pregnant women

Mapping a Syndemic of Psychosocial Risks During Pregnancy Using Network Analysis

Psychosocial risks during pregnancy impact maternal health in resource-limited settings, and HIV-positive women often bear a heavy burden of these factors. This study sought to use network modeling to characterize co-occurring psychosocial risks to maternal and child health among at-risk pregnant women.
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Retention on antiretroviral therapy during Universal Test and Treat implementation in Zomba district, Malawi: a retrospective cohort study

Since June 2016, the national HIV programme in Malawi has adopted Universal Test and Treat (UTT) guidelines requiring that all persons who test HIV positive will be referred to start antiretroviral therapy (ART). Although there is strong evidence from clinical trials that early initiation of ART leads to reduced morbidity and mortality, the impact of UTT on retention on ART in real-life programmatic settings in Africa is not yet known.
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‘If I had not taken it [HIVST kit] home, my husband would not have come to the facility to test for HIV’: HIV self-testing perceptions, delivery strategies, and post-test experiences among pregnant women and their male partners in Central Uganda

Author
Joseph K. B. Matovu, Rose Kisa, Esther Buregyeya, Harriet Chemusto, Shaban Mugerwa, William Musoke, Caroline J. Vrana, Angela M. Malek, Jeffrey E. Korte & Rhoda K. Wanyenze

Background: HIV self-testing (HIVST) can improve HIV-testing rates in ‘hard-to-reach’ populations, including men. We explored HIVST perceptions, delivery strategies, and post-test experiences among pregnant women and their male partners in Central Uganda.

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Antiretroviral therapy in pregnant women living with HIV: a clinical practice guideline

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Yes
Author
BMJ

Approximately 1.4 million women living with HIV become pregnant every year. Most women use antiretroviral therapy, to reduce the risk of vertical transmission or for personal health reasons. Using the GRADE framework according to the BMJ Rapid Recommendation process, we make recommendations for optimal choice of combination antiretroviral regimen considering patient values and preferences, the balance of desirable and undesirable outcomes, their uncertainty, and practical issues.

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Misdiagnosed HIV infection in pregnant women initiating universal ART in South Africa

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Yes
Author
Nei-yuan Hsiao, Allison Zerbe, Tamsin K. Phillips, Landon Myer, Elaine J. Abrams

Rapid diagnostic tests (RDTs) are the primary diagnostic tools for HIV used in resource-constrained settings. Without a proper confirmation algorithm, there is concern that false-positive (FP) RDTs could result in misdiagnosis of HIV infection and inappropriate antiretroviral treatment (ART) initiation, but programmatic data on FP are few.

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Increasing HIV testing among pregnant women in Nigeria: evaluating the traditional birth attendant and primary health center integration (TAP-In) model

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Yes
Author
Chizoba AF, Pharr JR, Oodo G, Ezeobi E, Ilozumb J, Egharevba J, Ezeanolue EE, Nwandu A

Engaging Traditional Birth Attendants (TBAs) may be critical to preventing mother-to-child transmission of HIV (PMTCT) in Nigeria. We integrated TBAs into Primary Health Centers (PHCs) and provided the TBAs with HIV counseling and testing (HCT) training for PMTCT (TAP-In). The purpose of this study was to evaluate the impact of TAP-In on HCT uptake among pregnant women. A quasi-experimental design was used for this study. Twenty PHCs were assigned to the intervention group that integrated TAP-In and 20 were assigned to the control group.

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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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