Initiation of antiretroviral therapy or antiretroviral prophylaxis in pregnant women living with HIV registered in five townships of Mandalay, Myanmar: A cross sectional study

Abstract Background A series of interventions are required to prevent mother to child transmission (PMTCT) of Human Immunodeficiency Virus (HIV) starting from HIV testing of pregnant women, initiating antiretroviral therapy (ART) or antiretroviral prophylaxis to HIV-positive pregnant women to providing HIV prophylaxis to newborn babies. Gaps in each step can significantly affect the effectiveness of PMTCT interventions. We aimed to determine the gap in initiation of ART/antiretroviral prophylaxis for pregnant women living with HIV, delay in initiation of ART/antiretroviral prophylaxis and factors associated with the delay. Methods This is a cross sectional study using routinely collected programme data from five health facilities providing PMTCT services located at Township Health Departments (THD) of Mandalay, Myanmar. Results There were 363 pregnant women living with HIV enrolled between January 2012 and December 2017. Sixty (16%) women were excluded from the study due to missing data on dates of HIV diagnosis. Of 303 (84%) women included in the study, 89/303 (29%) and 214/303 (71%) were diagnosed with HIV before and during current pregnancy respectively. Among 214 women, 180 (84%) women were started on ART by the censor date (31st March 2018). Among those who started ART, 109 (61%) women had a delay of starting ART > 2 weeks from diagnosis. Women residing in township 4 had a significantly higher risk of delay in initiation of ART/antiretroviral prophylaxis compared to women residing in township 1 [adjusted prevalence ratio 4.2 (95% confidence interval 1.2–14.8]. Conclusions We found that one in four women living with HIV knew their HIV status before current pregnancy. Although the rate of ART/antiretroviral prophylaxis initiation was high among pregnant women living with HIV, there was a delay. Early initiation of ART/antiretroviral prophylaxis among newly HIV diagnosed pregnant women needs to be strengthened.

Download Full-text

Health Utility of Pregnant Women Living with HIV/AIDS: Prevention of Mother-to-Child Transmission of HIV (PMTCT) Programs in Yunnan Province: A Cross-Sectional Study

Value in Health Regional Issues ◽

10.1016/j.vhri.2017.05.004 ◽

2018 ◽

Vol 15 ◽

pp. 27-33 ◽

Cited By ~ 2

Author(s):

Xiaowen Wang ◽

Guangping Guo ◽

Xiumin Liang ◽

Ling Zhou ◽

Jiarui Zheng ◽

...

Keyword(s):

Pregnant Women ◽

Yunnan Province ◽

Health Utility ◽

Cross Sectional Study ◽

Sectional Study ◽

Child Transmission ◽

Cross Sectional ◽

Women Living With Hiv ◽

Living With Hiv ◽

Mother To Child

Download Full-text

Adherence to antiretroviral therapy among women living with HIV/AIDS in the interior of the Brazilian state of Pará: cross-sectional study

Sao Paulo Medical Journal ◽

10.1590/1516-3180.2020.0370.r1.18112020 ◽

2021 ◽

Vol 139 (2) ◽

pp. 99-106

Author(s):

Paula Gabrielle Gomes Candido ◽

Bruna Melo Amador ◽

Fabricio Ferreira Silva ◽

Floriacy Stabnow Santos ◽

Luiz Marcelo de Lima Pinheiro ◽

...

Keyword(s):

Antiretroviral Therapy ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Women Living With Hiv ◽

Brazilian State ◽

Living With Hiv ◽

Hiv Aids

Download Full-text

Hepatitis B infection among pregnant and post-partum women living with HIV and on antiretroviral therapy in Kinshasa, DR Congo: A cross-sectional study

PLoS ONE ◽

10.1371/journal.pone.0216293 ◽

2019 ◽

Vol 14 (5) ◽

pp. e0216293 ◽

Cited By ~ 3

Author(s):

Christian Mpody ◽

Peyton Thompson ◽

Martine Tabala ◽

Noro Lantoniaina Rosa Ravelomanana ◽

Fathy Malongo ◽

...

Keyword(s):

Antiretroviral Therapy ◽

Hepatitis B ◽

Post Partum ◽

Cross Sectional Study ◽

Hepatitis B Infection ◽

Sectional Study ◽

Dr Congo ◽

Cross Sectional ◽

Women Living With Hiv ◽

Living With Hiv

Download Full-text

Relating CYP2B6 Genotype and EFV Resistance Among Women Living With HIV With High Viremia in Uganda: A Nested Cross-Sectional Study.

10.21203/rs.3.rs-401314/v1 ◽

2021 ◽

Author(s):

ALLAN BUZIBYE ◽

Kara Wools-Kaloustian ◽

Adeniyi Olagunju ◽

Ellon Twinomuhwezi ◽

Constantin Yiannoutsos ◽

...

Keyword(s):

Drug Resistance ◽

Viral Load ◽

Antiretroviral Therapy ◽

Post Partum ◽

Cross Sectional Study ◽

World Health ◽

Sectional Study ◽

Cross Sectional ◽

Women Living With Hiv ◽

Living With Hiv

Abstract BackgroundWe investigated the association between CYP2B6 polymorphisms and efavirenz drug resistance among women living with HIV started on anti-retroviral therapy during pregnancy and with high viremia during post-partum.MethodsThis was a cross sectional study. Women between 6-12 weeks post-partum with viral load >1000 copies/ml were eligible. Sanger sequencing to detect resistant mutations and host genotyping were performed. We categorized efavirenz metabolizer genotype according to the AIDS clinical trials group algorithm as slow, intermediate and extensive; and compared efavirenz resistance among the metabolizer genotypes.Results Over a one-year period (July 2017-July 2018), three hundred and thirty two women were screened of whom 112 (34.8%) had viral load ≥1000 copies/ml of whom 62 had whole blood available for genotyping. Fifty-nine of these women had both viral resistance and human host genotypic results. We observed a higher frequency of efavirenz resistance among slow metabolizers (47% versus 34% in extensive and 28% in intermediate, metabolizers) but due to low numbers, this was not statistically significant. ConclusionsOur findings raise the possibility that CYP2B6 polymorphism may contribute to efavirenz drug resistance in women started on antiretroviral therapy during pregnancy and with high viremia in the post-partum period. If confirmed in a larger study, this would have important implications for all patients in sub-Saharan Africa receiving efavirenz and add further support to the changes in World Health Organization policy to switch away from efavirenz as first line antiretroviral therapy in countries with a high prevalence of CYP2B6 polymorphisms.

Download Full-text

URINARY SYMPTOMS AND THEIR EFFECT ON QUALITY OF LIFE IN WOMEN LIVING WITH HIV: A CROSS-SECTIONAL STUDY

10.26226/morressier.59b63e40d462b8029238944e ◽

2017 ◽

Author(s):

Maryse Larouche

Keyword(s):

Quality Of Life ◽

Cross Sectional Study ◽

Urinary Symptoms ◽

Sectional Study ◽

Cross Sectional ◽

Women Living With Hiv ◽

Living With Hiv

Download Full-text

Symptoms of common mental disorders and adherence to antiretroviral therapy among adults living with HIV in rural Zimbabwe: a cross-sectional study

BMJ Open ◽

10.1136/bmjopen-2021-049824 ◽

2021 ◽

Vol 11 (7) ◽

pp. e049824

Author(s):

Andreas D Haas ◽

Cordelia Kunzekwenyika ◽

Stefanie Hossmann ◽

Josphat Manzero ◽

Janneke van Dijk ◽

...

Keyword(s):

Antiretroviral Therapy ◽

Suicidal Ideation ◽

Mental Disorders ◽

Common Mental Disorders ◽

Cross Sectional Study ◽

People Living With Hiv ◽

Art Adherence ◽

Sectional Study ◽

Cross Sectional ◽

Living With Hiv

ObjectivesTo examine the proportion of people living with HIV who screen positive for common mental disorders (CMD) and the associations between CMD and self-reported adherence to antiretroviral therapy (ART).SettingSixteen government-funded health facilities in the rural Bikita district of Zimbabwe.DesignCross-sectional study.ParticipantsHIV-positive non-pregnant adults, aged 18 years or older, who lived in Bikita district and had received ART for at least 6 months.Outcome measuresThe primary outcome was the proportion of participants screening positive for CMD defined as a Shona Symptoms Questionnaire score of 9 or greater. Secondary outcomes were the proportion of participants reporting suicidal ideation, perceptual symptoms and suboptimal ART adherence and adjusted prevalence ratios (aPR) for factors associated with CMD, suicidal ideation, perceptual symptoms and suboptimal ART adherence.ResultsOut of 3480 adults, 18.8% (95% CI 14.8% to 23.7%) screened positive for CMD, 2.7% (95% CI 1.5% to 4.7%) reported suicidal ideations, and 1.5% (95% CI 0.9% to 2.6%) reported perceptual symptoms. Positive CMD screens were more common in women (aPR 1.67, 95% CI 1.19 to 2.35) than in men and were more common in adults aged 40–49 years (aPR 1.47, 95% CI 1.16 to 1.85) or aged 50–59 years (aPR 1.51, 95% CI 1.05 to 2.17) than in those 60 years or older. Positive CMD screen was associated with suboptimal adherence (aPR 1.53; 95% CI 1.37 to 1.70).ConclusionsA substantial proportion of people living with HIV in rural Zimbabwe are affected by CMD. There is a need to integrate mental health services and HIV programmes in rural Zimbabwe.Trial registration numberNCT03704805.

Download Full-text