Fatti, G., Shaikh, N., Jackson, D. et al. PLOS ONE (July 2017), 12(7): e0181691, doi: 10.1371/journal.pone0181691.
This study examined the impact of a combination HIV prevention intervention among HIV-negative young women, and identified elements associated with acquiring HIV. The combination intervention included a range of behavioral, biomedical, and structural interventions. The 1,356 participants were assigned community health workers who provided home-based care two to three times weekly until six weeks postpartum and then monthly. Among 5,289 HIV tests provided, 11 new HIV infections were identified, eight during pregnancy and three postpartum. Mother-to-child transmission was 22.2 percent. Women ≥25 years, and those who had the first antenatal care appointment later in pregnancy, were more likely to be lost to follow-up. Women who received social security grants or family planning counseling, and those whose partners received HIV testing and counseling, were less likely to be lost to follow-up. Five of 722 male partners who received HIV testing and counseling were diagnosed with HIV. All were linked to HIV services, but only one initiated treatment. Prevention packages, including home-based counseling for pregnant women and their partners should be considered to reduce maternal and pediatric HIV infections in low-resource settings.