Mobility during the post-partum period and viraemia in women living with HIV in South Africa.

Autor: Odayar J; Division of Epidemiology and Biostatistics, School of Public Health, University of Cape Town, Cape Town, South Africa., Phillips TK; Division of Epidemiology and Biostatistics, School of Public Health, University of Cape Town, Cape Town, South Africa., Kabanda S; Division of Epidemiology and Biostatistics, School of Public Health, University of Cape Town, Cape Town, South Africa., Malaba TR; Division of Epidemiology and Biostatistics, School of Public Health, University of Cape Town, Cape Town, South Africa., Mukonda E; Division of Epidemiology and Biostatistics, School of Public Health, University of Cape Town, Cape Town, South Africa., Hsiao NY; Division of Medical Virology, National Health Laboratory Service, University of Cape Town and Groote Schuur Hospital, Cape Town, South Africa., Lesosky M; Division of Epidemiology and Biostatistics, School of Public Health, University of Cape Town, Cape Town, South Africa., Myer L; Division of Epidemiology and Biostatistics, School of Public Health, University of Cape Town, Cape Town, South Africa.
Jazyk: angličtina
Zdroj: International health [Int Health] 2023 Nov 03; Vol. 15 (6), pp. 692-701.
DOI: 10.1093/inthealth/ihad001
Abstrakt: Background: We investigated the association between travel and viraemia in post-partum women with human immunodeficiency virus on antiretroviral therapy (ART).
Methods: Data are from a trial of post-partum ART delivery strategies. Women who initiated ART during pregnancy, were clinically stable with a viral load (VL) <400 copies/ml and were <10 weeks post-partum were enrolled at a primary care antenatal clinic in Cape Town, South Africa. Study visits at 3, 6, 12, 18 and 24 months post-partum included questions about travel, defined as ≥1 night spent outside of the city, and VL testing. Generalised mixed effects models assessed the association between travel and subsequent VL ≥400 copies/ml.
Results: Among 402 women (mean age 29 y, 35% born in the Western Cape), 69% reported one or more travel events over 24 months. Being born beyond the Western Cape (adjusted odds ratio [aOR] 2.03 [95% confidence interval {CI} 1.49 to 2.77]), duration post-partum in months (aOR 1.03 [95% CI 1.02 to 1.05]) and living with the child (aOR 0.60 [95% CI 0.38 to 0.93]) were associated with travel. In multivariable analyses, a travel event was associated with a 92% increase in the odds of a VL ≥400 copies/ml (aOR 1.92 [95% CI 1.19 to 3.10]).
Conclusions: Interventions to support women on ART who travel are urgently required.
(© The Author(s) 2023. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene.)
Databáze: MEDLINE
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