Retention and viral suppression of newly diagnosed and known HIV positive pregnant women on Option B+ in Western Kenya

ABSTRACT

Kenya introduced universal antiretroviral treatment (ART) for pregnant and breastfeeding women living with HIV (Option B+) in 2014. A retrospective study was conducted to review consecutive records for HIV positive pregnant women presenting for antenatal care (ANC) at five clinics in western Kenya. Known positive women (KP :HIV diagnosis prior to current pregnancy) were compared to newly positive (NP) women regarding virologic suppression and retention in care. Among 165 women included, 71 (43%) NP and 94 (57%) KP, NP were younger (24.5 years (SD 4.6) vs. 28.1 years (SD 5.6) compared to KP (p < .001). Almost all NP (97%) were initiated on Option B+ while over half of KP (59%) started ART for clinical/immunological criteria (p < .0001). KPs were more likely than NPs to have a VL performed following Kenyan guidelines (64% vs. 31%; p < .001). Among those tested, virologic suppression was high in both groups (92% KP vs. 100% NP; p = .31). More KPs (82%) vs. NPs (66%) remained active in care at 15–18 months of follow-up (p = .02). Women newly diagnosed with HIV during pregnancy show poorer uptake of VL testing and worse retention in care than those diagnosed prior to pregnancy.

KEYWORDS:

• Women
• HIV
• routine viral load monitoring
• vertical transmission
• retention

Acknowledgements

The authors would also like to acknowledge the Ministry of Health staff. This manuscript is published with the support of the Director KEMRI. The findings and conclusions in this report are those of the author(s) and do not necessarily represent the official position of the funding agencies.

Disclosure statement

No potential conflict of interest was reported by the authors.

ORCID

Lisa L. Abuogi http://orcid.org/0000-0003-1492-5090

Additional information

Funding

This project (Family AIDS Care and Education Services) has been supported by the U.S. President Emergency Plan for AIDS Relief (PEPFAR) through the Centers for Disease Control and Prevention (CDC) [under the terms of PS001913-01].