Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA.
Department of Paediatrics, Moi University College of Health Sciences, Eldoret, Kenya.
AIDS Behav. 2022 Nov;26(11):3494-3505. doi: 10.1007/s10461-022-03666-w. Epub 2022 Apr 25.
Medical records of pregnant and postpartum women living with HIV and their infants attending a large referral facility in Kenya from 2015 to 2019 were analyzed to identify characteristics associated with retention in care and viral suppression. Women were stratified based on the timing of HIV care enrollment: known HIV-positive (KHP; enrolled pre-pregnancy) and newly HIV-positive (NHP; enrolled during pregnancy). Associations with retention at 18 months postpartum and viral suppression (< 1000 copies/mL) were determined. Among 856 women (20% NHP), retention was 83% for KHPs and 53% for NHPs. Viral suppression was 88% for KHPs and 93% for NHPs, but 19% of women were missing viral load results. In a competing risk model, viral suppression increased by 18% for each additional year of age but was not associated with other factors. Overall, 1.9% of 698 infants with ≥ 1 HIV test result were HIV-positive. Tailored interventions are needed to promote retention and viral load testing, particularly for NHPs, in the PMTCT continuum.
对肯尼亚一家大型转诊机构 2015 年至 2019 年期间的 HIV 感染孕妇和产后妇女及其婴儿的医疗记录进行了分析，以确定与护理保留和病毒抑制相关的特征。根据 HIV 护理登记的时间对妇女进行分层：已知 HIV 阳性（KHP；妊娠前登记）和新发现 HIV 阳性（NHP；妊娠期间登记）。确定了与产后 18 个月保留和病毒抑制（<1000 拷贝/ml）相关的因素。在 856 名妇女（20%的 NHP）中，KHP 的保留率为 83%，而 NHP 的保留率为 53%。KHP 的病毒抑制率为 88%，NHP 的病毒抑制率为 93%，但有 19%的妇女缺少病毒载量结果。在竞争风险模型中，病毒抑制率每增加 1 岁增加 18%，但与其他因素无关。总的来说，在 698 名至少有一次 HIV 检测结果的婴儿中，有 1.9%为 HIV 阳性。需要有针对性的干预措施来促进 PMTCT 连续体中的保留和病毒载量检测，特别是针对 NHP。
