Evidence map›Paper›PMID 35718940›Full record

ArticleJournal of the International AIDS Society2022

The effect of a Mentor Mothers program on prevention of vertical transmission of HIV outcomes in Zambézia Province, Mozambique: a retrospective interrupted time series analysis.

James G Carlucci, Zhihong Yu, Purificación González, Magdalena Bravo, Gustavo Amorim, Cristina das Felicidades Cugara, Helga Guambe, Jaime Mucanhenga, Wilson Silva, José A Tique and 4 more

Open access · goldAbstract read
In one paragraph

Article in Journal of the International AIDS Society, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed
2.7field-weighted citation impact, top 8% 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

8 citing papers in PubMed, 27 citations in OpenAlex.

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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

14 authors at 5 institutions in 3 countries.

James G CarlucciRyan White Center for Pediatric Infectious Diseases and Global Health, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, Indiana, USA.ORCID 0000-0002-3969-8544
Zhihong YuDepartment of Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Purificación GonzálezFriends in Global Health, Quelimane, Mozambique.
Magdalena BravoFriends in Global Health, Maputo, Mozambique.
Gustavo AmorimDepartment of Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Cristina das Felicidades CugaraMinistry of Health, Provincial Health Directorate of Zambézia, Quelimane, Mozambique.
Helga GuambeMinistry of Health, National Directorate of Public Health, Maputo, Mozambique.
Jaime MucanhengaFriends in Global Health, Quelimane, Mozambique.
Wilson SilvaFriends in Global Health, Maputo, Mozambique.
José A TiqueFriends in Global Health, Maputo, Mozambique.
Maria Fernanda Sardella AlvimFriends in Global Health, Maputo, Mozambique.
Erin GravesVanderbilt Institute for Global Health, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Caroline De SchachtFriends in Global Health, Maputo, Mozambique.
C William WesterVanderbilt Institute for Global Health, Vanderbilt University Medical Center, Nashville, Tennessee, USA.ORCID 0000-0002-8375-3926
Vanderbilt University Medical Center · USFriends United · USIndiana University Health · USMinistry of Health · MZNational Directorate of Geology · MZ

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionMentor Mothers (MM) provide peer support to pregnant and postpartum women living with HIV (PPWH) and their infants with perinatal HIV exposure (IPE) throughout the cascade of prevention of vertical transmission (PVT) services. MM were implemented in Zambézia Province, Mozambique starting in August 2017. This evaluation aimed to determine the effect of MM on PVT outcomes.

methodsA retrospective interrupted time series analysis was done using routinely collected aggregate data from 85 public health facilities providing HIV services in nine districts of Zambézia. All PPWH (and their IPE) who initiated antiretroviral therapy (ART) from August 2016 through April 2019 were included. Outcomes included the proportion per month per district of: PPWH retained in care 12 months after ART initiation, PPWH with viral suppression and IPE with HIV DNA PCR test positivity by 9 months of age. The effect of MM on outcomes was assessed using logistic regression.

resultsThe odds of 12-month retention increased 1.5% per month in the pre-MM period, compared to a monthly increase of 7.6% with-MM (35-61% pre-MM, 56-72% with-MM; p < 0.001). The odds of being virally suppressed decreased by 0.9% per month in the pre-MM period, compared to a monthly increase of 3.9% with-MM (49-85% pre-MM, 59-80% with-MM; p < 0.001). The odds of DNA PCR positivity by 9 months of age decreased 8.9% per month in the pre-MM period, compared to a monthly decrease of 0.4% with-MM (0-14% pre-MM, 4-10% with-MM; p < 0.001). The odds of DNA PCR uptake (the proportion of IPE who received DNA PCR testing) by 9 months of age were significantly higher in the with-MM period compared to the pre-MM period (48-100% pre-MM, 87-100% with-MM; p < 0.001).

conclusionsMM services were associated with improved retention in PVT services and higher viral suppression rates among PPWH. While there was ongoing but diminishing improvement in DNA PCR positivity rates among IPE following MM implementation, this might be explained by increased uptake of HIV testing among high-risk IPE who were previously not getting tested. Additional efforts are needed to further optimize PVT outcomes, and MM should be one part of a comprehensive strategy to address this critical need.

Indexed as

Anti-HIV AgentsHIV InfectionsPregnancy Complications, InfectiousFemaleHumansInfantInfectious Disease Transmission, VerticalInterrupted Time Series AnalysisMentorsMothersMozambiquePregnancyRetrospective StudiesAnti-HIV AgentsHIV/AIDSmaternal-child healthMozambiquepeer supportprevention of vertical transmissionviral suppression

Identifiers

PMID35718940
PMCPMC9207359
OpenAlexW4283156459

What OpenQuestion holds

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LicenceCC BY
Read underepoch 390

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.