1. Slow Acceptance of Universal Antiretroviral Therapy (ART) Among Mothers Enrolled in IMPAACT PROMISE Studies Across the Globe
- Author
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Mwangelwa Mubiana-Mbewe, Camlin Tierney, Nahida Chakhtoura, Neetal Nevrekar, M Mutambanengwe, Mandisa Nyati, José Henrique Pilotto, Esau Joao, Sean S Brummel, Pendo Mlay, Anne Coletti, Patricia M. Flynn, Gaerolwe Masheto, Ricardo H. Oliveira, Thanomsak Anekthananon, Jim Aizire, Katie McCarthy, Lauren Ziemba, S Hanley, Michael Basar, Breno Santos, Promise study team, Lynda Stranix-Chibanda, Konstantia Angelidou, Renee Browning, Judith S. Currier, R Chamanga, Mary Glenn Fowler, Moreen Kamateeka, Gerhard Theron, Linda Aurpibul, V Chanaiwa, M Maluwa, and T Mhembere
- Subjects
Infectious Disease Transmission ,Maternal Health ,Globe ,HIV Infections ,Reproductive health and childbirth ,0302 clinical medicine ,Universal ART ,Pregnancy ,Antiretroviral Therapy, Highly Active ,Medicine ,PROMISE study team ,Vertical ,Maternal health ,030212 general & internal medicine ,Pregnancy Complications, Infectious ,Pediatric ,education.field_of_study ,Postpartum Period ,Infectious ,Health psychology ,medicine.anatomical_structure ,Infectious Diseases ,6.1 Pharmaceuticals ,Public Health and Health Services ,Women with HIV ,HIV/AIDS ,Female ,Public Health ,medicine.symptom ,0305 other medical science ,Adult ,medicine.medical_specialty ,Social Work ,Social Psychology ,Anti-HIV Agents ,Population ,Clinical Trials and Supportive Activities ,Antiretroviral Therapy ,Mothers ,Treat All ,Asymptomatic ,03 medical and health sciences ,Young Adult ,Clinical Research ,Humans ,Highly Active ,education ,Original Paper ,030505 public health ,Relative efficacy ,business.industry ,Public health ,Prevention ,Public Health, Environmental and Occupational Health ,Evaluation of treatments and therapeutic interventions ,Infant ,Patient Acceptance of Health Care ,Antiretroviral therapy ,Infectious Disease Transmission, Vertical ,CD4 Lymphocyte Count ,Pregnancy Complications ,Good Health and Well Being ,Family medicine ,business - Abstract
The PROMISE trial enrolled asymptomatic HIV-infected pregnant and postpartum women not eligible for antiretroviral treatment (ART) per local guidelines and randomly assigned proven antiretroviral strategies to assess relative efficacy for perinatal prevention plus maternal/infant safety and maternal health. The START study subsequently demonstrated clear benefit in initiating ART regardless of CD4 count. Active PROMISE participants were informed of results and women not receiving ART were strongly recommended to immediately initiate treatment to optimize their own health. We recorded their decision and the primary reason given for accepting or rejecting the universal ART offer after receiving the START information. One-third of participants did not initiate ART after the initial session, wanting more time to consider. Six sessions were required to attain 95% uptake. The slow uptake of universal ART highlights the need to prepare individuals and sensitize communities regarding the personal and population benefits of the "Treat All" strategy.
- Published
- 2019