Factors associated with a history of treatment interruption among pregnant women living with HIV in Malawi: A cross-sectional study
<h4>Introduction</h4> Long-term care engagement of women on antiretroviral therapy (ART) is essential to effective HIV public health measures. We sought to explore factors associated with a history of HIV treatment interruption among pregnant women living with HIV presenting to an antena...
| Main Authors: | , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Public Library of Science (PLoS)
2022-01-01
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| Series: | PLoS ONE |
| Online Access: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9017884/?tool=EBI |
| _version_ | 1811332359295860736 |
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| author | Simone A. Sasse Bryna J. Harrington Bethany L. DiPrete Maganizo B. Chagomerana Laura Limarzi Klyn Shaphil D. Wallie Madalitso Maliwichi Allan N. Jumbe Irving F. Hoffman Nora E. Rosenberg Jennifer H. Tang Mina C. Hosseinipour on behalf of the S4 Study |
| author_facet | Simone A. Sasse Bryna J. Harrington Bethany L. DiPrete Maganizo B. Chagomerana Laura Limarzi Klyn Shaphil D. Wallie Madalitso Maliwichi Allan N. Jumbe Irving F. Hoffman Nora E. Rosenberg Jennifer H. Tang Mina C. Hosseinipour on behalf of the S4 Study |
| author_sort | Simone A. Sasse |
| collection | DOAJ |
| description | <h4>Introduction</h4> Long-term care engagement of women on antiretroviral therapy (ART) is essential to effective HIV public health measures. We sought to explore factors associated with a history of HIV treatment interruption among pregnant women living with HIV presenting to an antenatal clinic in Lilongwe, Malawi. <h4>Methods</h4> We performed a cross-sectional study of pregnant women living with HIV who had a history of ART interruption presenting for antenatal care. Women were categorized as either retained in HIV treatment or reinitiating care after loss-to-follow up (LTFU). To understand factors associated with treatment interruption, we surveyed socio-demographic and partner relationship characteristics. Crude and adjusted prevalence ratios (aPR) for factors associated with ART interruption were estimated using modified Poisson regression with robust variance. We additionally present patients’ reasons for ART interruption. <h4>Results</h4> We enrolled 541 pregnant women living with HIV (391 retained and 150 reinitiating). The median age was 30 years (interquartile range (IQR): 25–34). Factors associated with a history of LTFU were age <30 years (aPR 1.46; 95% CI: 1.33–1.63), less than a primary school education (aPR 1.25; CI: 1.08–1.46), initiation of ART during pregnancy or breastfeeding (aPR 1.49, CI: 1.37–1.65), nondisclosure of HIV serostatus to their partner (aPR 1.39, CI: 1.24–1.58), lack of awareness of partner’s HIV status (aPR 1.41, CI: 1.27–1.60), and no contraception use at conception (aPR 1.60, CI 1.40–1.98). Access to care challenges were the most common reasons reported by women for treatment interruption (e.g., relocation, transport costs, or misplacing health documentation). <h4>Conclusions</h4> Interventions that simplify the ART clinic transfer process, facilitate partner disclosure, and provide counseling about the importance of lifelong ART beyond pregnancy and breastfeeding should be further evaluated for improving retention in ART treatment of women living with HIV in Malawi. |
| first_indexed | 2024-04-13T16:35:35Z |
| format | Article |
| id | doaj.art-d05d809b977b43ffba7d3e4c7729dfd0 |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-04-13T16:35:35Z |
| publishDate | 2022-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-d05d809b977b43ffba7d3e4c7729dfd02022-12-22T02:39:27ZengPublic Library of Science (PLoS)PLoS ONE1932-62032022-01-01174Factors associated with a history of treatment interruption among pregnant women living with HIV in Malawi: A cross-sectional studySimone A. SasseBryna J. HarringtonBethany L. DiPreteMaganizo B. ChagomeranaLaura Limarzi KlynShaphil D. WallieMadalitso MaliwichiAllan N. JumbeIrving F. HoffmanNora E. RosenbergJennifer H. TangMina C. Hosseinipouron behalf of the S4 Study<h4>Introduction</h4> Long-term care engagement of women on antiretroviral therapy (ART) is essential to effective HIV public health measures. We sought to explore factors associated with a history of HIV treatment interruption among pregnant women living with HIV presenting to an antenatal clinic in Lilongwe, Malawi. <h4>Methods</h4> We performed a cross-sectional study of pregnant women living with HIV who had a history of ART interruption presenting for antenatal care. Women were categorized as either retained in HIV treatment or reinitiating care after loss-to-follow up (LTFU). To understand factors associated with treatment interruption, we surveyed socio-demographic and partner relationship characteristics. Crude and adjusted prevalence ratios (aPR) for factors associated with ART interruption were estimated using modified Poisson regression with robust variance. We additionally present patients’ reasons for ART interruption. <h4>Results</h4> We enrolled 541 pregnant women living with HIV (391 retained and 150 reinitiating). The median age was 30 years (interquartile range (IQR): 25–34). Factors associated with a history of LTFU were age <30 years (aPR 1.46; 95% CI: 1.33–1.63), less than a primary school education (aPR 1.25; CI: 1.08–1.46), initiation of ART during pregnancy or breastfeeding (aPR 1.49, CI: 1.37–1.65), nondisclosure of HIV serostatus to their partner (aPR 1.39, CI: 1.24–1.58), lack of awareness of partner’s HIV status (aPR 1.41, CI: 1.27–1.60), and no contraception use at conception (aPR 1.60, CI 1.40–1.98). Access to care challenges were the most common reasons reported by women for treatment interruption (e.g., relocation, transport costs, or misplacing health documentation). <h4>Conclusions</h4> Interventions that simplify the ART clinic transfer process, facilitate partner disclosure, and provide counseling about the importance of lifelong ART beyond pregnancy and breastfeeding should be further evaluated for improving retention in ART treatment of women living with HIV in Malawi.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9017884/?tool=EBI |
| spellingShingle | Simone A. Sasse Bryna J. Harrington Bethany L. DiPrete Maganizo B. Chagomerana Laura Limarzi Klyn Shaphil D. Wallie Madalitso Maliwichi Allan N. Jumbe Irving F. Hoffman Nora E. Rosenberg Jennifer H. Tang Mina C. Hosseinipour on behalf of the S4 Study Factors associated with a history of treatment interruption among pregnant women living with HIV in Malawi: A cross-sectional study PLoS ONE |
| title | Factors associated with a history of treatment interruption among pregnant women living with HIV in Malawi: A cross-sectional study |
| title_full | Factors associated with a history of treatment interruption among pregnant women living with HIV in Malawi: A cross-sectional study |
| title_fullStr | Factors associated with a history of treatment interruption among pregnant women living with HIV in Malawi: A cross-sectional study |
| title_full_unstemmed | Factors associated with a history of treatment interruption among pregnant women living with HIV in Malawi: A cross-sectional study |
| title_short | Factors associated with a history of treatment interruption among pregnant women living with HIV in Malawi: A cross-sectional study |
| title_sort | factors associated with a history of treatment interruption among pregnant women living with hiv in malawi a cross sectional study |
| url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9017884/?tool=EBI |
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