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Evaluating viral load monitoring in antiretroviral-experienced HIV-positive pregnant women accessing antenatal care in Khayelitsha, Cape Town
Includes bibliographical references
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| Main Author: | |
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| Other Authors: | |
| Format: | Thesis |
| Language: | English |
| Published: |
Department of Public Health and Family Medicine
2016
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| _version_ | 1867613222243139584 |
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| access_status_str | Open Access |
| author | Cragg, Carol Diane |
| author2 | Stinson, Kathryn |
| author_browse | Cragg, Carol Diane Stinson, Kathryn |
| author_facet | Stinson, Kathryn Cragg, Carol Diane |
| author_sort | Cragg, Carol Diane |
| collection | Thesis |
| description | Includes bibliographical references |
| format | Thesis |
| id | oai:open.uct.ac.za:11427/16490 |
| institution | University of Cape Town (South Africa) |
| language | eng |
| last_indexed | 2026-06-10T12:32:42.829Z |
| license_str | Not specified — see source repository |
| provenance_str_mv | Harvested via OAI-PMH from UCTD — University of Cape Town Open Access Repository |
| publishDate | 2016 |
| publishDateRange | 2016 |
| publishDateSort | 2016 |
| publisher | Department of Public Health and Family Medicine |
| publisherStr | Department of Public Health and Family Medicine |
| record_format | dspace |
| source_str | UCTD — University of Cape Town Open Access Repository |
| spelling | oai:open.uct.ac.za:11427/16490 Evaluating viral load monitoring in antiretroviral-experienced HIV-positive pregnant women accessing antenatal care in Khayelitsha, Cape Town Cragg, Carol Diane Stinson, Kathryn Giddy, Janet Public Health HIV Infections Pregnancy Reproductive Health Antenatal Care Includes bibliographical references BACKGROUND: A viral load monitoring algorithm in the 2013 Western Cape Department of Health PMTCT guidelines include VL measurement in women who are antiretroviral (ART)-experienced at presentation for antenatal care, the timing of subsequent VL measurements and criteria for regimen change. The study evaluates the implementation of the algorithm in women who are virologically nonsuppressed and determines the outcomes of virological resuppression and infant PCR status. METHODS: This retrospective cohort study focused on all ART-experienced women who presented for antenatal care at one of two primary level Maternity Obstetric Units (MOUs) in Khayelitsha, Cape Town between July 2013 and June 2014. The study used routine data from facility registers, clinical records and electronic monitoring systems at the MOU, and referral ART sites and hospitals. Data collected included age, ART clinic, start date and regimen, and maternal VL and infant PCR results. RESULTS: Forty percent of the 1412 HIV-positive pregnant women, were ART-experienced, of whom 14.1 % were VNS. Predictors of being VNS included a duration on ART of more than 4 years (p= 0.04), attending an ART clinic other than that in the facility (p= 0.02), being on a second-line ART regimen (p=0.07) and being younger than 25 years (p= 0.05). The algorithm was correctly followed in up to 87.5% of women identified as VNS. The rate of virological resuppression by three months postpartum was 70.0% to 82.3%. Excluding three neonates who died, all of the 82.2% of infants tested were PCR negative. CONCLUSIONS: Nearly 15% of ART-experienced women were virologically nonsuppressed on presentation for antenatal care. Levels of adherence to the guideline, and virological resuppression rates of up to 82.3% are encouraging. The implementation of the VLM algorithm could be improved by the integration of obstetric and ART care, the adoption of a single electronic monitoring system and the use of standardised integrated clinical stationery. 2016-01-21T12:59:12Z 2016-01-21T12:59:12Z 2015 Master Thesis Masters MPH http://hdl.handle.net/11427/16490 eng application/pdf Department of Public Health and Family Medicine Faculty of Health Sciences University of Cape Town |
| spellingShingle | Public Health HIV Infections Pregnancy Reproductive Health Antenatal Care Cragg, Carol Diane Evaluating viral load monitoring in antiretroviral-experienced HIV-positive pregnant women accessing antenatal care in Khayelitsha, Cape Town |
| thesis_degree_str | Master's |
| title | Evaluating viral load monitoring in antiretroviral-experienced HIV-positive pregnant women accessing antenatal care in Khayelitsha, Cape Town |
| title_full | Evaluating viral load monitoring in antiretroviral-experienced HIV-positive pregnant women accessing antenatal care in Khayelitsha, Cape Town |
| title_fullStr | Evaluating viral load monitoring in antiretroviral-experienced HIV-positive pregnant women accessing antenatal care in Khayelitsha, Cape Town |
| title_full_unstemmed | Evaluating viral load monitoring in antiretroviral-experienced HIV-positive pregnant women accessing antenatal care in Khayelitsha, Cape Town |
| title_short | Evaluating viral load monitoring in antiretroviral-experienced HIV-positive pregnant women accessing antenatal care in Khayelitsha, Cape Town |
| title_sort | evaluating viral load monitoring in antiretroviral experienced hiv positive pregnant women accessing antenatal care in khayelitsha cape town |
| topic | Public Health HIV Infections Pregnancy Reproductive Health Antenatal Care |
| url | http://hdl.handle.net/11427/16490 |
| work_keys_str_mv | AT craggcaroldiane evaluatingviralloadmonitoringinantiretroviralexperiencedhivpositivepregnantwomenaccessingantenatalcareinkhayelitshacapetown |