ArticleBMJ open2022
HIV viral load non-suppression and associated factors among pregnant and postpartum women in rural northeastern South Africa: a cross-sectional survey.
Article in BMJ open, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 4 of them syntheses that pooled it.
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Who cites it
21 citing papers in PubMed, 4 syntheses or guidelines pooled it, 26 citations in OpenAlex.
- Pooled it
- Factors associated with unsuppressed HIV viral load among children under 15 years in sub-Saharan africa: a systematic review.AIDS research and therapy · 2025Pooled it
- Characterizing the HIV care continuum among children and adolescents with HIV in eastern and southern Africa in the era of "Universal Test and Treat": A systematic review and meta-analysis.Journal of the International AIDS Society · 2025Pooled it
- Prevalence and factors associated with viral non-suppression in people living with HIV receiving antiretroviral therapy in sub-Saharan Africa: A systematic review and meta-analysis.Reviews in medical virology · 2024Pooled it
- Drivers of HIV Viral Non-suppression Among Children and Adolescents Aged 0-19 Years in Masaka District, Uganda: A Cross-Sectional Study.AIDS and behavior · 2026Article
- Article
- Observational
- HIV-1 genetic diversity and reverse transcriptase resistance mutations in Benin before dolutegravir era, West Africa.PloS one · 2026Article
- Article
- Comparison of infant feeding practices by maternal HIV status, and associated factors, in a rural district, South Africa 2019.International breastfeeding journal · 2025Article
- Human Immunodeficiency Virus (HIV) viral load suppression status and associated factors among pregnant women receiving Highly Active Antiretroviral Therapy (HAART) in Ethiopia.Virology journal · 2025Article
- Factors associated with viral load suppression in pregnant and postpartum women living with HIV in Rwanda: an open-observational cohort study.Frontiers in public health · 2025Observational
- Sexually transmitted infections and bacterial vaginosis among adolescent girls and young women in the early postpartum period: a cross-sectional study.BMC infectious diseases · 2024Article
- 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
- Preventing breast milk HIV transmission using broadly neutralizing monoclonal antibodies: One size does not fit all.Immunity, inflammation and disease · 2024Article
- Article
- "I desire to have an HIV-free baby": pregnant and breastfeeding mothers' perceptions of Viral load testing and suppression in HIV care in southwestern Uganda.Discover social science and health · 2024Article
- Forgetting to Take Medication, Treatment Adherence and Their Relationship with Viral Load Suppression Among People Living with HIV in the Kilimanjaro Region, Tanzania.HIV/AIDS (Auckland, N.Z.) · 2024Article
- Antiretroviral therapy retention, adherence, and clinical outcomes among postpartum women with HIV in Nigeria.PloS one · 2024Article
- Novel Approaches to Postnatal Prophylaxis to Eliminate Vertical Transmission of HIV.Global health, science and practice · 2023Article
Corrections and comments
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Authors and funding
9 authors at 6 institutions in 6 countries.
Funding
Abstract
objectivesWe aimed to measure the prevalence of maternal HIV viral load (VL) non-suppression and assess associated factors, to evaluate progress towards United Nations-AIDS (UNAIDS) targets.
designCross-sectional study.
settingThe eight largest community health centres of Ehlanzeni, a rural district in northeast South Africa.
participantsPregnant women living with HIV (WLHIV) in their third trimester and postpartum WLHIV and their biological infants, recruited equally across all stages of the first 24 months post partum, were included. A sample of 612 mothers participated from a target of 1000. PRIMARY OUTCOME MEASURES: The primary outcome was maternal VL (mVL) non-suppression (defined here as mVL >1000 copies/mL). We collected information on antiretroviral use, healthcare visits and sociodemographics through interviews and measured plasma mVL. Descriptive statistics, χ
resultsAll mothers (median age: 30 years) were on antiretroviral therapy (ART) and 24.9% were on ART ≤12 months. The prevalence of mVL non-suppression was 14.7% (95% CI: 11.3% to 19.0%), while 13.8% had low-level viraemia (50-1000 copies/mL). Most (68.9%) women had initiated breast feeding and 37.6% were currently breast feeding their infants. Being younger than 25 years (adjusted odds ratio (AOR): 2.6 (95% CI: 1.1 to 6.4)), on first-line ART (AOR: 2.3 (95% CI: 1.1 to 4.6)) and married/cohabiting (AOR: 1.9 (95% CI: 1.0 to 3.7)) were significantly associated with increased odds of mVL non-suppression.
conclusionsThe prevalence of mVL ≤1000 copies/mL of 85.3% among pregnant and postpartum WLHIV and attending public healthcare centres in this rural district is below the 2020 90-90-90 and 2030 95-95-95 UNAIDS targets. Given that low-level viraemia may also increase the risk of vertical HIV transmission, we recommend strengthened implementation of the new guidelines which include better ART options, improved ART regimen switching and mVL monitoring schedules, and intensified psychosocial support for younger women, while exploring district-level complementary interventions, to sustain VLs below 50 copies/mL among all women.
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