Trial reportJournal of acquired immune deficiency syndromes (1999)2015
Implementation and Operational Research: Effect of Integration of HIV Care and Treatment Into Antenatal Care Clinics on Mother-to-Child HIV Transmission and Maternal Outcomes in Nyanza, Kenya: Results From the SHAIP Cluster Randomized Controlled Trial.
Trial report 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 25 papers, 7 of them syntheses that pooled it.
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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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
25 citing papers in PubMed, 7 syntheses or guidelines pooled it, 33 citations in OpenAlex.
- Global Health Facility-Based Interventions to Achieve UNAIDS 90-90-90: A Systematic Review and Narrative Analysis.AIDS and behavior · 2022Pooled it
- Evaluation of HIV treatment outcomes with reduced frequency of clinical encounters and antiretroviral treatment refills: A systematic review and meta-analysis.PLoS medicine · 2022Pooled it
- Interventions to increase early infant diagnosis of HIV infection: A systematic review and meta-analysis.PloS one · 2022Pooled it
- Integrating HIV services and other health services: A systematic review and meta-analysis.PLoS medicine · 2021Pooled it
- Cryptococcosis in pregnancy and the postpartum period: Case series and systematic review with recommendations for management.Medical mycology · 2020Pooled it
- A systematic review of strategies to increase access to health services among children in low and middle income countries.BMC health services research · 2017Pooled it
- A systematic review of interventions to improve prevention of mother-to-child HIV transmission service delivery and promote retention.Journal of the International AIDS Society · 2016Pooled it
- A context-responsive health systems intervention improves the uptake of early infant HIV diagnosis: Controlled before and after study in Malawi.PLOS global public health · 2026Article
- Spatial patterns and associated factors of HIV testing and counselling (HTC) as a component of antenatal care services in Ethiopia.PloS one · 2024Article
- Interventions to enhance healthcare utilisation among pregnant women to reduce maternal mortality in low- and middle-income countries: a review of systematic reviews.BMC public health · 2023Review
- Integration of HIV care into maternal and child health services in the global IeDEA consortium.Frontiers in global women's health · 2023Article
- Economic evaluation of integrated services for non-communicable diseases and HIV: costs and client outcomes in rural Malawi.BMJ open · 2022Article
- Utilization of HIV testing and counselling services by women with disabilities during antenatal care in Uganda: analysis of 2016 demographic and health survey.BMC public health · 2021Article
- Late antiretroviral refills and condomless sex in a cohort of HIV-seropositive pregnant and postpartum Kenyan women.PloS one · 2021Article
- Integrating Prevention of Mother-to-Child Transmission of HIV Care into General Maternal Child Health Care in Western Kenya.International journal of MCH and AIDS · 2021Article
- Expanding access to non-communicable disease care in rural Malawi: outcomes from a retrospective cohort in an integrated NCD-HIV model.BMJ open · 2020Article
- Protocol for a prospective evaluation of postpartum engagement in HIV care among women living with HIV in South Africa.BMJ open · 2020Article
- Toward Improving Accessibility of Point-of-Care Diagnostic Services for Maternal and Child Health in Low- and Middle-Income Countries.Point of care · 2019Article
- Achieving UNAIDS 90-90-90 targets for pregnant and postpartum women in sub-Saharan Africa: progress, gaps and research needs.Journal of virus eradication · 2018Article
- Achieving development goals for HIV, tuberculosis and malaria in sub-Saharan Africa through integrated antenatal care: barriers and challenges.BMC medicine · 2016Article
Corrections and comments
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Authors and funding
9 authors at 4 institutions in 2 countries.
Funding
Abstract
backgroundMany HIV-infected pregnant women identified during antenatal care (ANC) do not enroll in long-term HIV care, resulting in deterioration of maternal health and continued risk of HIV transmission to infants.
methodsWe performed a cluster randomized trial to evaluate the effect of integrating HIV care into ANC clinics in rural Kenya. Twelve facilities were randomized to provide either integrated services (ANC, prevention of mother-to-child transmission, and HIV care delivered in the ANC clinic; n = 6 intervention facilities) or standard ANC services (including prevention of mother-to-child transmission and referral to a separate clinic for HIV care; n = 6 control facilities).
resultsThere were high patient attrition rates over the course of this study. Among study participants who enrolled in HIV care, there was 12-month follow-up data for 256 of 611 (41.8%) women and postpartum data for only 325 of 1172 (28%) women. By 9 months of age, 382 of 568 (67.3%) infants at intervention sites and 338 of 594 (57.0%) at control sites had tested for HIV [odds ratio (OR) 1.45, 95% confidence interval (CI): 0.71 to 2.82]; 7.3% of infants tested HIV positive at intervention sites compared with 8.0% of infants at control sites (OR 0.89, 95% CI: 0.56 to 1.43). The composite clinical/immunologic progression into AIDS was similar in both arms (4.9% vs. 5.1%, OR 0.83, 95% CI: 0.41 to 1.68).
conclusionsDespite the provision of integrated services, patient attrition was substantial in both arms, suggesting barriers beyond lack of service integration. Integration of HIV services into the ANC clinic was not associated with a reduced risk of HIV transmission to infants and did not appear to affect short-term maternal health outcomes.
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