Initial Programmatic Implementation of WHO Option B in Botswana Associated with Increased Projected MTCT

Details

• Alternative Title:
  J Acquir Immune Defic Syndr
• Personal Author:
  Dryden-Peterson, Scott ; Lockman, Shahin ; Zash, Rebecca ; Lei, Quonhong ; Chen, Jennifer Y. ; Souda, Sajini ; Petlo, Chipo ; Dintwa, Eldah ; Lebelonyane, Refeletswe ; Mmalane, Mompati ; Shapiro, Roger L.
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• Description:
  : Botswana was one of the first African countries to transition from WHO Option A to Option B for prevention of mother-to-child HIV transmission (MTCT). We evaluated the impact of this transition on projected MTCT risk through review of 10,681 obstetric records of HIV-infected women delivering at 6 maternity wards. Compared with Option A, women receiving antenatal care under Option B were more likely to receive combination antiretroviral therapy (ART), adjusted odds ratio (aOR): 2.59 (95% confidence interval: 2.25 to 2.98), but they were also more likely to receive no antenatal antiretrovirals, aOR: 2.10 (95% confidence interval: 1.74 to 2.53). Consequently, initial implementation of Option B was associated with increased projected MTCT at 6 months of age, 3.79% under Option A and 4.69% under Option B (P < 0.001). Successful implementation of Option B or B+ may require that ART can be initiated within antenatal clinics, and novel strategies to remove barriers to rapid ART initiation.
• Keywords:
  • PMTCT
  • Option B
  • implementation science
  • sub-Saharan Africa
  • ART initiation
  • HIV-1
  • Adult
  • Anti-Retroviral Agents
  • Antiretroviral Therapy, Highly Active
  • Botswana
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• Source:
  J Acquir Immune Defic Syndr. 68(3):245-249
• Pubmed ID:
  25501611
• Pubmed Central ID:
  PMC4326565
• Document Type:
  Text
• Funding:
  5K23AI091434/AI/NIAID NIH HHSUnited States/ ; K23 AI091434/AI/NIAID NIH HHSUnited States/ ; R01 HD044391/HD/NICHD NIH HHSUnited States/ ; 3R01HD044391-06S1/HD/NICHD NIH HHSUnited States/ ; U2G PS000941/PS/NCHHSTP CDC HHSUnited States/ ; T32 AI007433/AI/NIAID NIH HHSUnited States/ ; U2GPS000941/PHS HHSUnited States/
• Genre:
  Journal Article
• Volume:
  68
• Issue:
  3
• Download URL:
  https://stacks.cdc.gov/view/cdc/42019/cdc_42019_DS1.pdf
• File Type:
  [PDF - 322.65 KB]
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha-512:9ddcfa10a047dfb6a70d99dc633e625ef7319b10b4be7787a565d1b650cba99ce69ab729dac70128adada1525316b34502e6bc7f2cf93ef3c7466e2dc330d0b1