention in low-income settings. However, little data is available regarding their effectiveness amongst HIV-positive pregnant women. We compared birth outcomes amongst HIV-positive pregnant women who received and did not receive CBAS in South Africa. | ||||
| Method / Issue: Through home visits, CBAS workers seek to improve virological suppression by providing HIV-linked education, ART adherence counselling and psychosocial support for pregnant women and their infants. Nutrition security, substance abuse and non-disclosure are also addressed. A cohort of HIV-positive pregnant women and their infants were followed at three sentinel surveillance facilities in the Nelson Mandela Bay Metropolitan district of South Africa between 2009-2012. Routine individual-level clinical data were collected antenatally and postnatally. Birth outcomes and vertical HIV transmission at 6 weeks were analysed using log-binomial and Cox regression controlled for confounding. | ||||
| Results / Comments: A total of 1105 mother-infant pairs were included in analyses. Of these, 264 (23.9%) pregnant women received CBAS. The median baseline CD4 cell count was lower in pregnant women who received CBAS (305 cells/µL vs. 361 cells/µL amongst women who received and did not receive CBAS, respectively P=0.010). ART uptake during pregnancy was more rapid amongst women who received CBAS, median 26 days (IQR: 13-49) vs. 39 days (IQR: 22-72) amongst women without CBAS (P=0.0053) adjusted hazard ratio=1.48 (95% CI: 1.10-1.99). Triple ART coverage at delivery was higher in women who received CBAS (62.7% vs. 43.2% adjusted risk ratio (aRR)=1.24 (95% CI: 1.10-1.40 P<0.0001). Women with CBAS had a lower risk of stillbirth (1.5% vs. 5.4% (P=0.016) aRR=0.33 (95% CI: 0.10-1.08). Vertical HIV transmission in infants at 6 weeks was equivalent between women with and without PAs (3.4% P=0.78). | ||||
| Discussion: HIV-positive pregnant women who received CBAS started ART more rapidly during pregnancy, had higher ART coverage by delivery, and had a lower risk of stillbirth. Further expansion of this intervention should be considered in resource-poor settings. | ||||
| Go Back | ||||