Background: The WHO 2010 guidelines for prevention of mother-to-child transmission (PMTCT) of HIV recommended prophylactic antiretroviral treatment (ART) either for infants (Option A) or mothers (Option B) during breastfeeding for pregnant women with a CD4 count of >350 cell/µL in low-income countries. In 2012, WHO proposed that all HIV-infected pregnant women should receive triple ART for life (B+) irrespective of CD4 count. Tanzania has recently switched from Option A to B+, with a few centers practicing B. However, more information on the real-life feasibility of these options is needed. This qualitative study explored women's preferences for Option A vs B and their views on Option B+ in Dar es Salaam, Tanzania.
Methods: We conducted four focus group discussions with a total of 27 pregnant women with unknown HIV status, attending reproductive and child health clinics, and 31 in-depth interviews among HIV-infected pregnant and post-delivery women, 17 of whom were also asked about B+.
Results: Most participants were in favor of Option B compared to A. The main reasons for choosing Option B were: HIV-associated stigma, fear of drug side-effects on infants and difficult logistics for postnatal drug adherence. Some of the women asked about B+ favored it as they agreed that they would eventually need ART for their own survival. Some were against B+ anticipating loss of motivation after protecting the child, fearing drug side-effects and not feeling ready to embark on lifelong medication. Some were undecided.
Conclusion: Option B was preferred. Since Tanzania has recently adopted Option B+, women with CD4 counts of >350 cell/µL should be counseled about the possibility to "opt-out" from ART after cessation of breastfeeding. Drug safety and benefits, economic concerns and available resources for laboratory monitoring and evaluation should be addressed during B+ implementation to enhance long-term feasibility and effectiveness.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3899007 | PMC |
| http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0085310 | PLOS |
Publication Analysis
Top Keywords
Similar Publications
The implication of pericardial effusion in the third trimester for preeclampsia and heart failure in high-risk pregnant women.
J Echocardiogr
January 2025
Division of Cardiology, Department of Internal Medicine, Keimyung University Dongsan Medical Center, Keimyung University School of Medicine, 1035 Dalgubeol-Daero, Dalseo-Gu, Daegu, 42601, Republic of Korea.
Background: With the growing number of high-risk pregnant women, echocardiography frequently reveals pericardial effusion (PE). However, the clinical implications of PE are unknown.
Method: We analyzed a cohort of 406 high-risk pregnant women who underwent echocardiography in the third trimester between November 2019 and December 2022.
A systematic review and meta-analysis of exercise-based intervention to prevent gestational diabetes in women with overweight or obesity.
BMC Pregnancy Childbirth
January 2025
Department of Gynecology and Obstetrics, Reina Sofía Hospital, Tudela, Spain.
Background: There is evidence that exercise may reduce the risk of gestational diabetes mellitus (GDM) and improve other obstetric outcomes in overweight or obese pregnant women. However, the available evidence is of low quality and inconclusive. The purpose of this study is to assess the effects of exercise, compared with usual care, in reducing GDM and other obstetric risks, in overweight and obese pregnant women.
View Article and Find Full Text PDFMicronutrient dose response (MiNDR) study among women of reproductive age and pregnant women in rural Bangladesh: study protocol for double-blind, randomised, controlled trials.
BMJ Open
January 2025
Center for Human Nutrition, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
Introduction: Optimising the micronutrient status of women before and during reproduction confers benefits to them and their offspring. Antenatal multiple micronutrient supplements (MMS), given as a daily tablet with nutrients at ~1 recommended dietary allowance (RDA) or adequate intake (AI) reduces adverse birth outcomes. However, at this dosage, MMS may not fully address micronutrient deficiencies in settings with chronically inadequate diets and infection.
View Article and Find Full Text PDFDigital health technologies enabling the transition from pregnancy to early parenthood: A scoping review.
Z Evid Fortbild Qual Gesundhwes
January 2025
Department Digital Health Sciences and Biomedicine, School of Life Sciences, University of Siegen, Siegen, Germany.
Background: Pregnant women and their families, especially those navigating chronic illness or challenging life situations, often seek information and counseling. The pregnancy period and the transition to parenthood can exacerbate these circumstances, leaving families particularly vulnerable. Addressing stressful situations becomes a hurdle in this context.
View Article and Find Full Text PDFReadability, quality and accuracy of generative artificial intelligence chatbots for commonly asked questions about labor epidurals: a comparison of ChatGPT and Bard.
Int J Obstet Anesth
December 2024
Department of Anesthesiology, 8700 Beverly Blvd #4209, Cedars-Sinai Medical Center, Los Angeles, CA 90064, United States. Electronic address:
Introduction: Over 90% of pregnant women and 76% expectant fathers search for pregnancy health information. We examined readability, accuracy and quality of answers to common obstetric anesthesia questions from the popular generative artificial intelligence (AI) chatbots ChatGPT and Bard.
Methods: Twenty questions for generative AI chatbots were derived from frequently asked questions based on professional society, hospital and consumer websites.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!