Division of Epidemiology and Biostatistics, School of Public Health, University of Cape Town, Cape Town, South Africa.
Division of Medical Virology, National Health Laboratory Service, University of Cape Town and Groote Schuur Hospital, Cape Town, South Africa.
Int Health. 2023 Nov 3;15(6):692-701. doi: 10.1093/inthealth/ihad001.
We investigated the association between travel and viraemia in post-partum women with human immunodeficiency virus on antiretroviral therapy (ART).
Data are from a trial of post-partum ART delivery strategies. Women who initiated ART during pregnancy, were clinically stable with a viral load (VL) <400 copies/ml and were <10 weeks post-partum were enrolled at a primary care antenatal clinic in Cape Town, South Africa. Study visits at 3, 6, 12, 18 and 24 months post-partum included questions about travel, defined as ≥1 night spent outside of the city, and VL testing. Generalised mixed effects models assessed the association between travel and subsequent VL ≥400 copies/ml.
Among 402 women (mean age 29 y, 35% born in the Western Cape), 69% reported one or more travel events over 24 months. Being born beyond the Western Cape (adjusted odds ratio [aOR] 2.03 [95% confidence interval {CI} 1.49 to 2.77]), duration post-partum in months (aOR 1.03 [95% CI 1.02 to 1.05]) and living with the child (aOR 0.60 [95% CI 0.38 to 0.93]) were associated with travel. In multivariable analyses, a travel event was associated with a 92% increase in the odds of a VL ≥400 copies/ml (aOR 1.92 [95% CI 1.19 to 3.10]).
Interventions to support women on ART who travel are urgently required.
我们研究了在接受抗逆转录病毒治疗（ART）的产后艾滋病毒感染者中，旅行与病毒血症之间的关联。
本数据来自产后 ART 传递策略的试验。在南非开普敦的一个初级保健产前诊所，招募了在妊娠期间开始接受 ART、病毒载量（VL）<400 拷贝/ml 且产后<10 周的临床稳定的妇女。产后 3、6、12、18 和 24 个月的研究访视包括有关旅行的问题，旅行定义为在城市以外过夜≥1 晚，以及 VL 检测。广义混合效应模型评估了旅行与随后的 VL≥400 拷贝/ml 之间的关联。
在 402 名妇女（平均年龄 29 岁，35%出生在西开普省）中，69%的人在 24 个月内报告了一次或多次旅行事件。出生在西开普省以外地区（调整后的优势比 [aOR] 2.03 [95%置信区间 {CI} 1.49 至 2.77]）、产后月份（aOR 1.03 [95% CI 1.02 至 1.05]）和与孩子同住（aOR 0.60 [95% CI 0.38 至 0.93]）与旅行有关。在多变量分析中，旅行事件与 VL≥400 拷贝/ml 的几率增加 92%相关（aOR 1.92 [95% CI 1.19 至 3.10]）。
迫切需要为旅行的接受抗逆转录病毒治疗的妇女提供干预措施。
