option B+

Prevalence of antiretroviral therapy treatment failure among HIV-infected pregnant women at first antenatal care: PMTCT Option B+ in Malawi

Author
Chagomerana, M. B., et al.

BACKGROUND: In Malawi's PMTCT Option B+ program, HIV-infected pregnant women who are already receiving ART are continued on their current therapy regimen without testing for treatment failure at the first antenatal care (ANC) visit. HIV RNA screening at ANC may identify women with treatment failure and ensure that viral suppression is maintained throughout the pregnancy.

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The impact of "Option B" on HIV transmission from mother to child in Rwanda: An interrupted time series analysis

Author
Abimpaye M, Kirk CM, Iyer HS, Gupta N, Remera E, Mugwaneza P, Law MR

Nearly a quarter of a million children have acquired HIV, prompting the implementation of new protocols-Option B and B+-for treating HIV+ pregnant women. While efficacy has been demonstrated in randomized trials, there is limited real-world evidence on the impact of these changes. Using longitudinal, routinely collected data we assessed the impact of the adoption of WHO Option B in Rwanda on mother to infant transmission.

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Challenges and successes in the implementation of option B+ to prevent mother-to-child transmission of HIV in southern Eswatini

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Yes
Author
Etoori D, Kerschberger B, Staderini N, Ndlangamandla M, Nhlabatsi B, Jobanputra K, Mthethwa-Hleza S, Parker LA, Sibanda S, Mabhena E, Pasipamire M, Kabore SM, Rusch B, Jamet C, Ciglenecki I, Teck R

Universal antiretroviral therapy (ART) for all pregnant/ breastfeeding women living with HIV, known as prevention of mother-to-child transmission of HIV (PMTCT) Option B+ (PMTCTB+), is being scaled up in most countries in Sub-Saharan Africa. In the transition to PMTCTB+, many countries face challenges with proper implementation of the HIV care cascade. We aimed to describe the feasibility of a PMTCTB+ approach in the public health sector in Swaziland.

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HIV-positivity among HIV-exposed infants in Lesotho in the era of Option B+

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Yes
Author
Tsigereda G. Belachew, Kieran Hartsough, Andrea Schaaf, Mahlompho Ntholeng, Tiffany G. Harris

Lesotho's HIV prevalence among pregnant women is 28%. In 2013, Lesotho's Prevention of Mother to Child Transmission (PMTCT) program adopted Option B+ and revitalized the village health worker (VHW) program to strengthen community level PMTCT. The national goal was to test 95% of HIV-exposed infants (HEI) at 2 and 18 months and reduce transmission rates to

We reviewed routinely collected PMTCT data of infants aged

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Retention in care among HIV-infected pregnant and breastfeeding women on lifelong antiretroviral therapy in Uganda: A retrospective cohort study

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Yes
Author
Simon Muhumuza, Evelyn Akello, Charity Kyomugisha-Nuwagaba, Rose Baryamutuma, Isaac Sebuliba, Ibrahim M. Lutalo, Edgar Kansiime, Linda N. Kisaakye, Agnes N. Kiragga, Rachel King, William Bazeyo, Christina Lindan

In 2013, Uganda updated its prevention of maternal-to-child transmission of HIV program to Option B+, which requires that all HIV-infected pregnant and breastfeeding women be started on lifelong antiretroviral therapy (ART) regardless of CD4 count. We describe retention in care and factors associated with loss to follow-up (LTFU) among women initiated on Option B+ as part of an evaluation of the effectiveness of the national program.

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"We Have Heard It Together": A Qualitative Analysis of Couple HIV Testing and Counselling Recruitment in Malawi's Option B+ Programme

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Yes
Author
Rosenberg, N.E., Gross, R., Mtande, T., et al.

This qualitative study described experiences of participants in a randomized controlled trial that examined male partner recruitment strategies for couples HIV testing and counseling within an antenatal unit in Malawi. Strategies included inviting the man to attend an appointment with his partner, and providing the invitation plus phone and community tracing for individuals who did not follow up at the clinic. All women disclosed their HIV status and gave the invitation to their partner.

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Prevention of mother-to-child transmission of HIV Option B+ cascade in rural Tanzania: The One Stop Clinic model

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Yes
Author
Anna Gamell, Lameck Bonaventure Luwanda, Aneth Vedastus Kalinjuma, Leila Samson, Alex John Ntamatungiro, Maja Weisser, Winfrid Gingo, Marcel Tanner, Christoph Hatz, Emilio Letang, Manuel Battegay

Background

Strategies to improve the uptake of Prevention of Mother-To-Child Transmission of HIV (PMTCT) are needed. We integrated HIV and maternal, newborn and child health services in a One Stop Clinic to improve the PMTCT cascade in a rural Tanzanian setting.

Methods

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Lessons Learned From Option B+ in the Evolution toward "Test and Start" from Malawi, Cameroon, and the United Republic of Tanzania

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Yes
Author
Kalua, T., Tippett Barr, B.A., van Oosterhout, J.J., et al.

Option B+ for prevention of mother-to-child transmission (PMTCT) specifies treating all HIV-positive women with antiretroviral therapy (ART) regardless of CD4 count. This simplified approach enhances countries' capacity to reach national HIV targets and contribute to the global 90-90-90 goals. This article reviewed the progress of Malawi's adoption of Option B+ for PMTCT and briefly described its implementation in Cameroon and Tanzania. Option B+ was developed in Malawi in response to numerous systemic barriers to the rapid scale-up of ART and PMTCT services.

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Webinar: Gender and PMTCT/EMTCT Participation in Malawi and Uganda under Option B+

Venue
Webinar

The USAID-funded MEASURE Evaluation project is hosting a webinar and live Q&A session on Tuesday, December 13, from 9:00-10:00am EST to present findings from a study on Gender and Participation in Prevention or Elimination of Mother-to-Child HIV Transmission Programs in Malawi and Uganda under Option B+.

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Women with HIV have higher risk of loss to follow-up and death after delivery

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Yes
Author
Carole Leach-Lemens

Despite the widespread implementation of Option B+ (lifelong antiretroviral therapy (ART) for pregnant and breastfeeding women regardless of CD4 cell count) postpartum HIV-positive women remain at higher risk of loss to follow-up and death, studies from South Africa and Botswana presented at the 21st International AIDS Conference (AIDS 2016) in Durban last week show.

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