ArticleJournal of acquired immune deficiency syndromes (1999)2016
HIV-Infected Ugandan Women on Antiretroviral Therapy Maintain HIV-1 RNA Suppression Across Periconception, Pregnancy, and Postpartum Periods.
Article in Journal of acquired immune deficiency syndromes (1999), 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 2 of them syntheses that pooled it.
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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
22 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- A Systematic Review of the Current Status of Safer Conception Strategies for HIV Affected Heterosexual Couples in Sub-Saharan Africa.AIDS and behavior · 2018Pooled it
- Medication adherence in pregnant women with human immunodeficiency virus receiving antiretroviral therapy in sub-Saharan Africa: a systematic review.BMC public health · 2018Pooled it
- Viral Suppression and Retention in Care up to 5 Years After Initiation of Lifelong ART During Pregnancy (Option B+) in Rural Uganda.Journal of acquired immune deficiency syndromes (1999) · 2017Trial
- Implementation and Operational Research: Impact of a Systems Engineering Intervention on PMTCT Service Delivery in Côte d'Ivoire, Kenya, Mozambique: A Cluster Randomized Trial.Journal of acquired immune deficiency syndromes (1999) · 2016Trial
- Association of comprehensiveness of antiretroviral care and detectable HIV viral load suppression among pregnant and postpartum women in the Democratic Republic of the Congo: a cross-sectional study.Frontiers in global women's health · 2024Article
- Implementation of a safer conception programme for HIV-affected men and women in rural Uganda.Global public health · 2024Article
- Understanding clinical outcome measures reported in HIV pregnancy studies involving antiretroviral-naive and antiretroviral-experienced women.The Lancet. Infectious diseases · 2023Review
- Treatment with Antiviral Drugs Will Significantly Inhibit the HIV-1 RNA POL Gene Expression and Viral Load in AIDS Patients.Disease markers · 2023Article
- Marker events associated with adherence to HIV/AIDS treatment in a cohort study.Revista de saude publica · 2023Article
- Fertility Intentions and Clinical Care Attendance Among Women Living with HIV in South Africa.AIDS and behavior · 2020Article
- HIV viraemia during pregnancy in women receiving preconception antiretroviral therapy in KwaDukuza, KwaZulu-Natal.Southern African journal of HIV medicine · 2019Article
- HIV Infection and risk of postpartum infection, complications and mortality in rural Uganda.AIDS care · 2018Article
- What is new in perinatal HIV prevention?Current opinion in pediatrics · 2018Review
- "I beg you…breastfeed the baby, things changed": infant feeding experiences among Ugandan mothers living with HIV in the context of evolving guidelines to prevent postnatal transmission.BMC public health · 2018Article
- Viraemia before, during and after pregnancy in HIV-infected women on antiretroviral therapy in rural KwaZulu-Natal, South Africa, 2010-2015.Tropical medicine & international health : TM & IH · 2018Article
- Pregnant and breastfeeding women: A priority population for HIV viral load monitoring.PLoS medicine · 2017Article
- Program Implementation of Option B+ at a President's Emergency Plan for AIDS Relief-Supported HIV Clinic Improves Clinical Indicators But Not Retention in Care in Mbarara, Uganda.AIDS patient care and STDs · 2017Article
- Timing of pregnancy, postpartum risk of virologic failure and loss to follow-up among HIV-positive women.AIDS (London, England) · 2017Article
- Trends in one-year cumulative incidence of death between 2005 and 2013 among patients initiating antiretroviral therapy in Uganda.International journal of STD & AIDS · 2017Article
- Offering pre-exposure prophylaxis for HIV prevention to pregnant and postpartum women: a clinical approach.Journal of the International AIDS Society · 2017Review
Corrections and comments
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Authors and funding
12 authors.
Funding
Abstract
backgroundHIV-infected women risk sexual and perinatal HIV transmission during conception, pregnancy, childbirth, and breastfeeding. We compared HIV-1 RNA suppression and medication adherence across periconception, pregnancy, and postpartum periods, among women on antiretroviral therapy (ART) in Uganda.
methodsWe analyzed data from women in a prospective cohort study, aged 18-49 years, enrolled at ART initiation and with ≥1 pregnancy between 2005 and 2011. Participants were seen quarterly. The primary exposure of interest was pregnancy period, including periconception (3 quarters before pregnancy), pregnancy, postpartum (6 months after pregnancy outcome), or nonpregnancy related. Regression models using generalized estimating equations compared the likelihood of HIV-1 RNA ≤400 copies per milliliter, <80% average adherence based on electronic pill caps (medication event monitoring system), and likelihood of 72-hour medication gaps across each period.
resultsOne hundred eleven women contributed 486 person-years of follow-up. Viral suppression was present at 89% of nonpregnancy, 97% of periconception, 93% of pregnancy, and 89% of postpartum visits, and was more likely during periconception (adjusted odds ratio, 2.15) compared with nonpregnant periods. Average ART adherence was 90% [interquartile range (IQR), 70%-98%], 93% (IQR, 82%-98%), 92% (IQR, 72%-98%), and 88% (IQR, 63%-97%) during nonpregnant, periconception, pregnant, and postpartum periods, respectively. Average adherence <80% was less likely during periconception (adjusted odds ratio, 0.68), and 72-hour gaps per 90 days were less frequent during periconception (adjusted relative risk, 0.72) and more frequent during postpartum (adjusted relative risk, 1.40).
conclusionsWomen with pregnancy were virologically suppressed at most visits, with an increased likelihood of suppression and high adherence during periconception follow-up. Increased frequency of 72-hour gaps suggests a need for increased adherence support during postpartum periods.
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