Setback for HIV Option B+
WOMEN initiated on anti-retroviral drugs based on how sick they are, are more likely to continue and adhere to treatment compared to those who are initiated because they are pregnant, a recent study on adherence of ARVs in pregnant women has shown.
Presenting study results in Harare yesterday, Clinton Health Access Initiative country director Mr Alexio Mangwiro said of the 1 150 women who took part in the study, 8,5 percent were lost to follow-up in the first three months.
He said a majority of these were younger women especially teenage girls, late presenters to antenatal care and women who were newly diagnosed of HIV.
Mr Mangwiro said a further 4,8 percent of pregnant women were lost in the preceding three months. He said the last quarter of the year saw another 8,6 percent of the remaining women dropping again from care, leaving about 67 percent of the 1 150 women adherent to treatment in the first year of post initiation.
He said only 39 percent of those who continued with treatment the whole year after initiation were adherent to their treatment.
“Adherence meant one had sufficient pills for 95 percent of their days,” said Mr Mangwiro.
Mr Mangwiro said there was need to target teenage, late-presenting, and recently-diagnosed women with specific interventions to encourage them to continue taking their medication at given times.
“These sub-groups had the poorest retention and adherence measures. They could benefit from targeted interventions. Further research is needed to identify the most effective strategies to support these subgroups of vulnerable women,” said Mr Mangwiro.
In 2013, Zimbabwe adopted a new HIV prevention intervention-code named Option B+ meant to eliminate HIV transmission from mother to child by initiating all HIV positive mothers on treatment regardless of their CD4 count.
Under the new intervention, HIV- positive women were required to take a three-in-one pill everyday of their life even after giving birth.
Option B+ was meant to reduce numbers of new infections in children and HIV related deaths.
An estimated 10 000 new infections were recorded each year with 90 percent of them being through mother to child transmission.
Commenting on the study results, Health and Child Care Minister Dr David Parirenyatwa said there was need to come up with interventions that encourage retention and adherence of pregnant and lactating women such as mother support groups.
“We hope mother support groups are going to be scaled up to improve retention of pregnant and lactating women in care for the country to achieve its global targets and goals,” said Dr Parirenyatwa ( pictured below).
WHO country representative Dr David Okello said Zimbabwe had an opportunity to utilise the results of the study and also to provide evidence to support inclusion of prevention of mother transmission interventions in upcoming funding requests to the Global Fund.
The project, which ran for five years, was a collaboration between WHO, Global Affairs Canada and ministries of Health in Zimbabwe, Malawi and Nigeria.