Achieving UNAIDS 90-90-90 targets for pregnant and postpartum women in sub-Saharan Africa: progress, gaps and research needs

被引:0
|
作者
Abuogi, Lisa L. [1 ]
Humphrey, John M. [2 ]
Mpody, Christian [3 ]
Yotebieng, Marcel [3 ]
Murnane, Pamela M. [4 ]
Clouse, Kate [5 ]
Otieno, Lindah [6 ]
Cohen, Craig R. [7 ]
Wools-Kaloustian, Kara [2 ]
机构
[1] Univ Colorado, Dept Pediat, Aurora, CO 80202 USA
[2] Indiana Univ, Sch Med, Dept Med, Indianapolis, IN USA
[3] Ohio State Univ, Div Epidemiol, Columbus, OH 43210 USA
[4] Univ Calif San Francisco, Ctr AIDS Prevent Studies, San Francisco, CA 94143 USA
[5] Vanderbilt Univ, Vanderbilt Inst Global Hlth, 221 Kirkland Hall, Nashville, TN 37235 USA
[6] Kenya Govt Med Res Ctr, Res Care & Training Program, Ctr Microbial Res, Nairobi, Kenya
[7] Univ Calif San Francisco, Dept Obstet Gynecol & Reprod Sci, San Francisco, CA USA
关键词
prevention of mother-to-child transmission; prevention of vertical transmission; HIV; pregnancy; postpartum; sub-Saharan Africa; CHILD HIV TRANSMISSION; OPTION B PLUS; ANTIRETROVIRAL THERAPY INITIATION; MENTOR MOTHER PROGRAMS; RAPID SCALE-UP; VIRAL SUPPRESSION; INFECTED WOMEN; ANTENATAL CARE; COST-EFFECTIVENESS; INCOME COUNTRIES;
D O I
暂无
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
The implementation of the 2013 World Health Organization Option B+ recommendations for HIV treatment during pregnancy has helped drive significant progress in achieving universal treatment for pregnant and postpartum women in sub-Saharan Africa (SSA). Yet, critical research and implementation gaps exist in achieving the UNAIDS 90-90-90 targets. To help guide researchers, programmers and policymakers in prioritising these areas, we undertook a comprehensive review of the progress, gaps and research needs to achieve the 90-90-90 targets for this population in the Option B+ era, including early infant HIV diagnosis (EID) for HIV-exposed infants. Salient areas where progress has been achieved or where gaps remain include: (1) knowledge of HIV status is higher among people with HIV in southern and eastern Africa compared to western and central Africa (81% versus 48%, UNAIDS); (2) access to antiretroviral therapy (ART) for pregnant women has doubled in 22 of 42 SSA countries, but only six have achieved the second 90, and nearly a quarter of pregnant women initiating ART become lost to follow-up; (3) viral suppression data for this population are sparse (estimates range from 30% to 98% peripartum), with only half of women maintaining suppression through 12 months postpartum; and (4) EID rates range from 15% to 62%, with only three of 21 high-burden SSA countries testing >50% HIV-exposed infants within the first 2 months of life. We have identified and outlined promising innovations and research designed to address these gaps and improve the health of pregnant and postpartum women living with HIV and their infants.
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页码:33 / 39
页数:7
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