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

Journal of Virus Eradication

John M. Humphrey¹  Kate Clouse²  Craig R. Cohen³  Christian Mpody⁴  Kara Wools-Kaloustian⁵  Lisa L. Abuogi⁶  Marcel Yotebieng⁷  Pamela M. Murnane⁷  Lindah Otieno⁸ 

[1] Corresponding author: Lisa Abuogi, Department of Pediatrics, University of Colorado, Denver, Aurora, CO, USA;Center for AIDS Prevention Studies, University of California San Francisco, San Francisco, CA, USA;Center for Microbial Research, Research Care and Training Program, Kenya Medical Research Institute, Nairobi, Kenya;Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA;;Department of Obstetrics, Gynecology &Department of Pediatrics, University of Colorado, Denver, Aurora, CO, USA;Division of Epidemiology, Ohio State University, Columbus, OH, USA;Vanderbilt Institute for Global Health, Vanderbilt University, Nashville, TN, USA;

关键词: prevention of mother-to-child transmission;    prevention of vertical transmission;    HIV;    pregnancy;    postpartum;    sub-Saharan Africa;   

DOI  :  

来源: DOAJ

【 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.

【 授权许可】

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