Evidence map›Paper›PMID 34021715›Full record

ArticleJournal of the International AIDS Society2021

Timing of HIV diagnosis relative to pregnancy and postpartum HIV care continuum outcomes among Latin American women, 2000 to 2017.

Nathaniel T Yohannes, Cathy A Jenkins, Kate Clouse, Claudia P Cortés, Fernando Mejía Cordero, Denis Padgett, Vanessa Rouzier, Ruth K Friedman, Catherine C McGowan, Bryan E Shepherd and 1 more

Abstract read
In one paragraph

Article in Journal of the International AIDS Society, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

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0cells of the map it votes in
2citing papers in PubMed
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1 · What the graph read from it

What it found

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Nathaniel T YohannesVanderbilt University School of Medicine, Nashville, TN, USA.
Cathy A JenkinsDepartment of Biostatistics, Vanderbilt University Medical Center, Nashville, TN, USA.
Kate ClouseDivision of Infectious Diseases, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA.ORCID 0000-0002-0190-7398
Claudia P CortésFundación Arriaran y Clínica Santa María, Santiago, Chile.
Fernando Mejía CorderoInstituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru.
Denis PadgettInstituto Hondureño de Seguridad Social & Hospital Escuela Universitario, Tegucigalpa, Honduras.
Vanessa RouzierGroupe Haitien d'Etudes du Sarcome de Kaposi et des Infections Opportunistes, Port-au-Prince, Haiti.
Ruth K FriedmanInstituto Nacional de Infectologia Evandro Chagas (INI), Fundação Oswaldo Cruz, Rio de Janeiro, Brazil.
Catherine C McGowanDivision of Infectious Diseases, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA.
Bryan E ShepherdDepartment of Biostatistics, Vanderbilt University Medical Center, Nashville, TN, USA.
Peter F RebeiroDepartment of Biostatistics, Vanderbilt University Medical Center, Nashville, TN, USA.ORCID 0000-0003-1951-9104

Funding

CCASAnet: Caribbean, Central and South America NetworkU01AI069923 · NIAID · VANDERBILT UNIVERSITY MEDICAL CENTER · PI Pedro Enrique Cahn, Jessica L Castilho · 2006 to 2026
$41.6M
Tennessee CFAR: Implementation of Culturally Responsive Trauma-Informed Care with Youth with HIV in Memphis, TNP30AI110527 · NIAID · VANDERBILT UNIVERSITY MEDICAL CENTER · PI Chandravanu Dash · 2015 to 2026
$27.5M
The HIV Care Continuum and Health Policy: Changes through Context and GeographyK01AI131895 · NIAID · VANDERBILT UNIVERSITY MEDICAL CENTER · PI REBEIRO, PETER F · 2017 to 2021
$623k
NIAID NIH HHS K01 AI131895NIAID NIH HHS P30 AI110527NIAID NIH HHS U01 AI069923
6 · The paper itself

Abstract

backgroundHIV incidence among women of reproductive age and vertical HIV transmission rates remain high in Latin America. We, therefore, quantified HIV care continuum barriers and outcomes among pregnant women living with HIV (WLWH) in Latin America.

methodsWLWH (aged ≥16 years) enrolling at Caribbean, Central and South America network for HIV epidemiology (CCASAnet) sites from 2000 to 2017 who had HIV diagnosis, pregnancy and delivery dates contributed. Logistic regression produced adjusted odds ratios (aOR) and 95% confidence intervals (CI) for retention in care (≥2 visits ≥3 months apart) and virological suppression (viral load <200 copies/mL) 12 months after pregnancy outcome. Cumulative incidences of loss to follow-up (LTFU) postpartum were estimated using Cox regression. Evidence of HIV status at pregnancy confirmation was the exposure. Covariates included pregnancy outcome (born alive vs. others); AIDS diagnosis prior to delivery; CD4, age, HIV-1 RNA and cART regimen at first delivery and CCASAnet country.

resultsAmong 579 WLWH, median postpartum follow-up was 4.34 years (IQR 1.91, 7.35); 459 (79%) were HIV-diagnosed before pregnancy confirmation, 445 (77%) retained in care and 259 (45%) virologically suppressed at 12 months of postpartum. Cumulative incidence of LTFU was 21% by 12 months and 40% by five years postpartum. Those HIV-diagnosed during pregnancy had lower odds of retention (aOR = 0.58, 95% CI: 0.35 to 0.97) and virological suppression (aOR = 0.50, 95% CI: 0.31 to 0.82) versus those HIV-diagnosed before.

conclusionHIV diagnosis during pregnancy was associated with poorer 12-month retention and virological suppression. Young women should be tested and linked to HIV care earlier to narrow these disparities.

Indexed as

HIV InfectionsPregnancy Complications, InfectiousContinuity of Patient CareFemaleHumansLatin AmericaPostpartum PeriodPregnancyPregnancy OutcomeViral LoadHIV care continuumHIV epidemiologyLatin America and the Caribbean (Region)retentionvertical transmissionwomen

Identifiers

PMID34021715
PMCPMC8140191

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.