What is needed to eliminate new pediatric HIV infections: the contribution of model-based analyses
Open accessAbstract
PURPOSE OF REVIEW: Computer simulation models can identify key clinical, operational, and economic interventions that will be needed to achieve the elimination of new pediatric HIV infections. In this review, we summarize recent findings from model-based analyses of strategies for prevention of mother-to-child HIV transmission (MTCT). RECENT FINDINGS: In order to achieve elimination of MTCT (eMTCT), model-based studies suggest that scale-up of services will be needed in several domains: uptake of services and retention in care (the PMTCT 'cascade'), interventions to prevent HIV infections in women and reduce unintended pregnancies (the 'four-pronged approach'), efforts to support medication adherence through long periods of pregnancy and breastfeeding, and strategies to make breastfeeding safer and/or shorter. Models also project the economic resources that will be needed to achieve these goals in the most efficient ways to allocate limited resources for eMTCT. Results suggest that currently recommended PMTCT regimens (WHO Option A, Option B, and Option B+) will be cost-effective in most settings. SUMMARY: Model-based results can guide future implementation science, by highlighting areas in which additional data are needed to make informed decisions and by outlining critical interventions that will be necessary in order to eliminate new pediatric HIV infections.
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PMTCT care cascade failures drive pediatric HIV infections in sub-Saharan Africa.
“Gaps in the implementation of prevention of mother-to-child HIV transmission (PMTCT) services drive pediatric HIV infection in sub-Saharan Africa (SSA) [1-3].”
In practice, HIV transmission rates are several times higher than trial rates because of high drop-out rates of HIV-positive women along the PMTCT care cascade.
“the rates are several times higher in practice because of the high drop-out rates of HIV-positive women along the PMTCT care cascade [1-3,6-9].”
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Sorted by citations
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- Authors
- Doherty, K., & Ciaranello, A.
- Affiliations
- Massachusetts General Hospital (US)
- Corresponding author
- Doherty, Katie
- ORCID
- Ciaranello, Andrea
- Venue
- Current Opinion in HIV and AIDS
- Published
- 2013-09
- Volume
- 8
- Issue
- 5
- Pages
- 457-466
- ISSN
- 1746-630X (ISSN-L)
- PMC
- PMC3799993
- OpenAlex
- W2074339575
- Cited by
- 13
- References
- 44
- Citations by year
- 2023: 1 · 2022: 1 · 2019: 1 · 2018: 2 · 2017: 2 · 2016: 1 · 2015: 3 · 2014: 1 · 2013: 1
- FWCI
- 0.26
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Current Opinion in HIV and AIDS (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Allergy and Infectious Diseases (K01AI078754, U01AI068616, 5 U01 AI41110, U01AI068632, U01AI041110, UM1AI068616, UM1AI106716, UM1AI068632, R01AI058736)
- National Institute of Diabetes and Digestive and Kidney Diseases (N01-DK-9-001/, HHSN267200800001G)
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (HHSN267200800001C)
- Topics
- Health Sciences › Medicine › Infectious Diseases › HIV/AIDS Research and Interventions
- Health Sciences › Medicine › Epidemiology › HIV, Drug Use, Sexual Risk
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Global Maternal and Child Health
- Keywords
- prevention of mother-to-child transmission of HIV, pediatric HIV, cascade of care, retention in care, unintended pregnancy, antiretroviral therapy adherence, breastfeeding, cost-effectiveness, resource allocation, HIV prevention strategies
- MeSH terms
- Computer Simulation, Costs and Cost Analysis, Family Planning Services, Female, Humans, Infant, Newborn, Pregnancy, HIV Infections, Infectious Disease Transmission, Vertical, Perinatal Care, Anti-Retroviral Agents, Medication Adherence
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