Long term engagement in HIV care among postpartum women with perinatal HIV infection in the United States

ABSTRACT

Despite growing literature on pregnancy in women with perinatally-acquired HIV infection (PHIV), little is known regarding HIV and reproductive health outcomes postpartum. We describe pregnancy, reproductive, and HIV care outcomes for 2 years postpartum among pregnant women with PHIV who delivered in a large urban health system in Atlanta, Georgia, USA from 2011–2016. We reviewed medical records of women with PHIV to estimate retention in HIV care (two HIV care visits or viral load measurements >90 days apart) and viral suppression (<200 copies/mL) at 12 and 24 months postpartum. Among 22 pregnant women with PHIV, 13 (59%) had a CD4 count of less than 300 cells/mm³ at the time of antenatal care entry; most (n = 13, 59%) women achieved viral suppression at time of delivery. Three quarters of women attended a postpartum HIV primary care visit, within an average of 193 (range 17–727) days. Only 4 (20%) women were retained and 3 (15%) virally suppressed at 12 postpartum, and 2 (12%) were retained and none virally suppressed at 24 months. Despite the unique challenges they face, multidisciplinary efforts are needed to engage women with PHIV during pregnancy and facilitate the transition to sustained HIV primary care in the postpartum period.

KEYWORDS:

• HIV care continuum
• postpartum
• Georgia, USA
• perinatal HIV infection

Acknowledgements

The authors thank Grady Health System patients, clinicians, and staff. Drs. Susan Davis, Emily Grossniklaus, and Jessica Tarleton and Ms. Jeronia Blue who contributed to building the dataset.

Disclosure statement

No potential conflict of interest was reported by the author.

ORCID

Christina M. Meade http://orcid.org/0000-0003-1233-4334

Additional information

Funding

This work was supported by the National Institutes for Health [grant number 1K23AI114407, ANS].