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Postpartum Engagement in HIV Care: An Important Predictor of Long-term Retention in Care and Viral Suppression
Journal article   Open access   Peer reviewed

Postpartum Engagement in HIV Care: An Important Predictor of Long-term Retention in Care and Viral Suppression

Joëlla W Adams, Kathleen A Brady, Yvonne L Michael, Baligh R Yehia and Florence M Momplaisir
Clinical infectious diseases, v 61(12), pp 1880-1887
15 Dec 2015
DOI: https://doi.org/10.1093/cid/civ678
PMID: 26265499
Featured in Collection :   UN Sustainable Development Goals @ Drexel
url
https://doi.org/10.1093/cid/civ678View
Published, Version of Record (VoR)Maybe Open Access (Publisher Bronze),  Open

Abstract

Adult Female HIV Infections - diagnosis HIV Infections - drug therapy Humans Infant, Newborn Medication Adherence Philadelphia Postpartum Period Pregnancy Prognosis Retrospective Studies Young Adult
Human immunodeficiency virus (HIV)-infected women are at risk of virologic failure postpartum. We evaluated factors influencing retention in care and viral suppression in postpartum HIV-infected women. We conducted a retrospective cohort analysis (2005-2011) of 695 deliveries involving 561 HIV-infected women in Philadelphia. Multivariable logistic regression evaluated factors, including maternal age, race/ethnicity, substance use, antiretroviral therapy during pregnancy, timing of HIV diagnosis, previous pregnancy with HIV, adequacy of prenatal care, and postpartum HIV care engagement (≥ 1 CD4 count or viral load [VL] test within 90 days of delivery), associated with retention in care (≥ 1 CD4 count or VL test in each 6-month interval of the period with ≥ 60 days between tests) and viral suppression (VL ≤ 200 copies/mL at the last measure in the period) at 1 and 2 years postpartum. Overall, 38% of women engaged in HIV care within 90 days postpartum; with 39% and 31% retained in care and virally suppressed, respectively, at 1 year postpartum, and 25% and 34% retained in care and virally suppressed, respectively, at 2 years postpartum. In multivariable analyses, women who engaged in HIV care within 90 days of delivery were more likely to be retained (adjusted odds ratio [AOR], 11.38; 95% confidence interval [CI], 7.74-16.68) and suppressed (AOR, 2.60 [95% CI, 1.82-3.73]) at 1 year postpartum. This association persisted in the second year postpartum for both retention (AOR, 6.19 [95% CI, 4.04-9.50]) and suppression (AOR, 1.40 [95% CI, 1.01-1.95]). The prevalence of postpartum HIV-infected women retained in care and maintaining viral suppression is low. Interventions seeking to engage women in care shortly after delivery have the potential to improve clinical outcomes.

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74 citations in Web of Science
73 citations in Scopus

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UN Sustainable Development Goals (SDGs)

This publication has contributed to the advancement of the following goals:

#3 Good Health and Well-Being

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Collaboration types
Domestic collaboration
Web of Science research areas
Immunology
Infectious Diseases
Microbiology
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