Receipt of infant HIV DNA PCR test results is associated with a reduction in retention of HIV-exposed infants in integrated HIV care and healthcare services: a quantitative sub-study nested within a cluster randomised trial in rural Malawi

• Published in: BMC public health 2020-12, Vol.20 (1), p.1879-1879, Article 1879
• Main Authors: Milanzi, Elasma, Mwapasa, Victor, Joseph, Jessica, Jousset, Aurelie, Tchereni, Timothy, Gunda, Andrews, Phiri, Jennipher, Reece, Jeanette C
• Format: Article
• Language: English
• Subjects: Babies; Breast feeding; Breastfeeding & lactation; Child; Childrens health; Clinics; Clusters; Data collection; Delivery of Health Care; Demographic aspects; Diagnosis; Disease transmission; DNA; Evaluation; Exposure; Family planning; Female; Health care; Health care facilities; Health facilities; HIV; HIV infection; HIV Infections - diagnosis; HIV Infections - transmission; HIV PCR test; HIV testing; Human immunodeficiency virus; Humans; Infant; Infants; Infectious Disease Transmission, Vertical - prevention & control; Malawi; Male; Maternal & child health; Maternal health services; Medical tests; Mother-pair infants; Mother-to-child-transmission; Mothers; Pediatrics; Polymerase Chain Reaction; Postpartum; Pregnancy; Pregnancy Complications, Infectious - prevention & control; Prevention; PRIME; Public health; Retention; Risk factors; Rural health services; Short message service; Text messaging
• ISSN: 1471-2458; 1471-2458
• DOI: 10.1186/s12889-020-09973-y

Retention of HIV-infected mothers in integrated HIV and healthcare facilities is effective at reducing mother-to-child-transmission (MTCT) of HIV. In the context of Option B+, we examined maternal and HIV-exposed infant retention across three study arms to 18 months postpartum: mother-and-infant clinics (MIP), MIP with short-messaging service (MIP + SMS) and standard of care (SOC). In particular, we focused on the impact of mothers receiving an infant's HIV PCR test result on maternal and infant study retention. A quantitative sub-study nested within a cluster randomised trial undertaken between May 2013 and August 2016 across 30 healthcare facilities in rural Malawi enrolling HIV-infected pregnant mothers and HIV-exposed infants on delivery, was performed. Survival probabilities of maternal and HIV-exposed infant study retention was estimated using Kaplan-Meier curves. Associations between mother's receiving an infant's HIV test result and in particular, an infant's HIV-positive result on maternal and infant study retention were modelled using time-varying multivariate Cox regression. Four hundred sixty-one, 493, and 396 HIV-infected women and 386, 399, and 300 HIV-exposed infants were enrolled across study arms; MIP, MIP + SMS and SOC, respectively. A total of 47.5% of mothers received their infant's HIV test results