Postpartum Engagement in HIV Care: An Important Predictor of Long-term Retention in Care and Viral Suppression

Adams, John W.; Brady, Kathleen A.; Michael, Yvonne L.; Yehia, Baligh R.; Momplaisir, Florence

doi:10.1093/cid/civ678

Cited by 71 publications

(76 citation statements)

References 33 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…A recent study concluded that HIV-infected women on suppressive combination antiretroviral therapy, the risk of viral rebound is increased during postpartum, especially in the first 3 months, which may be related to reducing adherence (Huntington 2015). Also, postpartum viral rebound was linked with fewer prenatal visits and later gestational week of starting prenatal care (Cavallo 2010;Adams 2015). Indicating then the need for effective adherence interventions as well as in prenatal and postpartum period.…”

Section: Why It Is Important To Do This Reviewmentioning

confidence: 99%

Mobile Phone Communication for Improving Uptake of Antiretroviral Therapy in HIV-infected Pregnant Women: Review

Tamuzi¹,

Okwundu²

2017

IAM

View full text Add to dashboard Cite

Background: About 1.4 million pregnant women are living with HIV in low and middle-income countries with about 91% of these women residing in sub-Saharan Africa. HIV-infected pregnant women face several challenges that could decrease antiretroviral therapy adherence. Studies reported challenges such as poor mental health, lack of social support, fears of infecting children, medication side effects, cultural factors, economic instability, nausea and vomiting during pregnancy. This review investigated whether mobile phone text messaging could improve antiretroviral therapy in during and after pregnancy. Objectives : To assess the effectiveness mobile phone text messaging for improving adherence to antiretroviral therapy in HIV-infected pregnant women. To investigate whether mobile phone text messaging could improve follow-up in HIV-exposed infants. Search methods: We searched Cochrane Central Register of Controlled Trials (CENTRAL), Scopus, MEDLINE via PubMed, Web of Science, CINAHL (EBSCO). Furthermore, we searched studies through HIV/AIDS conferences websites: International AIDS conferences, The European AIDS Clinical Society (EACS) conferences, International AIDS Society Conference on HIV Pathogenesis and Treatment (IAS). Two authors extracted data in the study eligibility form. Selection criteria: We selected randomized controlled trials (RCTs) assessing mobile phone text messaging as reminders for antiretroviral therapy uptake in HIV-infected pregnant women. Data collection and analysis: Two authors independently identified and assessed all studies that met inclusion criteria. Study design, characteristics of study populations, interventions and controls and study results were extracted by two review authors. Also, the risk of bias of included studies was assessed independently by two reviewers. We reported the results narratively as meta-analysis was not feasible because of differences in the study design. We reported the odds ratio with 95% confidence intervals for the different outcomes. Main results: We identified five eligible studies; three ongoing and two completed studies. Findings from the included studies showed that mobile phone text messaging did not increase antiretroviral therapy initiation (OR 1.79 95%CI 1.09 to 2.94, 307 participants, 1 study). However, there was an increase in maternal clinic attendance and HIV tested infants; (RR 1.66 95%CI 1.02 to 2.70, 381 participants, 1 study) and (OR 2.01 95%CI 1.03 to 3.92, 325 participants, 1 study), respectively. The overall quality of evidence was assessed as moderate. None of the included studies reported on adherence to antiretroviral therapy. Authors' Conclusions: The review revealed that mobile phone text messaging may improve maternal clinic attendance and number infants tested for HIV compared to the standard care. Mobile phone communication did not improve ART initiation compared to standard care. Further studies are needed to evaluate the value of mobile phone communication in promoting adherence to antiretroviral drugs among pregnan...

show abstract

Section: Why It Is Important To Do This Reviewmentioning

confidence: 99%

Mobile Phone Communication for Improving Uptake of Antiretroviral Therapy in HIV-infected Pregnant Women: Review

Tamuzi¹,

Okwundu²

2017

IAM

View full text Add to dashboard Cite

show abstract

“…Postpartum engagement in HIV care was defined as having ≥1 CD4 or VL in the first 90 days post-delivery (Adams et al, 2015). …”

Section: Methodsmentioning

confidence: 99%

“…Depression can be a strong predictor of non-adherence to antiretroviral therapy (ART) (Ammassari, Antinori, Aloisi, Trotta, & Murri, 2004; Springer, Dushaj, & Azar, 2012) and may contribute to poor maternal outcomes at delivery and postpartum (Alder, Fink, Bitzer, Hösli, & Holzgreve, 2007; Goedhart et al, 2010). Previous studies have shown that WLWH have poor viral suppression at delivery (Momplaisir et al, 2015) and poor retention in HIV care postpartum (Adams, Brady, Michael, Yehia, & Momplaisir, 2015; Momplaisir, Storm, Nkwihoreze, Jayeola, & Jemmott, 2018). The impact of depression on HIV care outcomes during pregnancy and postpartum has not been well described.…”

Section: Introductionmentioning

confidence: 99%

HIV care continuum outcomes of pregnant women living with HIV with and without depression

et al. 2018

Self Cite

View full text Add to dashboard Cite

Women living with HIV (WLWH) suffer from poor viral suppression and retention postpartum. The effect of perinatal depression on care continuum outcomes during pregnancy and postpartum is unknown. We performed a retrospective cohort analysis using HIV surveillance data of pregnant WLWH enrolled in perinatal case management in Philadelphia and evaluated the association between possible or definite depression with four outcomes: viral suppression at delivery, care engagement within three months postpartum, retention and viral suppression at one-year postpartum. Out of 337 deliveries (2005–2013) from 281 WLWH, 53.1% (n = 179) had no depression; 46.9% had either definite (n = 126) or possible (n = 32) depression during pregnancy. There were no differences by depression status across all four HIV care continuum outcomes in unadjusted and adjusted analyses. The prevalence of possible or definite depression was high among pregnant WLWH. HIV care continuum outcomes did not differ by depression status, likely because of supportive services and intensive case management provided to women with possible or definite depression.

show abstract

“…Additionally, breastfeeding is not recommended given access to safe formula [12]. After delivery, establishment and maintenance of HIV care is critical to maternal health, prevention of HIV transmission to partners and prevention of perinatal transmission during subsequent pregnancies [13]. Referral to an infectious disease specialist is strongly recommended.…”

Section: Hiv Infection During Pregnancymentioning

confidence: 99%

“…A history of a prior pregnancy with HIV infection is associated with better compliance with retention in care. Women who were engaged in HIV care early after delivery, particularly within the first 90 days postpartum, were more likely to remain in care and virally suppressed at 1 and 2 years, compared with those who were not engaged early after delivery [13], suggesting that interventions focusing on early engagement in care during the immediate postpartum period may help with long-term retention and viral suppression. Only a third of women remained virally suppressed at 1 and 2 years postpartum, demonstrating a significant shortfall in the HIV Care Continuum among reproductive age women in the USA [7,17].…”

Section: Postpartum Strategies To Achieve Successful Engagement Into mentioning

confidence: 99%

HIV and Reproductive Healthcare in Pregnant and Postpartum HIV-infected Women: Adapting Successful Strategies

et al. 2016

View full text Add to dashboard Cite

show abstract

Postpartum Engagement in HIV Care: An Important Predictor of Long-term Retention in Care and Viral Suppression

Abstract: The prevalence of postpartum HIV-infected women retained in care and maintaining viral suppression is low. Interventions seeking to engage women in care shortly after delivery have the potential to improve clinical outcomes.

Cited by 71 publications

References 33 publications

Mobile Phone Communication for Improving Uptake of Antiretroviral Therapy in HIV-infected Pregnant Women: Review

Mobile Phone Communication for Improving Uptake of Antiretroviral Therapy in HIV-infected Pregnant Women: Review

HIV care continuum outcomes of pregnant women living with HIV with and without depression

HIV and Reproductive Healthcare in Pregnant and Postpartum HIV-infected Women: Adapting Successful Strategies

Contact Info

Product

Resources

About