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

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 e...

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Autores principales: Abuogi, Lisa L, Humphrey, John M, Mpody, Christian, Yotebieng, Marcel, Murnane, Pamela M, Clouse, Kate, Otieno, Lindah, Cohen, Craig R, Wools-Kaloustian, Kara
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Mediscript Ltd 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6248851/
https://www.ncbi.nlm.nih.gov/pubmed/30515312
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author Abuogi, Lisa L
Humphrey, John M
Mpody, Christian
Yotebieng, Marcel
Murnane, Pamela M
Clouse, Kate
Otieno, Lindah
Cohen, Craig R
Wools-Kaloustian, Kara
author_facet Abuogi, Lisa L
Humphrey, John M
Mpody, Christian
Yotebieng, Marcel
Murnane, Pamela M
Clouse, Kate
Otieno, Lindah
Cohen, Craig R
Wools-Kaloustian, Kara
author_sort Abuogi, Lisa L
collection PubMed
description 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.
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spelling pubmed-62488512018-12-04 Achieving UNAIDS 90-90-90 targets for pregnant and postpartum women in sub-Saharan Africa: progress, gaps and research needs Abuogi, Lisa L Humphrey, John M Mpody, Christian Yotebieng, Marcel Murnane, Pamela M Clouse, Kate Otieno, Lindah Cohen, Craig R Wools-Kaloustian, Kara J Virus Erad Review 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. Mediscript Ltd 2018-11-15 /pmc/articles/PMC6248851/ /pubmed/30515312 Text en © 2018 The Authors. Journal of Virus Eradication published by Mediscript Ltd http://creativecommons.org/licenses/by-nc/4.0/ This is an open access article published under the terms of a Creative Commons License.
spellingShingle Review
Abuogi, Lisa L
Humphrey, John M
Mpody, Christian
Yotebieng, Marcel
Murnane, Pamela M
Clouse, Kate
Otieno, Lindah
Cohen, Craig R
Wools-Kaloustian, Kara
Achieving UNAIDS 90-90-90 targets for pregnant and postpartum women in sub-Saharan Africa: progress, gaps and research needs
title Achieving UNAIDS 90-90-90 targets for pregnant and postpartum women in sub-Saharan Africa: progress, gaps and research needs
title_full Achieving UNAIDS 90-90-90 targets for pregnant and postpartum women in sub-Saharan Africa: progress, gaps and research needs
title_fullStr Achieving UNAIDS 90-90-90 targets for pregnant and postpartum women in sub-Saharan Africa: progress, gaps and research needs
title_full_unstemmed Achieving UNAIDS 90-90-90 targets for pregnant and postpartum women in sub-Saharan Africa: progress, gaps and research needs
title_short Achieving UNAIDS 90-90-90 targets for pregnant and postpartum women in sub-Saharan Africa: progress, gaps and research needs
title_sort achieving unaids 90-90-90 targets for pregnant and postpartum women in sub-saharan africa: progress, gaps and research needs
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6248851/
https://www.ncbi.nlm.nih.gov/pubmed/30515312
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