A new research study has found that at least 90 percent of African pregnant women on antiretroviral treatment (ART) had an undetectable viral load with reported maternal health having improved over time.
The PEPFAR PROMOTE study was a follow-up study to the IMPAACT PROMISE (Promoting Maternal and Infant Survival Everywhere) clinical trial.
During the 5-year study, a total of 4,619 mothers and children were enrolled in 8 PROMOTE sites across 4 African countries – Uganda, Malawi, Zimbabwe and South Africa.
The study looked at outcomes including retention in HIV care, adherence to ART, safety of ART, maternal health and fertility intentions.
The findings advocate for long-term benefits of ART and services to support maternal HIV care, treatment and to ensure reproductive health services be strengthened.
The authors of the multi county study cite that the overall retention rates were 96 percent for mothers, while children at 12 months were at 94 percent.
“1115 (89·1%) of 1252 women had an undetectable viral load at 42 months, which varied by site (81·7–93·8%).”
The study also found that the proportion of women with obesity was high in South Africa and “increased over time from 40·2% at baseline to 52·8% at 42 months.”
The proportion of unwell participants who visited a health centre declined from 14·7% to 2·8%, and the proportion of those admitted to hospital declined from 1·5% to 1·0%. The researchers also said the desire to have more children was consistently high at some sites.
The pregnancy rate was 95 percent, while the mortality rate stood at 2 percent, of the study participants.
The findings from this multicountry study are reassuring. These findings show that African women can consistently use ART for a long period after initiation, and long-term benefits can be maintained.
There is strong evidence that ART for cisgender women of reproductive age living with HIV reduces vertical HIV transmission and improves women’s health and survival. However, there is a dearth of research on the long-term effects of ART in reproductive-age women who started ART during pregnancy.