ArticlePloS one2017
Low HIV incidence in pregnant and postpartum women receiving a community-based combination HIV prevention intervention in a high HIV incidence setting in South Africa.
Article in PloS one, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 3 of them syntheses that pooled it.
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Who cites it
23 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Pooled it
- Recent levels and trends in HIV incidence rates among adolescent girls and young women in ten high-prevalence African countries: a systematic review and meta-analysis.The Lancet. Global health · 2019Pooled it
- Critical evaluation of arguments opposing male circumcision: A systematic review.Journal of evidence-based medicine · 2019Pooled it
- Trial
- Does the evidence support circumcision of infant males in the United Kingdom?-a systematic review.Translational andrology and urology · 2026Review
- Prevalence and factors associated with uptake of repeat HIV testing among pregnant women in Blantyre, Malawi.BMC public health · 2026Article
- Healthcare services provided to pregnant women with HIV and their outcomes at primary healthcare clinics in the Free State province, South Africa.Southern African journal of HIV medicine · 2026Article
- HIV Prevention and Sexual Health Conversations Among Women in Ending the HIV Epidemic Priority Communities: A Qualitative Exploration of Experiences and Preferences.Archives of sexual behavior · 2025Article
- The effect of multi-level HIV prevention interventions on common mental disorders among adolescents and young adults in rural South Africa.PLOS global public health · 2025Article
- HIV seroconversion and associated factors among seronegative pregnant women attending ANC in Ethiopia: an institution-based cross-sectional study.Frontiers in reproductive health · 2024Article
- Uptake of multi-level HIV interventions and HIV-related behaviours among young people in rural South Africa.PLOS global public health · 2024Article
- Mixed-methods cross-sectional study of the prevention of vertical HIV transmission program users unaware of male partner's HIV status, in six South African districts with a high antenatal HIV burden.BMC public health · 2023Article
- Participation in an HIV prevention intervention and access to and use of contraceptives among young women: A cross sectional analysis in six South African districts.Contraception · 2022Article
- Prevalence of undiagnosed HIV among children in South Africa, Côte d'Ivoire and Zimbabwe: a model-based analysis to inform paediatric HIV screening programmes.Journal of the International AIDS Society · 2022Article
- Evidence-based circumcision policy for Australia.Journal of men's health · 2022Article
- Pre-exposure prophylaxis use among HIV serodiscordant couples: a qualitative study in Mozambique.Global health action · 2021Article
- Article
- Accelerating progress towards the elimination of mother-to-child transmission of HIV: a narrative review.Journal of the International AIDS Society · 2020Review
- Pre-exposure prophylaxis uptake and early continuation among pregnant and post-partum women within maternal and child health clinics in Kenya: results from an implementation programme.The lancet. HIV · 2020Article
- The incidence of HIV and associated risk factors among pregnant women in Kabarole District, Uganda.PloS one · 2020Article
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Authors and funding
7 authors.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundYoung Southern African women have the highest HIV incidence globally. Pregnancy doubles the risk of HIV acquisition further, and maternal HIV acquisition contributes significantly to the paediatric HIV burden. Little data on combination HIV prevention interventions during pregnancy and lactation are available. We measured HIV incidence amongst pregnant and postpartum women receiving a community-based combination HIV prevention intervention in a high HIV incidence setting in South Africa.
methodsA cohort study that included HIV-uninfected pregnant women was performed. Lay community-based workers provided individualized HIV prevention counselling and performed three-monthly home and clinic-based individual and couples HIV testing. Male partners were referred for circumcision, sexually transmitted infections or HIV treatment as appropriate. Kaplan-Meier analyses and Cox's regression were used to estimate HIV incidence and factors associated with HIV acquisition.
resultsThe 1356 women included (median age 22.5 years) received 5289 HIV tests. Eleven new HIV infections were detected over 828.3 person-years (PY) of follow-up, with an HIV incidence rate of 1.33 infections/100 PY (95% CI: 0.74-2.40). Antenatally, the HIV incidence rate was 1.49 infections/100 PY (95% CI: 0.64-2.93) and postnatally the HIV incidence rate was 1.03 infections/100 PY (95% CI: 0.33-3.19). 53% of male partners received HIV testing and 66% of eligible partners received referral for circumcision. Women within known serodiscordant couples, and women with newly diagnosed HIV-infected partners, adjusted hazard ratio (aHR) = 32.7 (95% CI: 3.8-282.2) and aHR = 126.4 (95% CI: 33.8-472.2) had substantially increased HIV acquisition, respectively. Women with circumcised partners had a reduced risk of incident HIV infection, aHR = 0.22 (95% CI: 0.03-1.86).
conclusionsMaternal HIV incidence was substantially lower than previous regional studies. Community-based combination HIV prevention interventions may reduce high maternal HIV incidence in resource-poor settings. Expanded roll-out of home-based couples HIV testing and initiating pre-exposure prophylaxis for pregnant women within serodiscordant couples is needed in Southern Africa.
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