HIV viral suppression among pregnant and breastfeeding women in routine care in the Kinshasa province: a baseline evaluation of participants in CQI‐PMTCT study
Introduction Published data on viral suppression among pregnant and breastfeeding women in routine care settings are scarce. Here, we report provincial estimates of undetectable and suppressed viral load among pregnant or breastfeeding women in HIV care in Kinshasa, Democratic Republic of Congo (DRC...
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| Veröffentlicht in: | Journal of the International AIDS Society 2019-09, Vol.22 (9), p.e25376-n/a |
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| description | Introduction
Published data on viral suppression among pregnant and breastfeeding women in routine care settings are scarce. Here, we report provincial estimates of undetectable and suppressed viral load among pregnant or breastfeeding women in HIV care in Kinshasa, Democratic Republic of Congo (DRC) and associated risk factors.
Methods
This cross‐sectional study was conducted as part of a baseline assessment for the CQI‐PMTCT study: an ongoing cluster randomized trial to evaluate the effect of continuous quality interventions (CQI) on long‐term ART outcomes among pregnant and breastfeeding women (NCT03048669). From November 2016 to June 2018, in each of the 35 Kinshasa provincial health zones (HZ), study teams visited the three busiest maternal and child health clinics, enrolled all HIV‐positive pregnant or breastfeeding women (≤1 year post‐delivery) receiving ART, and performed viral load testing. Log binomial models with generalized estimating equations to account for clustering at the HZ level, were used to estimate prevalence ratios comparing participants with undetected ( |
| doi_str_mv | 10.1002/jia2.25376 |
| format | Article |
| fullrecord | <record><control><sourceid>gale_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_6732557</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A602777666</galeid><sourcerecordid>A602777666</sourcerecordid><originalsourceid>FETCH-LOGICAL-c5846-a1edcbe244976f67a2debc9a0df1c0a67bb5f832780048e597b61332f3abe1f53</originalsourceid><addsrcrecordid>eNp9ksGO0zAQhiMEYpeFCw-ALCEhhNTi2ImdcECqKmALiwCpcLUmyaT1KrGDnXTVG4_AK_BqPAkOXZYWVcgHezzf_DMeTxQ9jOk0ppQ9v9TApizlUtyKTmOZZhMmUnZ773wS3fP-klLBsiS_G53wOMkFTePT6Mf54gvZaAcN8UPXOfReW0OgtWZFgrkyYHoCpiKFQ_B9jVjp4LqyLRqiDXF26LVBUoLD0e7XSN5p49fgIQjYjTYlviBACvDYjCRuoBmgH9PYmnTgel3qLqTxY_z80-Lnt-8f3y_nS-L7odrej-7U0Hh8cL2fRZ9fv1rOzycXH94s5rOLSZlmiZhAjFVZIEuSXIpaSGAVFmUOtKrjkoKQRZHWGWcyozTJMM1lIWLOWc2hwLhO-Vn0cqfbDUUbtND0oSuqc7oFt1UWtDr0GL1WK7tRQnKWpjIIPL0WcPbrgL5XrfYlNg0YtINXjGUy5ZwmLKCP_0Ev7eBMeF6g8pwLyXL-l1pBg0qb2oa85SiqZoIyKaUQIlCTI9QKDYYircFah-sDfnqED6vCVpdHA57sBawRmn7tbTOMP-gPwWc7sHTWe4f1TfNiqsZJVeOkqt-TGuBH--2-Qf-MZgDiHXAV6tn-R0q9XczYTvQXskL0bg</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2299367293</pqid></control><display><type>article</type><title>HIV viral suppression among pregnant and breastfeeding women in routine care in the Kinshasa province: a baseline evaluation of participants in CQI‐PMTCT study</title><source>MEDLINE</source><source>DOAJ Directory of Open Access Journals</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><source>Wiley-Blackwell Open Access Titles</source><source>Wiley Online Library All Journals</source><source>PubMed Central</source><creator>Yotebieng, Marcel ; Mpody, Christian ; Ravelomanana, Noro LR ; Tabala, Martine ; Malongo, Fathy ; Kawende, Bienvenu ; Ntangu, Paul ; Behets, Frieda ; Okitolonda, Emile</creator><creatorcontrib>Yotebieng, Marcel ; Mpody, Christian ; Ravelomanana, Noro LR ; Tabala, Martine ; Malongo, Fathy ; Kawende, Bienvenu ; Ntangu, Paul ; Behets, Frieda ; Okitolonda, Emile ; CQI-PMTCT study team ; for the CQI‐PMTCT study team</creatorcontrib><description>Introduction
Published data on viral suppression among pregnant and breastfeeding women in routine care settings are scarce. Here, we report provincial estimates of undetectable and suppressed viral load among pregnant or breastfeeding women in HIV care in Kinshasa, Democratic Republic of Congo (DRC) and associated risk factors.
Methods
This cross‐sectional study was conducted as part of a baseline assessment for the CQI‐PMTCT study: an ongoing cluster randomized trial to evaluate the effect of continuous quality interventions (CQI) on long‐term ART outcomes among pregnant and breastfeeding women (NCT03048669). From November 2016 to June 2018, in each of the 35 Kinshasa provincial health zones (HZ), study teams visited the three busiest maternal and child health clinics, enrolled all HIV‐positive pregnant or breastfeeding women (≤1 year post‐delivery) receiving ART, and performed viral load testing. Log binomial models with generalized estimating equations to account for clustering at the HZ level, were used to estimate prevalence ratios comparing participants with undetected (<40 copies/mL) or suppressed (<1000 copies/mL) viral load across levels of individual and site characteristics.
Results
Of the 1752 eligible women, 1623 had viral load results available, including 38% who had been on ART for <6 months and 74% were on tenofovir‐lamivudine‐efavirenz. Viral load was undetectable in 53% of women and suppressed in 62%. Among women who were on ART for ≥12 months, only 60% and 67% respectively, had undetectable or suppressed viral load. Viral load was undetectable in 53%, 48% and 58% of women testing during pregnancy, at delivery, and in postpartum respectively. In multivariable log binomial models, duration of ART >12 months, older age, being married, disclosure of HIV status, receiving care in an urban health zone or one supported by PEPFAR were all positively associated with viral suppression.
Conclusions
The observed high level of detectable viral load suggests that high ART coverage alone without substantial efforts to improve the quality of care for pregnant and breastfeeding women, will not be enough to achieve the goal of virtual elimination of vertical HIV transmission in high‐burden and limited resources settings like DRC.</description><identifier>ISSN: 1758-2652</identifier><identifier>EISSN: 1758-2652</identifier><identifier>DOI: 10.1002/jia2.25376</identifier><identifier>PMID: 31496051</identifier><language>eng</language><publisher>Switzerland: International AIDS Society</publisher><subject>Acquired immune deficiency syndrome ; Adult ; AIDS ; Ambulatory care facilities ; Analysis ; Antiretroviral drugs ; Breast Feeding ; Cross-Sectional Studies ; Democratic Republic of the Congo - epidemiology ; Drug resistance ; Efavirenz ; Female ; HIV ; HIV Infections - epidemiology ; HIV Infections - physiopathology ; HIV Infections - virology ; HIV-1 - physiology ; Human immunodeficiency virus ; Humans ; Medical care quality ; option B ; Pregnancy ; Pregnancy Complications, Infectious - epidemiology ; Pregnancy Complications, Infectious - physiopathology ; Pregnancy Complications, Infectious - virology ; Pregnant women ; Prevalence ; Quality of care ; Studies ; treat all ; universal coverage ; Urban health ; vertical transmission ; Viral Load ; viral load monitoring ; viral suppression ; Womens health ; Young Adult</subject><ispartof>Journal of the International AIDS Society, 2019-09, Vol.22 (9), p.e25376-n/a</ispartof><rights>2019 The Authors. Journal of the International AIDS Society published by John Wiley & Sons Ltd on behalf of the International AIDS Society.</rights><rights>COPYRIGHT 2019 International AIDS Society</rights><rights>2019. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c5846-a1edcbe244976f67a2debc9a0df1c0a67bb5f832780048e597b61332f3abe1f53</citedby><cites>FETCH-LOGICAL-c5846-a1edcbe244976f67a2debc9a0df1c0a67bb5f832780048e597b61332f3abe1f53</cites><orcidid>0000-0003-2110-2631</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6732557/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6732557/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,864,885,1417,11562,27924,27925,45574,45575,46052,46476,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31496051$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Yotebieng, Marcel</creatorcontrib><creatorcontrib>Mpody, Christian</creatorcontrib><creatorcontrib>Ravelomanana, Noro LR</creatorcontrib><creatorcontrib>Tabala, Martine</creatorcontrib><creatorcontrib>Malongo, Fathy</creatorcontrib><creatorcontrib>Kawende, Bienvenu</creatorcontrib><creatorcontrib>Ntangu, Paul</creatorcontrib><creatorcontrib>Behets, Frieda</creatorcontrib><creatorcontrib>Okitolonda, Emile</creatorcontrib><creatorcontrib>CQI-PMTCT study team</creatorcontrib><creatorcontrib>for the CQI‐PMTCT study team</creatorcontrib><title>HIV viral suppression among pregnant and breastfeeding women in routine care in the Kinshasa province: a baseline evaluation of participants in CQI‐PMTCT study</title><title>Journal of the International AIDS Society</title><addtitle>J Int AIDS Soc</addtitle><description>Introduction
Published data on viral suppression among pregnant and breastfeeding women in routine care settings are scarce. Here, we report provincial estimates of undetectable and suppressed viral load among pregnant or breastfeeding women in HIV care in Kinshasa, Democratic Republic of Congo (DRC) and associated risk factors.
Methods
This cross‐sectional study was conducted as part of a baseline assessment for the CQI‐PMTCT study: an ongoing cluster randomized trial to evaluate the effect of continuous quality interventions (CQI) on long‐term ART outcomes among pregnant and breastfeeding women (NCT03048669). From November 2016 to June 2018, in each of the 35 Kinshasa provincial health zones (HZ), study teams visited the three busiest maternal and child health clinics, enrolled all HIV‐positive pregnant or breastfeeding women (≤1 year post‐delivery) receiving ART, and performed viral load testing. Log binomial models with generalized estimating equations to account for clustering at the HZ level, were used to estimate prevalence ratios comparing participants with undetected (<40 copies/mL) or suppressed (<1000 copies/mL) viral load across levels of individual and site characteristics.
Results
Of the 1752 eligible women, 1623 had viral load results available, including 38% who had been on ART for <6 months and 74% were on tenofovir‐lamivudine‐efavirenz. Viral load was undetectable in 53% of women and suppressed in 62%. Among women who were on ART for ≥12 months, only 60% and 67% respectively, had undetectable or suppressed viral load. Viral load was undetectable in 53%, 48% and 58% of women testing during pregnancy, at delivery, and in postpartum respectively. In multivariable log binomial models, duration of ART >12 months, older age, being married, disclosure of HIV status, receiving care in an urban health zone or one supported by PEPFAR were all positively associated with viral suppression.
Conclusions
The observed high level of detectable viral load suggests that high ART coverage alone without substantial efforts to improve the quality of care for pregnant and breastfeeding women, will not be enough to achieve the goal of virtual elimination of vertical HIV transmission in high‐burden and limited resources settings like DRC.</description><subject>Acquired immune deficiency syndrome</subject><subject>Adult</subject><subject>AIDS</subject><subject>Ambulatory care facilities</subject><subject>Analysis</subject><subject>Antiretroviral drugs</subject><subject>Breast Feeding</subject><subject>Cross-Sectional Studies</subject><subject>Democratic Republic of the Congo - epidemiology</subject><subject>Drug resistance</subject><subject>Efavirenz</subject><subject>Female</subject><subject>HIV</subject><subject>HIV Infections - epidemiology</subject><subject>HIV Infections - physiopathology</subject><subject>HIV Infections - virology</subject><subject>HIV-1 - physiology</subject><subject>Human immunodeficiency virus</subject><subject>Humans</subject><subject>Medical care quality</subject><subject>option B</subject><subject>Pregnancy</subject><subject>Pregnancy Complications, Infectious - epidemiology</subject><subject>Pregnancy Complications, Infectious - physiopathology</subject><subject>Pregnancy Complications, Infectious - virology</subject><subject>Pregnant women</subject><subject>Prevalence</subject><subject>Quality of care</subject><subject>Studies</subject><subject>treat all</subject><subject>universal coverage</subject><subject>Urban health</subject><subject>vertical transmission</subject><subject>Viral Load</subject><subject>viral load monitoring</subject><subject>viral suppression</subject><subject>Womens health</subject><subject>Young Adult</subject><issn>1758-2652</issn><issn>1758-2652</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>24P</sourceid><sourceid>WIN</sourceid><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><recordid>eNp9ksGO0zAQhiMEYpeFCw-ALCEhhNTi2ImdcECqKmALiwCpcLUmyaT1KrGDnXTVG4_AK_BqPAkOXZYWVcgHezzf_DMeTxQ9jOk0ppQ9v9TApizlUtyKTmOZZhMmUnZ773wS3fP-klLBsiS_G53wOMkFTePT6Mf54gvZaAcN8UPXOfReW0OgtWZFgrkyYHoCpiKFQ_B9jVjp4LqyLRqiDXF26LVBUoLD0e7XSN5p49fgIQjYjTYlviBACvDYjCRuoBmgH9PYmnTgel3qLqTxY_z80-Lnt-8f3y_nS-L7odrej-7U0Hh8cL2fRZ9fv1rOzycXH94s5rOLSZlmiZhAjFVZIEuSXIpaSGAVFmUOtKrjkoKQRZHWGWcyozTJMM1lIWLOWc2hwLhO-Vn0cqfbDUUbtND0oSuqc7oFt1UWtDr0GL1WK7tRQnKWpjIIPL0WcPbrgL5XrfYlNg0YtINXjGUy5ZwmLKCP_0Ev7eBMeF6g8pwLyXL-l1pBg0qb2oa85SiqZoIyKaUQIlCTI9QKDYYircFah-sDfnqED6vCVpdHA57sBawRmn7tbTOMP-gPwWc7sHTWe4f1TfNiqsZJVeOkqt-TGuBH--2-Qf-MZgDiHXAV6tn-R0q9XczYTvQXskL0bg</recordid><startdate>201909</startdate><enddate>201909</enddate><creator>Yotebieng, Marcel</creator><creator>Mpody, Christian</creator><creator>Ravelomanana, Noro LR</creator><creator>Tabala, Martine</creator><creator>Malongo, Fathy</creator><creator>Kawende, Bienvenu</creator><creator>Ntangu, Paul</creator><creator>Behets, Frieda</creator><creator>Okitolonda, Emile</creator><general>International AIDS Society</general><general>John Wiley & Sons, Inc</general><general>John Wiley and Sons Inc</general><scope>24P</scope><scope>WIN</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0003-2110-2631</orcidid></search><sort><creationdate>201909</creationdate><title>HIV viral suppression among pregnant and breastfeeding women in routine care in the Kinshasa province: a baseline evaluation of participants in CQI‐PMTCT study</title><author>Yotebieng, Marcel ; Mpody, Christian ; Ravelomanana, Noro LR ; Tabala, Martine ; Malongo, Fathy ; Kawende, Bienvenu ; Ntangu, Paul ; Behets, Frieda ; Okitolonda, Emile</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c5846-a1edcbe244976f67a2debc9a0df1c0a67bb5f832780048e597b61332f3abe1f53</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Acquired immune deficiency syndrome</topic><topic>Adult</topic><topic>AIDS</topic><topic>Ambulatory care facilities</topic><topic>Analysis</topic><topic>Antiretroviral drugs</topic><topic>Breast Feeding</topic><topic>Cross-Sectional Studies</topic><topic>Democratic Republic of the Congo - epidemiology</topic><topic>Drug resistance</topic><topic>Efavirenz</topic><topic>Female</topic><topic>HIV</topic><topic>HIV Infections - epidemiology</topic><topic>HIV Infections - physiopathology</topic><topic>HIV Infections - virology</topic><topic>HIV-1 - physiology</topic><topic>Human immunodeficiency virus</topic><topic>Humans</topic><topic>Medical care quality</topic><topic>option B</topic><topic>Pregnancy</topic><topic>Pregnancy Complications, Infectious - epidemiology</topic><topic>Pregnancy Complications, Infectious - physiopathology</topic><topic>Pregnancy Complications, Infectious - virology</topic><topic>Pregnant women</topic><topic>Prevalence</topic><topic>Quality of care</topic><topic>Studies</topic><topic>treat all</topic><topic>universal coverage</topic><topic>Urban health</topic><topic>vertical transmission</topic><topic>Viral Load</topic><topic>viral load monitoring</topic><topic>viral suppression</topic><topic>Womens health</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Yotebieng, Marcel</creatorcontrib><creatorcontrib>Mpody, Christian</creatorcontrib><creatorcontrib>Ravelomanana, Noro LR</creatorcontrib><creatorcontrib>Tabala, Martine</creatorcontrib><creatorcontrib>Malongo, Fathy</creatorcontrib><creatorcontrib>Kawende, Bienvenu</creatorcontrib><creatorcontrib>Ntangu, Paul</creatorcontrib><creatorcontrib>Behets, Frieda</creatorcontrib><creatorcontrib>Okitolonda, Emile</creatorcontrib><creatorcontrib>CQI-PMTCT study team</creatorcontrib><creatorcontrib>for the CQI‐PMTCT study team</creatorcontrib><collection>Wiley-Blackwell Open Access Titles</collection><collection>Wiley Free Content</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Journal of the International AIDS Society</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Yotebieng, Marcel</au><au>Mpody, Christian</au><au>Ravelomanana, Noro LR</au><au>Tabala, Martine</au><au>Malongo, Fathy</au><au>Kawende, Bienvenu</au><au>Ntangu, Paul</au><au>Behets, Frieda</au><au>Okitolonda, Emile</au><aucorp>CQI-PMTCT study team</aucorp><aucorp>for the CQI‐PMTCT study team</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>HIV viral suppression among pregnant and breastfeeding women in routine care in the Kinshasa province: a baseline evaluation of participants in CQI‐PMTCT study</atitle><jtitle>Journal of the International AIDS Society</jtitle><addtitle>J Int AIDS Soc</addtitle><date>2019-09</date><risdate>2019</risdate><volume>22</volume><issue>9</issue><spage>e25376</spage><epage>n/a</epage><pages>e25376-n/a</pages><issn>1758-2652</issn><eissn>1758-2652</eissn><abstract>Introduction
Published data on viral suppression among pregnant and breastfeeding women in routine care settings are scarce. Here, we report provincial estimates of undetectable and suppressed viral load among pregnant or breastfeeding women in HIV care in Kinshasa, Democratic Republic of Congo (DRC) and associated risk factors.
Methods
This cross‐sectional study was conducted as part of a baseline assessment for the CQI‐PMTCT study: an ongoing cluster randomized trial to evaluate the effect of continuous quality interventions (CQI) on long‐term ART outcomes among pregnant and breastfeeding women (NCT03048669). From November 2016 to June 2018, in each of the 35 Kinshasa provincial health zones (HZ), study teams visited the three busiest maternal and child health clinics, enrolled all HIV‐positive pregnant or breastfeeding women (≤1 year post‐delivery) receiving ART, and performed viral load testing. Log binomial models with generalized estimating equations to account for clustering at the HZ level, were used to estimate prevalence ratios comparing participants with undetected (<40 copies/mL) or suppressed (<1000 copies/mL) viral load across levels of individual and site characteristics.
Results
Of the 1752 eligible women, 1623 had viral load results available, including 38% who had been on ART for <6 months and 74% were on tenofovir‐lamivudine‐efavirenz. Viral load was undetectable in 53% of women and suppressed in 62%. Among women who were on ART for ≥12 months, only 60% and 67% respectively, had undetectable or suppressed viral load. Viral load was undetectable in 53%, 48% and 58% of women testing during pregnancy, at delivery, and in postpartum respectively. In multivariable log binomial models, duration of ART >12 months, older age, being married, disclosure of HIV status, receiving care in an urban health zone or one supported by PEPFAR were all positively associated with viral suppression.
Conclusions
The observed high level of detectable viral load suggests that high ART coverage alone without substantial efforts to improve the quality of care for pregnant and breastfeeding women, will not be enough to achieve the goal of virtual elimination of vertical HIV transmission in high‐burden and limited resources settings like DRC.</abstract><cop>Switzerland</cop><pub>International AIDS Society</pub><pmid>31496051</pmid><doi>10.1002/jia2.25376</doi><tpages>12</tpages><orcidid>https://orcid.org/0000-0003-2110-2631</orcidid><oa>free_for_read</oa></addata></record> |
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| source | MEDLINE; DOAJ Directory of Open Access Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Wiley-Blackwell Open Access Titles; Wiley Online Library All Journals; PubMed Central |
| subjects | Acquired immune deficiency syndrome Adult AIDS Ambulatory care facilities Analysis Antiretroviral drugs Breast Feeding Cross-Sectional Studies Democratic Republic of the Congo - epidemiology Drug resistance Efavirenz Female HIV HIV Infections - epidemiology HIV Infections - physiopathology HIV Infections - virology HIV-1 - physiology Human immunodeficiency virus Humans Medical care quality option B Pregnancy Pregnancy Complications, Infectious - epidemiology Pregnancy Complications, Infectious - physiopathology Pregnancy Complications, Infectious - virology Pregnant women Prevalence Quality of care Studies treat all universal coverage Urban health vertical transmission Viral Load viral load monitoring viral suppression Womens health Young Adult |
| title | HIV viral suppression among pregnant and breastfeeding women in routine care in the Kinshasa province: a baseline evaluation of participants in CQI‐PMTCT study |
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