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Member Research & Reports

Member Research & Reports

BU: Integrated Care for Pregnant Women with HIV Shows Promise

Integrating HIV treatment into prenatal care and linking new mothers and infants to community-based counselors improves the proportion of women initiated and retained in treatment, a study in southern Zambia led by Boston University School of Public Health (BUSPH) researchers has found.

The study in the Journal of Acquired Immune Deficiency Syndromes attempted to address programmatic barriers to early initiation of combination antiretroviral therapy (cART) for HIV-positive pregnant women, including decentralized care, assessment delays, and loss of women to follow-up care. Early treatment can decrease the rate of mother-to-child transmission of HIV.

The research team piloted an intervention at six government antenatal clinics (ANCs) in Southern Province, Zambia, that provided integrated antenatal and HIV care to pregnant women, including expedited blood-test results and HIV treatment onsite, follow-up of mother–infant pairs by community-based lay counselors, and early infant diagnostic testing for HIV. Pregnant women presenting to ANCs were tested for HIV and, if positive, were provided with five days of AZT and told to return to review their eligibility for cART. All HIV-exposed infants, meanwhile, were prescribed daily nevirapine for six weeks and were tested for HIV at six weeks, with follow-up testing at 6, 12, and 18 months.

The authors said the integrated approach has a number of advantages, including a “one-stop shop” that can streamline cART initiation by consolidating services, while also reducing stigma or fear of public disclosure of HIV status, as the clinics offer maternal and child health services, in addition to HIV care.

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