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ART offered at antenatal clinics doubles uptake in
Lusaka.
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| Article Type: | Brief article |
| Subject: |
Highly active antiretroviral therapy
(Dosage and administration) Maternal health services (Standards) Pregnant women (Care and treatment) |
| Pub Date: | 05/01/2010 |
| Publication: | Name: Reproductive Health Matters Publisher: Reproductive Health Matters Audience: General Format: Magazine/Journal Subject: Family and marriage; Health; Women's issues/gender studies Copyright: COPYRIGHT 2010 Reproductive Health Matters ISSN: 0968-8080 |
| Issue: | Date: May, 2010 Source Volume: 18 Source Issue: 35 |
| Topic: | Event Code: 350 Product standards, safety, & recalls |
| Geographic: | Geographic Scope: Zambia Geographic Code: 6ZAMB Zambia |
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| Accession Number: | 236247766 |
| Full Text: |
In Lusaka, Zambia, the model of HIV treatment for pregnant women is
referral from antenatal care (ANC) clinics to a separate antiretroviral
therapy (ART) clinic located on the same site but physically separate
and staffed separately. This study evaluated whether providing ART
integrated in ANC clinics resulted in more treatment-eligible women
initiating ART during pregnancy compared with the existing approach. The
integration programme was rolled out one clinic at a time (stepped-wedge
design) and the study included all HIV-positive, ART-eligible pregnant
women attending the eight Lusaka public sector district clinics. Between
July 2007 and July 2008, 13,917 women started ANC more than 60 days
before the intervention rollout and constituted the control cohort.
17,619 started ANC after integration and constituted the intervention
cohort. Each clinic acted as its own control. Of the 1,566 patients
found eligible for ART, more than twice the proportion enrolled in ART
clinics while pregnant and within 60 days of HIV diagnosis in the
intervention cohort (376/846, 44.4%) compared with the control cohort
(181/716, 25.3%) (adjusted odds ratio 2.06, 95% CI 1.27-3.34); and
initiated ART while pregnant more often in the intervention cohort
(278/846, 32.9%) compared with the control cohort (103/716, 14.4%) (AOR
2.01, 95% CI 1.37-2.95). Reasons for success may be that pregnant women
do not want to deal with going to two separate clinics, there are poor
staff attitudes in ART clinics towards pregnant women, and that an
integrated clinic has more interest in providing ART to pregnant women.
However, over 60% of those in need are still not accessing treatment,
and uptake should be further improved. (1) (1.) Killam WP, Tambatamba BC, Chintu N, et al. Antiretroviral therapy in antenatal care to increase treatment initiation in HIV-infected pregnant women: a stepped-wedge evaluation. AIDS 2010; 24(1):85-91. |
| Gale Copyright: | Copyright 2010 Gale, Cengage Learning. All rights reserved. |
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