ArticlePloS one2019
Viral load testing among women on 'option B+' in Mazowe, Zimbabwe: How well are we doing?
Article in PloS one, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 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
10 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- The viral load monitoring cascade in HIV treatment programmes in sub-Saharan Africa: a systematic review.BMC public health · 2024Pooled it
- Viral load monitoring for people living with HIV in the era of test and treat: progress made and challenges ahead - a systematic review.BMC public health · 2022Pooled it
- Modeling the Potential Impact of Mentor Mother Programs on Vertical Transmission of HIV in Kenya.Open forum infectious diseases · 2025Article
- Modeling the potential impact of viral load monitoring on vertical transmission of HIV in Kenya.AIDS (London, England) · 2025Article
- Compliance to Viral Load Monitoring Schedules Among Women Attending Prevention of Vertical HIV Transmission Services Before and During the COVID-19 Pandemic in Ehlanzeni District, Mpumalanga, South Africa.AIDS and behavior · 2024Article
- Viral load testing among pregnant women living with HIV in Mutare district of Manicaland province, Zimbabwe.AIDS research and therapy · 2022Article
- Virological outcomes and risk factors for non-suppression for routine and repeat viral load testing after enhanced adherence counselling during viral load testing scale-up in Zimbabwe: analytic cross-sectional study using laboratory data from 2014 to 2018.AIDS research and therapy · 2022Article
- Article
- Costs of Point-of-Care Viral Load Testing for Adults and Children Living with HIV in Kenya.Diagnostics (Basel, Switzerland) · 2021Article
- Non-uptake of viral load testing among people receiving HIV treatment in Gomba district, rural Uganda.BMC infectious diseases · 2020Article
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Authors and funding
9 authors.
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Abstract
backgroundGlobally, ten percent of new HIV infections are among children and most of these children acquire infection through mother-to-child transmission. To prevent this, lifelong ART among pregnant and breast feeding (PBF) women living with HIV, irrespective of the WHO clinical stage, was adopted (option B+). There is limited cohort-wise assessment of VL testing among women on 'option B+'.
objectiveAmong a pregnancy cohort on antiretroviral therapy in public hospitals and clinics of Mazowe district, Zimbabwe (2017), to determine the i) proportion undergoing VL testing anytime up to six months post child birth and associated factors; ii) turnaround time (TAT) from sending the specimen to results receipt and VL suppression among those undergoing VL testing.
methodsThis was a cohort study involving secondary programme data. Modified Poisson regression using robust variance estimates was used to determine the independent predictors of VL testing.
resultsOf 1112 women, 354 (31.8%, 95% CI: 29.2-34.6) underwent VL testing: 113 (31.9%) during pregnancy, 124 (35%) within six months of child birth and for 117 (33.1%), testing period was unknown. Of 354, VL suppression was seen in 334 (94.4%) and 13 out of 20 with VL non-suppression underwent repeat VL testing. Among those with available dates (125/354), the median TAT was 93 days (IQR 19.3-255). Of 1112, VL results were available between 32 weeks and child birth in 31 (2.8%) women. When compared to hospitals, women registered for antenatal care in clinics were 36% less likely to undergo VL testing [aRR: 0.64 (95% CI: 0.53, 0.76)].
conclusionAmong women on option B+, the uptake of HIV VL testing was low with unacceptably long TAT. VL suppression among those tested was satisfactory. There is an urgent need to prioritize VL testing among PBF women and to consider use of point of care machines. There is a critical need to strengthen the recording and local utilisation of routine clinic data in order to successfully monitor progress of healthcare services provided.
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