Background
Over the past 20 years, there has been significant progress in preventing the transmission of HIV from mothers to their babies, thanks to the widespread availability of antiretroviral therapy (ART). However, new infections in children still occur.
Study Overview
In a pilot study conducted in Lilongwe, Malawi, we tested a support package designed to help pregnant and breastfeeding women living with HIV stick to their ART. This package included a counseling approach called Integrated Next Step Counseling (iNSC) and the option to have an adherence supporter. Women were randomly assigned to either receive this support package or standard care.
Results
We screened 106 women and enrolled 100, with 51 receiving the support package and 49 receiving standard care. Most participants (94%) were newly diagnosed with HIV. At three months, 92% of women were still in care, and at six months, 84% remained. Among those who stayed in care, three-quarters had a low viral load, meaning they were effectively managing their HIV.
At three months, 70.6% of women in the support group and 69.4% in the control group achieved both retention in care and viral suppression. At six months, these rates were 68.6% for the support group and 61.2% for the control group.
Conclusions
The positive results from this pilot study suggest that the combination adherence support package could effectively help pregnant and breastfeeding women living with HIV manage their treatment. We also established that using both adherence and viral suppression as outcome measures is feasible.
Opportunities for Improvement
Based on the trial data, clinics can set measurable goals for patient retention and viral suppression. This may involve:
- Defining clear outcomes for patients to achieve.
- Implementing tailored AI tools to assist with patient management.
- Starting with pilot projects to track results and expand based on findings.
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