ART initiation among women newly diagnosed with HIV in a contraceptive trial in sub-Saharan Africa

dc.contributor.authorBeesham, Ivana
dc.contributor.authorIssema, Rodal
dc.contributor.authorPalanee-Phillips, Thesla
dc.contributor.authorOnono, Maricianah
dc.contributor.authorEvans, Shannon
dc.contributor.authorBeksinska, Mags
dc.contributor.authorAhmed, Khatija
dc.contributor.authorKasaro, Margaret P.
dc.contributor.authorBatting, Joanne
dc.contributor.authorDeese, Jennifer
dc.contributor.authorDlaminii, Lunga
dc.contributor.authorYankurije, Berthe
dc.contributor.authorThomas, Katherine K.
dc.contributor.authorHeffron, Renee
dc.date.accessioned2021-08-20T12:30:46Z
dc.date.available2021-08-20T12:30:46Z
dc.date.issued2022-04
dc.description.abstractCurrent guidelines recommend starting antiretroviral therapy (ART) as soon as possible after HIV diagnosis to reduce morbidity, mortality and onward HIV transmission. We examined factors influencing ART initiation by women who seroconverted during the Evidence for Contraceptive Options and HIV Outcomes (ECHO) Trial. ECHO, conducted between 2015 and 2018, enrolled HIV-negative, sexually active women, aged 16–35 years, from four African countries. Follow-up was 12–18 months, with quarterly HIV testing. Women with incident HIV infection received extensive counselling by trial staff and referral to local facilities for HIV care. Of 304 women with ≥90 days follow-up time since HIV diagnosis, 186(61.2%) initiated ART within 90 days, 69(22.7%) initiated after 90 days, and 49(16.1%) had not initiated by the end of the study. There were no statistically significant differences in characteristics among women who initiated ART ≤90 days versus those who did not. Frequent reasons for delayed or non-initiation of ART included not feeling ready to start ART and being newly diagnosed. In a large clinical trial, ART initiation was modest within 90 days of HIV diagnosis and grew to 84% with longer observation. Despite extensive counselling on the importance of early ART initiation, personal barriers delayed some women from starting ART.en_ZA
dc.description.departmentMedical Microbiologyen_ZA
dc.description.librarianpm2021en_ZA
dc.description.urihttps://www.tandfonline.com/loi/caic20en_ZA
dc.identifier.citationIvana Beesham, Rodal Issema, Thesla Palanee-Phillips, Maricianah Onono, Shannon Evans, Mags Beksinska, Khatija Ahmed, Margaret P. Kasaro, Joanne Batting, Jennifer Deese, Lunga Dlamini, Berthe Yankurije, Katherine K. Thomas, Renee Heffron & on behalf of the *ECHO Trial Consortium (2022): ART initiation among women newly diagnosed with HIV in a contraceptive trial in sub-Saharan Africa, AIDS Care, vol. 34, no. 4, pp. 478-485, DOI: 10.1080/09540121.2021.1944601.en_ZA
dc.identifier.issn0954-0121 (print)
dc.identifier.issn1360-0451 (online)
dc.identifier.other10.1080/09540121.2021.1944601
dc.identifier.urihttp://hdl.handle.net/2263/81413
dc.language.isoenen_ZA
dc.publisherTaylor and Francisen_ZA
dc.rights© 2021 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group. This is an Open Access article distributed under the terms of the Creative Commons Attribution License.en_ZA
dc.subjectAntiretroviral therapy (ART)en_ZA
dc.subjectWomenen_ZA
dc.subjectClinical trialsen_ZA
dc.subjectART initiationen_ZA
dc.subjectDelayed ART initiationen_ZA
dc.subjectHuman immunodeficiency virus (HIV)en_ZA
dc.subjectEvidence for contraceptive options and HIV outcomes (ECHO)en_ZA
dc.titleART initiation among women newly diagnosed with HIV in a contraceptive trial in sub-Saharan Africaen_ZA
dc.typeArticleen_ZA

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