Evidence map›Paper›PMID 34280229›Full record

ArticlePloS one2021

Late antiretroviral refills and condomless sex in a cohort of HIV-seropositive pregnant and postpartum Kenyan women.

McKenna C Eastment, John Kinuthia, Lei Wang, George Wanje, Katherine Wilson, Anne Kaggiah, Jane M Simoni, Kishorchandra Mandaliya, Danielle N Poole, Barbra A Richardson and 3 more

Open access · goldAbstract read
In one paragraph

Article in PloS one, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.1field-weighted citation impact, top 51% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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, 2 citations in OpenAlex.

  1. Article
  2. Review
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

13 authors at 4 institutions in 2 countries.

McKenna C EastmentDepartments of Medicine, University of Washington, Seattle, Washington, United States of America.ORCID 0000-0002-9185-0902
John KinuthiaGlobal Health, University of Washington, Seattle, Washington, United States of America.
Lei WangGlobal Health, University of Washington, Seattle, Washington, United States of America.
George WanjeDepartment of Medical Microbiology, University of Nairobi, Nairobi, Kenya.
Katherine WilsonGlobal Health, University of Washington, Seattle, Washington, United States of America.
Anne KaggiahKenyatta National Hospital, Nairobi, Kenya.
Jane M SimoniGlobal Health, University of Washington, Seattle, Washington, United States of America.
Kishorchandra MandaliyaGlobal Health, University of Washington, Seattle, Washington, United States of America.
Danielle N PooleDepartment of Geography, Dartmouth College, Hanover, New Hampshire, United States of America.
Barbra A RichardsonGlobal Health, University of Washington, Seattle, Washington, United States of America.
Walter JaokoDepartment of Medical Microbiology, University of Nairobi, Nairobi, Kenya.
Grace John-StewartDepartments of Medicine, University of Washington, Seattle, Washington, United States of America.
R Scott McClellandDepartments of Medicine, University of Washington, Seattle, Washington, United States of America.
University of Washington · USUniversity of Nairobi · KEDartmouth College · USKenyatta National Hospital · KE

Funding

University of Washington/Fred Hutch Center for AIDS ResearchP30AI027757 · NIAID · UNIVERSITY OF WASHINGTON · PI CONNIE L CELUM · 1988 to 2026
$104.9M
VENEREAL DISEASET32AI007140 · NIAID · UNIVERSITY OF WASHINGTON · PI Julia Cook Dombrowski · 1985 to 2026
$19.4M
Innate immune determinants of HIV rebound and persistenceR01HD103571 · NICHD · FRED HUTCHINSON CANCER RESEARCH CENTER · PI JULIE M. OVERBAUGH · 2020 to 2026
$6.7M
Women's Life Events & HIV Transmission Potential: A Multidisciplinary StudyR01HD072617 · NICHD · UNIVERSITY OF WASHINGTON · PI MCCLELLAND, RAYMOND SCOTT · 2012 to 2016
$2.1M
RCT of an Implementation Science Tool to Integrate HIV testing into Family Planning Services K24HD088229 · NICHD · UNIVERSITY OF WASHINGTON · PI MCCLELLAND, RAYMOND SCOTT · 2016 to 2020
$863k
Randomized controlled trial of an implementation science tool to increase cervical cancer screening in Mombasa, KenyaK08CA228761 · NCI · UNIVERSITY OF WASHINGTON · PI EASTMENT, MCKENNA CLAIRE · 2018 to 2022
$756k
NCI NIH HHS K08 CA228761NIAID NIH HHS P30 AI027757NIAID NIH HHS T32 AI007140NICHD NIH HHS K24 HD088229NICHD NIH HHS R01 HD072617NICHD NIH HHS R01 HD103571
6 · The paper itself

Abstract

introductionThe postpartum period can be challenging for women living with HIV. Understanding how the postpartum period impacts ART adherence and condomless sex could inform the development of comprehensive sexual and reproductive health and HIV services tailored to the needs of women living with HIV during this critical interval.

methodsIn a longitudinal cohort study of HIV-seropositive Kenyan women, late ART refills and self-reported condomless sex were compared between the woman's pregnancy and the postpartum period. Analyses were conducted using generalized estimating equations and adjusted for alcohol use, depressive symptoms, intimate partner violence (IPV), and having a recent regular partner. Effect modification was explored for selected variables. RESULTS AND DISCUSSION: 151 women contributed visits. Late ART refills occurred at 7% (32/439) of pregnancy visits compared to 18% (178/1016) during the postpartum period (adjusted relative risk [aRR] 2.44, 95% confidence interval [CI] 1.62-3.67). This association differed by women's education level. Women with ≥8 years of education had late ART refills more during the postpartum period than pregnancy (aRR 3.00, 95%CI 1.95-4.62). In contrast, in women with <8 years of education, late ART refills occurred similarly during pregnancy and the postpartum period (aRR 0.88, 95%CI 0.18-4.35). Women reported condomless sex at 10% (60/600) of pregnancy visits compared to 7% (72/1081) of postpartum visits (aRR 0.76, 95%CI 0.45-1.27). This association differed by whether women had experienced recent IPV. Women without recent IPV had a significant decline in condomless sex from pregnancy to postpartum (aRR 0.53, 95%CI 0.30-0.95) while women with recent IPV had no significant change in condomless sex from pregnancy to postpartum (aRR 1.76, 95%CI 0.87-3.55).

conclusionImproved support for ART adherence during the postpartum period and addressing IPV to limit condomless sex could improve HIV treatment and prevention outcomes for HIV-seropositive women as well as their infants and sexual partners.

Indexed as

Antiretroviral Therapy, Highly ActiveAdolescentAdultAnti-Retroviral AgentsFemaleHIV InfectionsHIV SeropositivityHumansIntimate Partner ViolenceKenyaLongitudinal StudiesMalePregnancyRisk FactorsSexual BehaviorSexual PartnersAnti-Retroviral Agents

Identifiers

PMID34280229
PMCPMC8289061
OpenAlexW3184962403

What OpenQuestion holds

Textmetadata
LicenceCC0
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Registered trials

None linked

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.