ArticleJournal of acquired immune deficiency syndromes (1999)2015
Evolution of antiretroviral therapy services for HIV-infected pregnant women in Cape Town, South Africa.
Article in Journal of acquired immune deficiency syndromes (1999), 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 44 papers, 2 of them syntheses that pooled it.
What it found
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
44 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Approaches to transitioning women into and out of prevention of mother-to-child transmission of HIV services for continued ART: a systematic review.Journal of the International AIDS Society · 2021Pooled it
- Pooled it
- Trial
- Integration of postpartum healthcare services for HIV-infected women and their infants in South Africa: A randomised controlled trial.PLoS medicine · 2018Trial
- Association between infant feeding practices and infant growth by maternal HIV and antiretroviral therapy status: a prospective study in Cape Town, South Africa.BMC pregnancy and childbirth · 2026Article
- Uptake and retention in HIV care among pregnant and postpartum women living with HIV under different eras of vertical transmission prevention policies in sub-Saharan Africa: a systematic review and meta-analysis.medRxiv : the preprint server for health sciences · 2026Article
- Attitudes, Beliefs, and Predictors of Gestational Weight Gain and Postpartum Weight Retention in South Africa: A Mixed Methods Analysis.AIDS and behavior · 2025Article
- Cardiometabolic Health in Pregnancy and Postpartum: Findings From a Prospective Cohort Study in South Africa.Open forum infectious diseases · 2024Article
- Prevalence and risk factors of detectable HIV viral load among pregnant women with HIV infection seeking antenatal care in Southern Malawi.AIDS care · 2024Article
- Experiences of transfer of care among postpartum women living with HIV attending primary healthcare services in South Africa.Global public health · 2024Article
- Womandla Health: development and rationale of a behavioral intervention to support HIV treatment adherence among postpartum women in South Africa.BMC women's health · 2023Article
- Mobility during the post-partum period and viraemia in women living with HIV in South Africa.International health · 2023Article
- Change in HIV-related characteristics of children hospitalised with infectious diseases in Western Cape, South Africa, 2008-2021: a time trend analysis.Journal of the International AIDS Society · 2023Article
- Smartphone Ownership and Usage Among Pregnant Women Living With HIV in South Africa: Secondary Analysis of CareConekta Trial Data.JMIR formative research · 2023Article
- Alcohol use and intimate partner violence in HIV-uninfected pregnant women in Cape Town, South Africa.AIDS care · 2022Article
- Growth patterns of infants with in- utero HIV and ARV exposure in Cape Town, South Africa and Lusaka, Zambia.BMC public health · 2022Observational
- Lower birth weight-for-age and length-for-age z-scores in infants with in-utero HIV and ART exposure: a prospective study in Cape Town, South Africa.BMC pregnancy and childbirth · 2021Article
- Optimizing HIV retesting during pregnancy and postpartum in four countries: a cost-effectiveness analysis.Journal of the International AIDS Society · 2021Article
- High blood pressure at entry into antenatal care and birth outcomes among a cohort of HIV-uninfected women and women living with HIV initiating antiretroviral therapy in South Africa.Pregnancy hypertension · 2021Article
- Article
Corrections and comments
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Authors and funding
6 authors.
Funding
Abstract
backgroundApproaches to antiretroviral therapy (ART) in HIV-infected pregnant women have changed considerably in recent years, but there are few comparative data on the implementation of different models of service delivery.
methodsUsing routine clinic records we examined ART initiation in pregnant women attending a large antenatal care (ANC) facility between January 2010 and December 2013 in Cape Town, South Africa. Over this time six different service delivery models were implemented sequentially to provide ART in pregnancy, including the integration of ART into ANC, use of point-of-care CD4 cell count testing, and universal ART initiation for all HIV-infected pregnant women.
resultsDuring the study period 19,432 women sought ANC, levels of HIV testing were high (98%) and 30% of pregnant women tested HIV-positive. Integration of ART into ANC was associated with significant increases in the proportion of eligible women initiating treatment before delivery compared to referral to a separate ART clinic (p<0.001). When CD4 cell counts were used to determine ART eligibility, point-of-care testing was associated with decreased delays to ART initiation compared to laboratory-based testing (p<0.001). The strategy of universal ART led to the highest levels of ART initiation (with 92% of women starting before delivery) and the shortest delays, with 82% of women starting ART on the day of the first ANC visit.
conclusionDevelopments in service delivery models, most notably service integration and universal ART for pregnant women, have improved antenatal ART initiation dramatically in this setting. Further research is needed into how strategies for antenatal ART initiation impact maternal and child health over the long-term.
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