Document Type

Article

Publication Date

5-29-2020

Identifier

DOI: 10.1371/journal.pone.0232358; PMCID: PMC7259657

Abstract

BACKGROUND: Kenya's guidelines for prevention of mother-to-child transmission of HIV (PMTCT) recommend routine viral load (VL) monitoring for pregnant and breastfeeding women.

METHOD: We assessed PMTCT VL monitoring and clinical action occurring between last menstrual period (LMP) and 6 months postpartum at 4 Kenyan government hospitals. Pregnant women enrolled in the HIV Infant Tracking System from May 2016-March 2018 were included. We computed proportions who received VL testing within recommended timeframes and who received clinical action after unsuppressed VL result.

RESULTS: Of 424 participants, any VL testing was documented for 305 (72%) women and repeat VL testing was documented for 79 (19%). Only 115 women (27%) received a guideline-adherent baseline VL test and 27 (6%) received a guideline-adherent baseline and repeat VL test sequence. Return of baseline and repeat VL test results to the facility was high (average 96%), but patient notification of VL results was low (36% baseline and 49% repeat). Clinical action for unsuppressed VL results was even lower: 11 of 38 (29%) unsuppressed baseline results and 2 of 14 (14%) unsuppressed repeat results triggered clinical action.

DISCUSSION: Guideline-adherent VL testing and clinical intervention during PMTCT must be prioritized to improve maternal care and reduce the risk of HIV transmission to infants.

Journal Title

PLoS One

Volume

15

Issue

5

First Page

0232358

Last Page

0232358

MeSH Keywords

Adult; Anti-HIV Agents; Female; HIV; Hospitals; Humans; Infant; Infectious Disease Transmission, Vertical; Mothers; Pregnancy; Viral Load

Keywords

Adult; Anti-HIV Agents; Female; HIV; Hospitals; Humans; Infant; Infectious Disease Transmission, Vertical; Mothers; Pregnancy; Viral Load

Comments

Grant support

This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

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