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Timing of HIV diagnosis relative to pregnancy and postpartum HIV care continuum outcomes among Latin American women, 2000 to 2017

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dc.contributor.author Yohannes, Nathaniel T.
dc.contributor.author Jenkins, Cathy A.
dc.contributor.author Clouse, Kate
dc.contributor.author Cortés, Claudia P.
dc.contributor.author Mejía-Cordero, Fernando
dc.contributor.author Padgett, Denis
dc.contributor.author Rouzier, Vanessa
dc.contributor.author Friedman, Ruth K.
dc.contributor.author McGowan, Catherine C.
dc.contributor.author Shepherd, Bryan E.
dc.contributor.author Rebeiro, Peter F.
dc.date.accessioned 2021-06-08T15:46:15Z
dc.date.available 2021-06-08T15:46:15Z
dc.date.issued 2021
dc.identifier.uri https://hdl.handle.net/20.500.12866/9515
dc.description.abstract BACKGROUND: HIV incidence among women of reproductive age and vertical HIV transmission rates remain high in Latin America. We, therefore, quantified HIV care continuum barriers and outcomes among pregnant women living with HIV (WLWH) in Latin America. METHODS: WLWH (aged ≥16 years) enrolling at Caribbean, Central and South America network for HIV epidemiology (CCASAnet) sites from 2000 to 2017 who had HIV diagnosis, pregnancy and delivery dates contributed. Logistic regression produced adjusted odds ratios (aOR) and 95% confidence intervals (CI) for retention in care (≥2 visits ≥3 months apart) and virological suppression (viral load <200 copies/mL) 12 months after pregnancy outcome. Cumulative incidences of loss to follow-up (LTFU) postpartum were estimated using Cox regression. Evidence of HIV status at pregnancy confirmation was the exposure. Covariates included pregnancy outcome (born alive vs. others); AIDS diagnosis prior to delivery; CD4, age, HIV-1 RNA and cART regimen at first delivery and CCASAnet country. RESULTS: Among 579 WLWH, median postpartum follow-up was 4.34 years (IQR 1.91, 7.35); 459 (79%) were HIV-diagnosed before pregnancy confirmation, 445 (77%) retained in care and 259 (45%) virologically suppressed at 12 months of postpartum. Cumulative incidence of LTFU was 21% by 12 months and 40% by five years postpartum. Those HIV-diagnosed during pregnancy had lower odds of retention (aOR = 0.58, 95% CI: 0.35 to 0.97) and virological suppression (aOR = 0.50, 95% CI: 0.31 to 0.82) versus those HIV-diagnosed before. CONCLUSION: HIV diagnosis during pregnancy was associated with poorer 12-month retention and virological suppression. Young women should be tested and linked to HIV care earlier to narrow these disparities en_US
dc.language.iso eng
dc.publisher Wiley
dc.relation.ispartofseries Journal of the International AIDS Society
dc.rights info:eu-repo/semantics/restrictedAccess
dc.rights.uri https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es
dc.subject women en_US
dc.subject HIV care continuum en_US
dc.subject HIV epidemiology en_US
dc.subject Latin America and the Caribbean (Region) en_US
dc.subject retention en_US
dc.subject vertical transmission en_US
dc.title Timing of HIV diagnosis relative to pregnancy and postpartum HIV care continuum outcomes among Latin American women, 2000 to 2017 en_US
dc.type info:eu-repo/semantics/article
dc.identifier.doi https://doi.org/10.1002/jia2.25740
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#3.03.08
dc.relation.issn 1758-2652


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