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PMTCT care cascade and factors associated with attrition in the first four years after Option B+ implementation in Mozambique

dc.rights.licenseopenen_US
hal.structure.identifierBordeaux population health [BPH]
dc.contributor.authorAHOUA-LERAY, Laurence
hal.structure.identifierBordeaux population health [BPH]
dc.contributor.authorTIENDREBEOGO, Kiswend-Sida Thierry
hal.structure.identifierBordeaux population health [BPH]
dc.contributor.authorARIKAWA, Shino
dc.contributor.authorLAHUERTA, M.
dc.contributor.authorALY, D.
dc.contributor.authorJOURNOT, V.
dc.contributor.authorABRAMS, E. J.
hal.structure.identifierBordeaux population health [BPH]
dc.contributor.authorBECQUET, Renaud
hal.structure.identifierBordeaux population health [BPH]
dc.contributor.authorDABIS, Francois
dc.date.accessioned2021-01-12T15:24:30Z
dc.date.available2021-01-12T15:24:30Z
dc.date.issued2020
dc.identifier.issn1365-3156 (Electronic) 1360-2276 (Linking)en_US
dc.identifier.urihttps://oskar-bordeaux.fr/handle/20.500.12278/23764
dc.description.abstractEnObjective To evaluate the effectiveness of the prevention of mother‐to‐child transmission (PMTCT) Option B+ programme in two provinces with high human immunodeficiency virus (HIV) burden in Mozambique over the first four years of programme implementation. Methods We assessed the PMTCT cascade in antenatal care (ANC) from July 2013 to December 2017 using facility‐level data and performed a retrospective cohort analysis with patient‐level data. We compared the 12‐month antiretroviral therapy (ART) retention rates between women with HIV infection who initiated ART under Option B+ (‘B+ pregnant’) and those who initiated ART for their own health (‘own health’). Results A total of 916 280 pregnant women enrolled in ANC. The proportion of women with a documented HIV status increased from 93% in 2013 to 96% in 2017. The proportion of those tested HIV‐positive decreased from 8% to 6% while that of those HIV‐positive on ART increased from 42% to 95%. Of the 44 377 HIV‐positive women included in the analysis, 35% were lost to care. ‘B+ pregnant’ women initiating ART in 2015 were less likely to have no follow‐up (NFU) compared with ‘own health’ women starting ART during the same period (adjusted odds ratio: 0.77, 95% confidence interval [CI]: 0.64–0.94, P = 0.01). There was no statistical difference between the two groups during the other years in which ART was initiated. Of those returning for care after their first visit (N = 39 801), the ‘B+ pregnant’ women showed a higher risk of non‐retention than the other group (adjusted hazard ratio: 1.14, 95% CI: 1.03–1.25) when ART was initiated in 2013. The risk decreased during the subsequent years, with no difference observed between the groups. Conclusion PMTCT Option B+ programme scale‐up has yielded positive results, including the maintenance of high HIV testing and ART initiation rates in ANC. Challenges still remain, however, in improving immediate engagement in care and long‐term retention. Seeking alternative service delivery models to support existing health systems and prevent defaulters is required to achieve the UNAIDS 95‐95‐95 targets for PMTCT in Mozambique.
dc.language.isoENen_US
dc.subjectIDLIC
dc.title.enPMTCT care cascade and factors associated with attrition in the first four years after Option B+ implementation in Mozambique
dc.title.alternativeTrop Med Int Healthen_US
dc.typeArticle de revueen_US
dc.identifier.doi10.1111/tmi.13324en_US
dc.subject.halSciences du Vivant [q-bio]/Santé publique et épidémiologieen_US
dc.identifier.pubmed31667997en_US
bordeaux.journalTropical Medicine and International Healthen_US
bordeaux.page222-235en_US
bordeaux.volume25en_US
bordeaux.hal.laboratoriesBordeaux Population Health Research Center (BPH) - U1219en_US
bordeaux.issue2en_US
bordeaux.institutionUniversité de Bordeauxen_US
bordeaux.teamIDLICen_US
bordeaux.peerReviewedouien_US
bordeaux.inpressnonen_US
hal.identifierhal-03166472
hal.version1
hal.date.transferred2021-03-11T10:58:16Z
hal.exporttrue
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