CoChat
Sign Up
Cited by 12HIV/AIDS Research and InterventionsGlobal Maternal and Child HealthHealth Policy Implementation Science

The DOI matches its Crossref record; 4 of the 4 references it cites were found in a registry or an index.

Stepped-Wedge Cluster Randomized Controlled Trial to Promote Option B+ Retention in Central Mozambique

Open access
Pfeiffer, James T., Napúa, Manuel, Wagenaar, Bradley H., Chale, Falume, Hoek, Roxanne, Micek, Mark, Manuel, João, Michel, Cathy, Cowan, Jessica Greenberg, Cowan, James F., Gimbel, Sarah, Sherr, Kenneth, Gloyd, Stephen, Chapman, Rachel R.·2017·JAIDS Journal of Acquired Immune Deficiency Syndromes
DOI 10.1097/qai.0000000000001515PMC PMC7055502
Open this paper in CoChat — free account

Abstract

Background: This randomized trial studied performance of Option B+ in Mozambique and evaluated an enhanced retention package in public clinics. Setting: The study was conducted at 6 clinics in Manica and Sofala Provinces in central Mozambique. Methods: Seven hundred sixty-one pregnant women tested HIV+, immediately initiated antiretroviral (ARV) therapy, and were followed to track retention at 6 clinics from May 2014 to May 2015. Clinics were randomly allocated within a stepped-wedge fashion to intervention and control periods. The intervention included (1) workflow modifications and (2) active patient tracking. Retention was defined as percentage of patients returning for 30-, 60-, and 90-day medication refills within 25–35 days of previous refills. Results: During control periods, 52.3% of women returned for 30-day refills vs. 70.8% in intervention periods [odds ratio (OR): 1.80; 95% confidence interval (CI): 1.05 to 3.08]. At 60 days, 46.1% control vs. 57.9% intervention were retained (OR: 1.82; CI: 1.06 to 3.11), and at 90 days, 38.3% control vs. 41.0% intervention (OR: 1.04; CI: 0.60 to 1.82). In prespecified subanalyses, birth before pickups was strongly associated with failure—women giving birth before ARV pickup were 33.3 times (CI: 4.4 to 250.3), 7.5 times (CI: 3.6 to 15.9), and 3.7 times (CI: 2.2 to 6.0) as likely to not return for ARV pickups at 30, 60, and 90 days, respectively. Conclusions: The intervention was effective at 30 and 60 days, but not at 90 days. Combined 90-day retention (40%) and adherence (22.5%) were low. Efforts to improve retention are particularly important for women giving birth before ARV refills.

Overview

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Integrity signals

Registry

Crossref · 10.1097/qai.0000000000001515

Cites

4 of 4 references verified0 citation errors · 0 not checkable

Statistics

Verification

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Citations

Cites

Flagged first, then by citations

Show all 4 references

Research works printed but not linked: 36

  1. Ferguson, 2014, Linking women who test HIV-positive in pregnancy-related services to HIV care and treatment services in Kenya: a mixed methods prospective cohort study, PLoS One., 9, e89764, 10.1371/journal.pone.0089764 · DOI
  2. Wettstein, 2012, Missed opportunities to prevent mother-to-child-transmission: systematic review and meta-analysis, AIDS, 26, 2361, 10.1097/QAD.0b013e328359ab0c · DOI
  3. Ferguson, 2012, Patient attrition between diagnosis with HIV in pregnancy-related services and long-term HIV care and treatment services in Kenya: a retrospective study, J Acquir Immune Defic Syndr., 60, e90, 10.1097/QAI.0b013e318253258a · DOI
  4. Gamell, 2013, Uptake of guidelines on prevention of mother-to-child transmission of HIV in rural Tanzania: time for change, Swiss Med Wkly., 143, w13775
  5. Landes, 2012, Mortality and health outcomes in HIV-infected and HIV-uninfected mothers at 18–20 months postpartum in Zomba District, Malawi, PLoS One, 7, e44396, 10.1371/journal.pone.0044396 · DOI
  6. van Lettow, 2011, Uptake and outcomes of a prevention-of mother-to-child transmission (PMTCT) program in Zomba district, Malawi, BMC Public Health., 11, 426, 10.1186/1471-2458-11-426 · DOI
  7. Nachega, 2012, Adherence to antiretroviral therapy during and after pregnancy in low-income, middle-income, and high-income countries: a systematic review and meta-analysis, AIDS, 26, 2039, 10.1097/QAD.0b013e328359590f · DOI
  8. Ahmed, 2013, Risks and benefits of lifelong antiretroviral treatment for pregnant and breastfeeding women: a review of the evidence for the Option B+ approach, Curr Opin HIV AIDS., 8, 474, 10.1097/COH.0b013e328363a8f2 · DOI
  9. Clouse, 2014, “What they wanted was to give birth; nothing else”: barriers to retention in option B+ HIV care among postpartum women in South Africa, J Acquir Immune Defic Syndr., 67, e12, 10.1097/QAI.0000000000000263 · DOI
  10. Clouse, 2013, Loss to follow-up before and after delivery among women testing HIV positive during pregnancy in Johannesburg, South Africa, Trop Med Int Health., 18, 451, 10.1111/tmi.12072 · DOI
  11. Rollins, 2014, Defining and analyzing retention-in-care among pregnant and breastfeeding HIV-infected women: unpacking the data to interpret and improve PMTCT outcomes, J Acquir Immune Defic Syndr., 67, S150, 10.1097/QAI.0000000000000355 · DOI
  12. Shaffer, 2014, Option B+ for prevention of mother-to-child transmission of HIV in resource-constrained settings: great promise but some early caution, AIDS, 28, 599, 10.1097/QAD.0000000000000144 · DOI
  13. Mitiku, 2016, Factors associated with loss to follow-up among women in Option B+ PMTCT programme in northeast Ethiopia: a retrospective cohort study, J Int AIDS Soc., 19, 20662, 10.7448/IAS.19.1.20662 · DOI
  14. Tenthani, 2014, Retention in care under universal antiretroviral therapy for HIV-infected pregnant and breastfeeding women (“Option B+”) in Malawi, AIDS, 28, 589, 10.1097/QAD.0000000000000143 · DOI
  15. 2013, Impact of an innovative approach to prevent mother-to-child transmission of HIV–Malawi, July 2011-September 2012, MMWR Morb Mortal Wkly Rep., 62, 148
  16. 2013, Impact of an innovative approach to prevent mother-to-child transmission of HIV–Malawi, 2011–2012, MMWR Morb Mortal Wkly Rep., 62, 148
  17. Haas, 2016, Retention in care during the first 3 years of antiretroviral therapy for women in Malawi's option B+ programme: an observational cohort study, Lancet HIV., 3, e175, 10.1016/S2352-3018(16)00008-4 · DOI
  18. Llenas-García, 2016, Retention in care of HIV-infected pregnant and lactating women starting art under Option B+ in rural Mozambique, Trop Med Int Health., 21, 1003, 10.1111/tmi.12728 · DOI
  19. Matheson, 2015, Fundamental concerns of women living with HIV around the implementation of Option B, J Int AIDS Soc., 18, 20286, 10.7448/IAS.18.6.20286 · DOI
  20. Kieffer, 2014, Lessons learned from early implementation of option B+: the elizabeth glaser pediatric AIDS foundation experience in 11 African countries, J Acquir Immune Defic Syndr., 67, S188, 10.1097/QAI.0000000000000372 · DOI
  21. Gourlay, 2013, Barriers and facilitating factors to the uptake of antiretroviral drugs for prevention of mother-to-child transmission of HIV in sub-Saharan Africa: a systematic review, J Int AIDS Soc., 16, 18588, 10.7448/IAS.16.1.18588 · DOI · Paper page
  22. Auld, 2016, A decade of antiretroviral therapy scale-up in Mozambique: evaluation of outcome trends and new models of service delivery among more than 300,000 patients enrolled during 2004—2013, J Acquir Immune Defic Syndr., 73, e11, 10.1097/QAI.0000000000001137 · DOI
  23. Napua, 2016, Option B+ in Mozambique: formative research findings for the design of a facility-level clustered randomized controlled trial to improve ART retention in antenatal care, J Acquir Immune Defic Syndr., 72, S181, 10.1097/QAI.0000000000001061 · DOI · Paper page
  24. Fernandes, 2014, Effects of health-system strengthening on under-5, infant, and neonatal mortality: 11-year provincial-level time-series analyses in Mozambique, Lancet Glob Health., 2, e468, 10.1016/S2214-109X(14)70276-1 · DOI
  25. Cowan, 2015, Early ART initiation among HIV-positive pregnant women in central Mozambique: a stepped wedge randomized controlled trial of an optimized Option B+ approach, Implement Sci., 10, 61, 10.1186/s13012-015-0249-6 · DOI
  26. Hussey, 2007, Design and analysis of stepped wedge cluster randomized trials, Contemp Clin Trials., 28, 182, 10.1016/j.cct.2006.05.007 · DOI
  27. Herlihy, 2015, Implementation and operational research: integration of PMTCT and antenatal services improves combination antiretroviral therapy uptake for HIV-positive pregnant women in southern Zambia: a prototype for option B+?, J Acquir Immune Defic Syndr., 70, e123, 10.1097/QAI.0000000000000760 · DOI
  28. Dzangare, 2016, HIV testing uptake and retention in care of HIV-infected pregnant and breastfeeding women initiated on “Option B+”in rural Zimbabwe, Trop Med Int Health., 21, 202, 10.1111/tmi.12637 · DOI
  29. Ambia, 2016, A systematic review of interventions to improve prevention of mother-to-child HIV transmission service delivery and promote retention, J Int AIDS Soc., 19, 20309, 10.7448/IAS.19.1.20309 · DOI
  30. Wagenaar, 2016, Wait and consult times for primary healthcare services in central Mozambique: a time-motion study, Glob Health Action., 9, 31980, 10.3402/gha.v9.31980 · DOI
  31. Fairley, 2005, Long-term utility of measuring adherence by self-report compared with pharmacy record in a routine clinic setting, HIV Med., 6, 366, 10.1111/j.1468-1293.2005.00322.x · DOI
  32. Altice, 2001, Trust and the acceptance of and adherence to antiretroviral therapy, J Acquir Immune Defic Syndr., 28, 47, 10.1097/00042560-200109010-00008 · DOI
  33. Walsh, 2001, Reasons for non-adherence to antiretroviral therapy: patients' perspectives provide evidence of multiple causes, AIDS Care., 13, 709, 10.1080/09540120120076878 · DOI
  34. Harrigan, 2005, Predictors of HIV drug-resistance mutations in a large antiretroviral-naive cohort initiating triple antiretroviral therapy, J Infect Dis., 191, 339, 10.1086/427192 · DOI
  35. Weiser, 2004, Higher rates of viral suppression with nonnucleoside reverse transcriptase inhibitors compared to single protease inhibitors are not explained by better adherence, HIV Clin Trials., 5, 278, 10.1310/LNHD-K1R7-HQP5-HJCQ · DOI
  36. Bangsberg, 2004, Paradoxes of adherence and drug resistance to HIV antiretroviral therapy, J Antimicrob Chemother., 53, 696, 10.1093/jac/dkh162 · DOI

Cited by

Sorted by citations

See all 12

Metadata

Authors
Pfeiffer, J. T., Napúa, M., Wagenaar, B. H., Chale, F., Hoek, R., Micek, M., Manuel, J., Michel, C., Cowan, J. G., Cowan, J. F., Gimbel, S., Sherr, K., Gloyd, S., & Chapman, R. R.
Affiliations
  • University of Washington (US)
  • Ministry of Health (MZ)
  • Health Alliance International (US)
  • University of Wisconsin–Madison (US)
Corresponding author
  • Pfeiffer, James T.
  • Hoek, Roxanne
  • Cowan, Jessica Greenberg
  • Cowan, James F.
  • Gimbel, Sarah
  • Sherr, Kenneth
  • Gloyd, Stephen
ORCID
Venue
JAIDS Journal of Acquired Immune Deficiency Syndromes
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2017-11-01
Volume
76
Issue
3
Pages
273-280
ISSN
1525-4135 (ISSN-L)
DOI
10.1097/qai.0000000000001515
PMC
PMC7055502
OpenAlex
W2742469958
Cited by
12
References
4
Citations by year
2026: 1 · 2025: 1 · 2022: 2 · 2021: 1 · 2020: 3 · 2019: 1 · 2018: 3
FWCI
1.47
Type
journal article
Language
en
Open access
Locations
  • JAIDS Journal of Acquired Immune Deficiency Syndromes (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • National Institute of Allergy and Infectious Diseases (P30AI027757)
  • Eunice Kennedy Shriver National Institute of Child Health and Human Development (R01HD074557)
Topics
  • Health Sciences › Medicine › Infectious Diseases › HIV/AIDS Research and Interventions
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Global Maternal and Child Health
  • Health Sciences › Health Professions › General Health Professions › Health Policy Implementation Science
Keywords
Option B+, HIV-positive pregnant women, retention in care, antiretroviral therapy, medication adherence, patient tracking, workflow modification, prevention of mother-to-child transmission of HIV, Mozambique
MeSH terms
Assessment of Medication Adherence, Adult, Delivery of Health Care, Female, Humans, Middle Aged, Mozambique, Patient Acceptance of Health Care, Pregnancy, Pregnancy Complications, Infectious, HIV Infections, Drug Monitoring, Infectious Disease Transmission, Vertical, CD4 Lymphocyte Count, Anti-HIV Agents, Medication Adherence, Young Adult

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review