Providing a conceptual framework for HIV prevention cascades and assessing feasibility of empirical measurement with data from east Zimbabwe: a case study.

Ahmadou Alioum; Mario Cortina-borja; François Dabis; Laurence Dequae-merchadou; Geert Haverkamp; James Hughes; John Karon; Valeriane Valériane Leroy; Marie-louise Newell; Barbra A Richardson; Liesbeth Van Weert; Gerrit-jan Weverling; U Inserm; Institut Epidémiologie; Santé Publique; Université Victor; Segalen Bordeaux; Patricia Opondo Awiti; Alessandra Grotta; Mia Van Der Kop; John Dusabe; Anna Thorson; Jonathan Mwangi; Rino Belloco; Richard Lester; Laura Ternent; Edwin Were; Anna Mia Ekström; Media Brief; Echezona E Ezeanolue; Byron J Powell; Dina Patel; Ayodotun Olutola; Michael Obiefune; Patrick Dakum; Prosper Okonkwo; Bola Gobir; Timothy Akinmurele; Mary Glenn Fowler; Geoffrey P Garnett; Timothy B Hallett; Albert Takaruza; James R Hargreaves; Rebecca Rhead; Mitchel Warren; Constance Nyamukapa; Simon Gregson; Peter Godfrey-Faussett; Michael E Herce; Tiwonge Mtande; Frank Chimbwandira; Innocent Mofolo; Christine K Chingondole; Nora E Rosenberg; Kathy E Lancaster; Esmie Kamanga; Jacqueline Chinkonde; Wiza Kumwenda; Gerald Tegha; Mina C Hosseinipour; Irving F Hoffman; Francis E Martinson; Eva Stein; Charles M van der Horst; Daniel R Hogan; Rob Baltussen; Chika Hayashi; Jeremy A Lauer; Joshua A Salomon; Scott E Kellerman; Saeed Ahmed; Theresa Feeley-summerl; Jonathan Jay; Maria Kim; B Ryan Phelps; Nandita Sugandhi; Pregnant Women; Shari Krishnaratne; Bernadette Hensen; Jillian Cordes; Joanne Enstone; James R Hargreaves; Colin D Mathers; Dejan Loncar; S N Mothi; M M Lala; A R Tappuni; Hermine L Nguena Nguefack; Henri Gwet; Sophie Desmonde; Odile Ouwe Missi Oukem-boyer; Céline Nkenfou; Mathurin Téjiokem; Patrice Tchendjou; Irénée Domkam; Valeriane Valériane Leroy; Thomas M Painter; Kassamba L Diaby; Danielle M Matia; Lillian S Lin; Toussaint S Sibailly; Moise K Kouassi; Ehounou R Ekpini; Thierry H Roels; Stefan Z Wiktor; F O R Parliamentarians; O N Hiv; Global Plan; Towards The; Elimination Of; N E W Hiv; Keeping Their; Mothers Alive; Bernhard Schwartländer; John Stover; Timothy B Hallett; Rifat Atun; Carlos Avila; Eleanor Gouws; Michael Bartos; Peter D Ghys; Marjorie Opuni; David Barr; Ramzi Alsallaq; Lori Bollinger; Marcelo De Freitas; Geoffrey P Garnett; Charles Holmes; Ken Legins; Yogan Pillay; Anderson Eduardo Stanciole; Melinda Gates Foundation; Jennifer a Smith; Sarah-Jane Anderson; Kate L Harris; Jessica B McGillen; Edward Lee; Geoffrey P Garnett; Timothy B Hallett; Kasioni Spiridoula; Pappas Stefanos; Vlachadis Nikolaos; Valsamidi Irene; Stournaras Stamatis; United States; John Stover; Lori Bollinger; Jose Antonio Izazola; Luiz Loures; Paul Delay; Executive Summary; Michael A Tolle; Daniel Dewey; World Vision; Integrated Approach; Strategic Approach; Tsitsi Bandason; Grace Mchugh; Ethel Dauya; Stanley Mungofa; Shungu M Munyati; Helen A Weiss; Hilda Mujuru; Katharina Kranzer; Rashida A Ferrand

doi:10.1016/S2352-3018(16)30038-8

Providing a conceptual framework for HIV prevention cascades and assessing feasibility of empirical measurement with data from east Zimbabwe: a case study.

Ahmadou Alioum, Mario Cortina-borja, François Dabis, Laurence Dequae-merchadou, Geert Haverkamp, James Hughes, John Karon, Valeriane Valériane Leroy, Marie-louise Newell, Barbra A Richardson, Liesbeth Van Weert, Gerrit-jan Weverling, U Inserm, Institut Epidémiologie, Santé Publique, Université Victor, Segalen Bordeaux, Patricia Opondo Awiti, Alessandra Grotta, Mia Van Der KopJohn Dusabe, Anna Thorson, Jonathan Mwangi, Rino Belloco, Richard Lester, Laura Ternent, Edwin Were, Anna Mia Ekström, Media Brief, Echezona E Ezeanolue, Byron J Powell, Dina Patel, Ayodotun Olutola, Michael Obiefune, Patrick Dakum, Prosper Okonkwo, Bola Gobir, Timothy Akinmurele, Mary Glenn Fowler, Geoffrey P Garnett, Timothy B Hallett, Albert Takaruza, James R Hargreaves, Rebecca Rhead, Mitchel Warren, Constance Nyamukapa, Simon Gregson, Peter Godfrey-Faussett, Michael E Herce, Tiwonge Mtande, Frank Chimbwandira, Innocent Mofolo, Christine K Chingondole, Nora E Rosenberg, Kathy E Lancaster, Esmie Kamanga, Jacqueline Chinkonde, Wiza Kumwenda, Gerald Tegha, Mina C Hosseinipour, Irving F Hoffman, Francis E Martinson, Eva Stein, Charles M van der Horst, Daniel R Hogan, Rob Baltussen, Chika Hayashi, Jeremy A Lauer, Joshua A Salomon, Scott E Kellerman, Saeed Ahmed, Theresa Feeley-summerl, Jonathan Jay, Maria Kim, B Ryan Phelps, Nandita Sugandhi, Pregnant Women, Shari Krishnaratne, Bernadette Hensen, Jillian Cordes, Joanne Enstone, James R Hargreaves, Colin D Mathers, Dejan Loncar, S N Mothi, M M Lala, A R Tappuni, Hermine L Nguena Nguefack, Henri Gwet, Sophie Desmonde, Odile Ouwe Missi Oukem-boyer, Céline Nkenfou, Mathurin Téjiokem, Patrice Tchendjou, Irénée Domkam, Valeriane Valériane Leroy, Thomas M Painter, Kassamba L Diaby, Danielle M Matia, Lillian S Lin, Toussaint S Sibailly, Moise K Kouassi, Ehounou R Ekpini, Thierry H Roels, Stefan Z Wiktor, F O R Parliamentarians, O N Hiv, Global Plan, Towards The, Elimination Of, N E W Hiv, Keeping Their, Mothers Alive, Bernhard Schwartländer, John Stover, Timothy B Hallett, Rifat Atun, Carlos Avila, Eleanor Gouws, Michael Bartos, Peter D Ghys, Marjorie Opuni, David Barr, Ramzi Alsallaq, Lori Bollinger, Marcelo De Freitas, Geoffrey P Garnett, Charles Holmes, Ken Legins, Yogan Pillay, Anderson Eduardo Stanciole, Melinda Gates Foundation, Jennifer a Smith, Sarah-Jane Anderson, Kate L Harris, Jessica B McGillen, Edward Lee, Geoffrey P Garnett, Timothy B Hallett, Kasioni Spiridoula, Pappas Stefanos, Vlachadis Nikolaos, Valsamidi Irene, Stournaras Stamatis, United States, John Stover, Lori Bollinger, Jose Antonio Izazola, Luiz Loures, Paul Delay, Executive Summary, Michael A Tolle, Daniel Dewey, World Vision, Integrated Approach, Strategic Approach, Tsitsi Bandason, Grace Mchugh, Ethel Dauya, Stanley Mungofa, Shungu M Munyati, Helen A Weiss, Hilda Mujuru, Katharina Kranzer, Rashida A Ferrand

Research output: Chapter in Book/Report/Conference proceeding › Chapter › peer-review

104 Citations (Scopus)

Abstract

BACKGROUND: We established Safeguard the Family (STF) to support Ministry of Health (MoH) scale-up of universal antiretroviral therapy (ART) for HIV-infected pregnant and breastfeeding women (Option B+) and to strengthen the prevention of mother-to-child transmission (PMTCT) cascade from HIV testing and counseling (HTC) through maternal ART provision and post-delivery early infant HIV diagnosis (EID). To these ends, we implemented the following interventions in 5 districts: 1) health worker training and mentorship; 2) couples' HTC and male partner involvement; 3) women's psychosocial support groups; and 4) health and laboratory system strengthening for EID. METHODS: We conducted a serial cross-sectional study using facility-level quarterly (Q) program data and individual-level infant HIV-1 DNA PCR data to evaluate STF performance on PMTCT indicators for project years (Y) 1 (April-December 2011) through 3 (January-December 2013), and compared these results to national averages. RESULTS: Facility-level uptake of HTC, ART, infant nevirapine prophylaxis, and infant DNA PCR testing increased significantly from quarterly baselines of 66 % (n/N = 32,433/48,804), 23 % (n/N = 442/1,958), 1 % (n/N = 10/1,958), and 52 % (n/N = 1,385/2,644) to 87 % (n/N = 39,458/45,324), 96 % (n/N = 2,046/2,121), 100 % (n/N = 2,121/2,121), and 62 % (n/N = 1,462/2,340), respectively, by project end (all p <0.001). Quarterly HTC, ART, and infant nevirapine prophylaxis uptake outperformed national averages over years 2-3. While transitioning EID laboratory services to MoH, STF provided first-time HIV-1 DNA PCR testing for 2,226 of 11,261 HIV-exposed infants (20 %) tested in the MoH EID program in STF districts from program inception (Y2) through Y3. Of these, 78 (3.5 %) tested HIV-positive. Among infants with complete documentation (n = 608), median age at first testing decreased from 112 days (interquartile range, IQR: 57-198) in Y2 to 76 days (IQR: 46-152) in Y3 (p <0.001). During Y3 (only year with national data for comparison), non-significantly fewer exposed infants tested HIV-positive (3.6 %) at first testing in STF districts than nationally (4.1 %) (p = 0.4). CONCLUSIONS: STF interventions, integrated within the MoH Option B+ program, achieved favorable HTC, maternal ART, infant prophylaxis, and EID services uptake, and a low proportion of infants found HIV-infected at first DNA PCR testing. Continued investments are needed to strengthen the PMTCT cascade, particularly around EID.

Original language	English
Title of host publication	The lancet. HIV
Publisher	BMC Infectious Diseases
Pages	e297-306
ISBN (Print)	0000000000000
DOIs	https://doi.org/10.1016/S2352-3018(16)30038-8
Publication status	Published - 2016

Publication series

Name	The lancet. HIV
Volume	3

Keywords

35
72
AIDS
Adult
Africa
Antiretroviral Therapy
Antiretroviral therapy (ART)
Breast Feeding
Breastfeeding
Children
Cross-Sectional Studies
Early Diagnosis
Female
HIV
HIV Infections
HIV Infections: drug therapy
HIV Infections: transmission
HIV/PMTCT
Highly Active
Humans
Infant
Infectious
Infectious Disease Transmission
Infectious: drug therapy
Kenya
Malawi
Male
Mobile health (m-health)
Modelling
Mother-to-child transmission
Newborn
Post-Exposure Prophylaxis
Postpartum Period
Pregnancy
Pregnancy Complications
Prenatal Care
Program Evaluation
Retention
Vertical
Vertical: prevention & control
Young Adult
adolescents
africa
aids
antiretroviral therapy
art
awiti
barriers
breastfeeding
children
com
correspondence
decrease in new hiv
early diagnosis and public
effective
exercises were conducted
fi c syndr 2016
gaps
gmail
have contributed to a
health campaigns
hermine
hiv
hiv screening
implementa-
implementation strategies
india
infections
j acquir immune de
kenya
ki
lives since fi rst
m-health
methods
mobile health
modelling
more than 34 million
mother-to-child transmission
nguena
nigeria
option b þ
patricia
pediatric
perinatal hiv infection
pmtct
pregnancy
prophylactic treatment of hiv
recognized
retention
s161
s166
se
testing and counselling
tion research
transmission
treatment
two 1-hour structured group
women

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Access to Document

10.1016/S2352-3018(16)30038-8

Cite this

Alioum, A., Cortina-borja, M., Dabis, F., Dequae-merchadou, L., Haverkamp, G., Hughes, J., Karon, J., Leroy, V. V., Newell, M., Richardson, B. A., Weert, L. V., Weverling, G., Inserm, U., Epidémiologie, I., Publique, S., Victor, U., Bordeaux, S., Awiti, P. O., Grotta, A., ... Ferrand, R. A. (2016). Providing a conceptual framework for HIV prevention cascades and assessing feasibility of empirical measurement with data from east Zimbabwe: a case study. In The lancet. HIV (pp. e297-306). (The lancet. HIV; Vol. 3). BMC Infectious Diseases. https://doi.org/10.1016/S2352-3018(16)30038-8

@inbook{e3ffd4d3a3d94b578bfceed00f22ebda,

title = "Providing a conceptual framework for HIV prevention cascades and assessing feasibility of empirical measurement with data from east Zimbabwe: a case study.",

abstract = "BACKGROUND: We established Safeguard the Family (STF) to support Ministry of Health (MoH) scale-up of universal antiretroviral therapy (ART) for HIV-infected pregnant and breastfeeding women (Option B+) and to strengthen the prevention of mother-to-child transmission (PMTCT) cascade from HIV testing and counseling (HTC) through maternal ART provision and post-delivery early infant HIV diagnosis (EID). To these ends, we implemented the following interventions in 5 districts: 1) health worker training and mentorship; 2) couples' HTC and male partner involvement; 3) women's psychosocial support groups; and 4) health and laboratory system strengthening for EID. METHODS: We conducted a serial cross-sectional study using facility-level quarterly (Q) program data and individual-level infant HIV-1 DNA PCR data to evaluate STF performance on PMTCT indicators for project years (Y) 1 (April-December 2011) through 3 (January-December 2013), and compared these results to national averages. RESULTS: Facility-level uptake of HTC, ART, infant nevirapine prophylaxis, and infant DNA PCR testing increased significantly from quarterly baselines of 66 % (n/N = 32,433/48,804), 23 % (n/N = 442/1,958), 1 % (n/N = 10/1,958), and 52 % (n/N = 1,385/2,644) to 87 % (n/N = 39,458/45,324), 96 % (n/N = 2,046/2,121), 100 % (n/N = 2,121/2,121), and 62 % (n/N = 1,462/2,340), respectively, by project end (all p <0.001). Quarterly HTC, ART, and infant nevirapine prophylaxis uptake outperformed national averages over years 2-3. While transitioning EID laboratory services to MoH, STF provided first-time HIV-1 DNA PCR testing for 2,226 of 11,261 HIV-exposed infants (20 %) tested in the MoH EID program in STF districts from program inception (Y2) through Y3. Of these, 78 (3.5 %) tested HIV-positive. Among infants with complete documentation (n = 608), median age at first testing decreased from 112 days (interquartile range, IQR: 57-198) in Y2 to 76 days (IQR: 46-152) in Y3 (p <0.001). During Y3 (only year with national data for comparison), non-significantly fewer exposed infants tested HIV-positive (3.6 %) at first testing in STF districts than nationally (4.1 %) (p = 0.4). CONCLUSIONS: STF interventions, integrated within the MoH Option B+ program, achieved favorable HTC, maternal ART, infant prophylaxis, and EID services uptake, and a low proportion of infants found HIV-infected at first DNA PCR testing. Continued investments are needed to strengthen the PMTCT cascade, particularly around EID.",

keywords = "35, 72, AIDS, Adult, Africa, Antiretroviral Therapy, Antiretroviral therapy (ART), Breast Feeding, Breastfeeding, Children, Cross-Sectional Studies, Early Diagnosis, Female, HIV, HIV Infections, HIV Infections: drug therapy, HIV Infections: transmission, HIV/PMTCT, Highly Active, Humans, Infant, Infectious, Infectious Disease Transmission, Infectious: drug therapy, Kenya, Malawi, Male, Mobile health (m-health), Modelling, Mother-to-child transmission, Newborn, Post-Exposure Prophylaxis, Postpartum Period, Pregnancy, Pregnancy Complications, Prenatal Care, Program Evaluation, Retention, Vertical, Vertical: prevention & control, Young Adult, adolescents, africa, aids, antiretroviral therapy, art, awiti, barriers, breastfeeding, children, com, correspondence, decrease in new hiv, early diagnosis and public, effective, exercises were conducted, fi c syndr 2016, gaps, gmail, have contributed to a, health campaigns, hermine, hiv, hiv screening, implementa-, implementation strategies, india, infections, j acquir immune de, kenya, ki, lives since fi rst, m-health, methods, mobile health, modelling, more than 34 million, mother-to-child transmission, nguena, nigeria, option b {\th}, patricia, pediatric, perinatal hiv infection, pmtct, pregnancy, prophylactic treatment of hiv, recognized, retention, s161, s166, se, testing and counselling, tion research, transmission, treatment, two 1-hour structured group, women",

author = "Ahmadou Alioum and Mario Cortina-borja and Fran{\c c}ois Dabis and Laurence Dequae-merchadou and Geert Haverkamp and James Hughes and John Karon and Leroy, {Valeriane Val{\'e}riane} and Marie-louise Newell and Richardson, {Barbra A} and Weert, {Liesbeth Van} and Gerrit-jan Weverling and U Inserm and Institut Epid{\'e}miologie and Sant{\'e} Publique and Universit{\'e} Victor and Segalen Bordeaux and Awiti, {Patricia Opondo} and Alessandra Grotta and Kop, {Mia Van Der} and John Dusabe and Anna Thorson and Jonathan Mwangi and Rino Belloco and Richard Lester and Laura Ternent and Edwin Were and Ekstr{\"o}m, {Anna Mia} and Media Brief and Ezeanolue, {Echezona E} and Powell, {Byron J} and Dina Patel and Ayodotun Olutola and Michael Obiefune and Patrick Dakum and Prosper Okonkwo and Bola Gobir and Timothy Akinmurele and Fowler, {Mary Glenn} and Garnett, {Geoffrey P} and Hallett, {Timothy B} and Albert Takaruza and Hargreaves, {James R} and Rebecca Rhead and Mitchel Warren and Constance Nyamukapa and Simon Gregson and Peter Godfrey-Faussett and Herce, {Michael E} and Tiwonge Mtande and Frank Chimbwandira and Innocent Mofolo and Chingondole, {Christine K} and Rosenberg, {Nora E} and Lancaster, {Kathy E} and Esmie Kamanga and Jacqueline Chinkonde and Wiza Kumwenda and Gerald Tegha and Hosseinipour, {Mina C} and Hoffman, {Irving F} and Martinson, {Francis E} and Eva Stein and {van der Horst}, {Charles M} and Hogan, {Daniel R} and Rob Baltussen and Chika Hayashi and Lauer, {Jeremy A} and Salomon, {Joshua A} and Kellerman, {Scott E} and Saeed Ahmed and Theresa Feeley-summerl and Jonathan Jay and Maria Kim and Phelps, {B Ryan} and Nandita Sugandhi and Pregnant Women and Shari Krishnaratne and Bernadette Hensen and Jillian Cordes and Joanne Enstone and Hargreaves, {James R} and Mathers, {Colin D} and Dejan Loncar and Mothi, {S N} and Lala, {M M} and Tappuni, {A R} and Nguefack, {Hermine L Nguena} and Henri Gwet and Sophie Desmonde and Oukem-boyer, {Odile Ouwe Missi} and C{\'e}line Nkenfou and Mathurin T{\'e}jiokem and Patrice Tchendjou and Ir{\'e}n{\'e}e Domkam and Leroy, {Valeriane Val{\'e}riane} and Painter, {Thomas M} and Diaby, {Kassamba L} and Matia, {Danielle M} and Lin, {Lillian S} and Sibailly, {Toussaint S} and Kouassi, {Moise K} and Ekpini, {Ehounou R} and Roels, {Thierry H} and Wiktor, {Stefan Z} and Parliamentarians, {F O R} and Hiv, {O N} and Global Plan and Towards The and Elimination Of and Hiv, {N E W} and Keeping Their and Mothers Alive and Bernhard Schwartl{\"a}nder and John Stover and Hallett, {Timothy B} and Rifat Atun and Carlos Avila and Eleanor Gouws and Michael Bartos and Ghys, {Peter D} and Marjorie Opuni and David Barr and Ramzi Alsallaq and Lori Bollinger and Freitas, {Marcelo De} and Garnett, {Geoffrey P} and Charles Holmes and Ken Legins and Yogan Pillay and Stanciole, {Anderson Eduardo} and Foundation, {Melinda Gates} and Smith, {Jennifer a} and Sarah-Jane Anderson and Harris, {Kate L} and McGillen, {Jessica B} and Edward Lee and Garnett, {Geoffrey P} and Hallett, {Timothy B} and Kasioni Spiridoula and Pappas Stefanos and Vlachadis Nikolaos and Valsamidi Irene and Stournaras Stamatis and United States and John Stover and Lori Bollinger and Izazola, {Jose Antonio} and Luiz Loures and Paul Delay and Executive Summary and Tolle, {Michael A} and Daniel Dewey and World Vision and Integrated Approach and Strategic Approach and Tsitsi Bandason and Grace Mchugh and Ethel Dauya and Stanley Mungofa and Munyati, {Shungu M} and Weiss, {Helen A} and Hilda Mujuru and Katharina Kranzer and Ferrand, {Rashida A}",

year = "2016",

doi = "10.1016/S2352-3018(16)30038-8",

language = "English",

isbn = "0000000000000",

series = "The lancet. HIV",

publisher = "BMC Infectious Diseases",

pages = "e297--306",

booktitle = "The lancet. HIV",

}

Alioum, A, Cortina-borja, M, Dabis, F, Dequae-merchadou, L, Haverkamp, G, Hughes, J, Karon, J, Leroy, VV, Newell, M, Richardson, BA, Weert, LV, Weverling, G, Inserm, U, Epidémiologie, I, Publique, S, Victor, U, Bordeaux, S, Awiti, PO, Grotta, A, Kop, MVD, Dusabe, J, Thorson, A, Mwangi, J, Belloco, R, Lester, R, Ternent, L, Were, E, Ekström, AM, Brief, M, Ezeanolue, EE, Powell, BJ, Patel, D, Olutola, A, Obiefune, M, Dakum, P, Okonkwo, P, Gobir, B, Akinmurele, T, Fowler, MG, Garnett, GP, Hallett, TB, Takaruza, A, Hargreaves, JR, Rhead, R, Warren, M, Nyamukapa, C, Gregson, S, Godfrey-Faussett, P, Herce, ME, Mtande, T, Chimbwandira, F, Mofolo, I, Chingondole, CK, Rosenberg, NE, Lancaster, KE, Kamanga, E, Chinkonde, J, Kumwenda, W, Tegha, G, Hosseinipour, MC, Hoffman, IF, Martinson, FE, Stein, E, van der Horst, CM, Hogan, DR, Baltussen, R, Hayashi, C, Lauer, JA, Salomon, JA, Kellerman, SE, Ahmed, S, Feeley-summerl, T, Jay, J, Kim, M, Phelps, BR, Sugandhi, N, Women, P, Krishnaratne, S, Hensen, B, Cordes, J, Enstone, J, Hargreaves, JR, Mathers, CD, Loncar, D, Mothi, SN, Lala, MM, Tappuni, AR, Nguefack, HLN, Gwet, H, Desmonde, S, Oukem-boyer, OOM, Nkenfou, C, Téjiokem, M, Tchendjou, P, Domkam, I, Leroy, VV, Painter, TM, Diaby, KL, Matia, DM, Lin, LS, Sibailly, TS, Kouassi, MK, Ekpini, ER, Roels, TH, Wiktor, SZ, Parliamentarians, FOR, Hiv, ON, Plan, G, The, T, Of, E, Hiv, NEW, Their, K, Alive, M, Schwartländer, B, Stover, J, Hallett, TB, Atun, R, Avila, C, Gouws, E, Bartos, M, Ghys, PD, Opuni, M, Barr, D, Alsallaq, R, Bollinger, L, Freitas, MD, Garnett, GP, Holmes, C, Legins, K, Pillay, Y, Stanciole, AE, Foundation, MG, Smith, JA, Anderson, S-J, Harris, KL, McGillen, JB, Lee, E, Garnett, GP, Hallett, TB, Spiridoula, K, Stefanos, P, Nikolaos, V, Irene, V, Stamatis, S, States, U, Stover, J, Bollinger, L, Izazola, JA, Loures, L, Delay, P, Summary, E, Tolle, MA, Dewey, D, Vision, W, Approach, I, Approach, S, Bandason, T, Mchugh, G, Dauya, E, Mungofa, S, Munyati, SM, Weiss, HA, Mujuru, H, Kranzer, K & Ferrand, RA 2016, Providing a conceptual framework for HIV prevention cascades and assessing feasibility of empirical measurement with data from east Zimbabwe: a case study. in The lancet. HIV. The lancet. HIV, vol. 3, BMC Infectious Diseases, pp. e297-306. https://doi.org/10.1016/S2352-3018(16)30038-8

Providing a conceptual framework for HIV prevention cascades and assessing feasibility of empirical measurement with data from east Zimbabwe: a case study. / Alioum, Ahmadou; Cortina-borja, Mario; Dabis, François et al.
The lancet. HIV. BMC Infectious Diseases, 2016. p. e297-306 (The lancet. HIV; Vol. 3).

Research output: Chapter in Book/Report/Conference proceeding › Chapter › peer-review

TY - CHAP

T1 - Providing a conceptual framework for HIV prevention cascades and assessing feasibility of empirical measurement with data from east Zimbabwe: a case study.

AU - Alioum, Ahmadou

AU - Cortina-borja, Mario

AU - Dabis, François

AU - Dequae-merchadou, Laurence

AU - Haverkamp, Geert

AU - Hughes, James

AU - Karon, John

AU - Leroy, Valeriane Valériane

AU - Newell, Marie-louise

AU - Richardson, Barbra A

AU - Weert, Liesbeth Van

AU - Weverling, Gerrit-jan

AU - Inserm, U

AU - Epidémiologie, Institut

AU - Publique, Santé

AU - Victor, Université

AU - Bordeaux, Segalen

AU - Awiti, Patricia Opondo

AU - Grotta, Alessandra

AU - Kop, Mia Van Der

AU - Dusabe, John

AU - Thorson, Anna

AU - Mwangi, Jonathan

AU - Belloco, Rino

AU - Lester, Richard

AU - Ternent, Laura

AU - Were, Edwin

AU - Ekström, Anna Mia

AU - Brief, Media

AU - Ezeanolue, Echezona E

AU - Powell, Byron J

AU - Patel, Dina

AU - Olutola, Ayodotun

AU - Obiefune, Michael

AU - Dakum, Patrick

AU - Okonkwo, Prosper

AU - Gobir, Bola

AU - Akinmurele, Timothy

AU - Fowler, Mary Glenn

AU - Garnett, Geoffrey P

AU - Hallett, Timothy B

AU - Takaruza, Albert

AU - Hargreaves, James R

AU - Rhead, Rebecca

AU - Warren, Mitchel

AU - Nyamukapa, Constance

AU - Gregson, Simon

AU - Godfrey-Faussett, Peter

AU - Herce, Michael E

AU - Mtande, Tiwonge

AU - Chimbwandira, Frank

AU - Mofolo, Innocent

AU - Chingondole, Christine K

AU - Rosenberg, Nora E

AU - Lancaster, Kathy E

AU - Kamanga, Esmie

AU - Chinkonde, Jacqueline

AU - Kumwenda, Wiza

AU - Tegha, Gerald

AU - Hosseinipour, Mina C

AU - Hoffman, Irving F

AU - Martinson, Francis E

AU - Stein, Eva

AU - van der Horst, Charles M

AU - Hogan, Daniel R

AU - Baltussen, Rob

AU - Hayashi, Chika

AU - Lauer, Jeremy A

AU - Salomon, Joshua A

AU - Kellerman, Scott E

AU - Ahmed, Saeed

AU - Feeley-summerl, Theresa

AU - Jay, Jonathan

AU - Kim, Maria

AU - Phelps, B Ryan

AU - Sugandhi, Nandita

AU - Women, Pregnant

AU - Krishnaratne, Shari

AU - Hensen, Bernadette

AU - Cordes, Jillian

AU - Enstone, Joanne

AU - Hargreaves, James R

AU - Mathers, Colin D

AU - Loncar, Dejan

AU - Mothi, S N

AU - Lala, M M

AU - Tappuni, A R

AU - Nguefack, Hermine L Nguena

AU - Gwet, Henri

AU - Desmonde, Sophie

AU - Oukem-boyer, Odile Ouwe Missi

AU - Nkenfou, Céline

AU - Téjiokem, Mathurin

AU - Tchendjou, Patrice

AU - Domkam, Irénée

AU - Leroy, Valeriane Valériane

AU - Painter, Thomas M

AU - Diaby, Kassamba L

AU - Matia, Danielle M

AU - Lin, Lillian S

AU - Sibailly, Toussaint S

AU - Kouassi, Moise K

AU - Ekpini, Ehounou R

AU - Roels, Thierry H

AU - Wiktor, Stefan Z

AU - Parliamentarians, F O R

AU - Hiv, O N

AU - Plan, Global

AU - The, Towards

AU - Of, Elimination

AU - Hiv, N E W

AU - Their, Keeping

AU - Alive, Mothers

AU - Schwartländer, Bernhard

AU - Stover, John

AU - Hallett, Timothy B

AU - Atun, Rifat

AU - Avila, Carlos

AU - Gouws, Eleanor

AU - Bartos, Michael

AU - Ghys, Peter D

AU - Opuni, Marjorie

AU - Barr, David

AU - Alsallaq, Ramzi

AU - Bollinger, Lori

AU - Freitas, Marcelo De

AU - Garnett, Geoffrey P

AU - Holmes, Charles

AU - Legins, Ken

AU - Pillay, Yogan

AU - Stanciole, Anderson Eduardo

AU - Foundation, Melinda Gates

AU - Smith, Jennifer a

AU - Anderson, Sarah-Jane

AU - Harris, Kate L

AU - McGillen, Jessica B

AU - Lee, Edward

AU - Garnett, Geoffrey P

AU - Hallett, Timothy B

AU - Spiridoula, Kasioni

AU - Stefanos, Pappas

AU - Nikolaos, Vlachadis

AU - Irene, Valsamidi

AU - Stamatis, Stournaras

AU - States, United

AU - Stover, John

AU - Bollinger, Lori

AU - Izazola, Jose Antonio

AU - Loures, Luiz

AU - Delay, Paul

AU - Summary, Executive

AU - Tolle, Michael A

AU - Dewey, Daniel

AU - Vision, World

AU - Approach, Integrated

AU - Approach, Strategic

AU - Bandason, Tsitsi

AU - Mchugh, Grace

AU - Dauya, Ethel

AU - Mungofa, Stanley

AU - Munyati, Shungu M

AU - Weiss, Helen A

AU - Mujuru, Hilda

AU - Kranzer, Katharina

AU - Ferrand, Rashida A

PY - 2016

Y1 - 2016

N2 - BACKGROUND: We established Safeguard the Family (STF) to support Ministry of Health (MoH) scale-up of universal antiretroviral therapy (ART) for HIV-infected pregnant and breastfeeding women (Option B+) and to strengthen the prevention of mother-to-child transmission (PMTCT) cascade from HIV testing and counseling (HTC) through maternal ART provision and post-delivery early infant HIV diagnosis (EID). To these ends, we implemented the following interventions in 5 districts: 1) health worker training and mentorship; 2) couples' HTC and male partner involvement; 3) women's psychosocial support groups; and 4) health and laboratory system strengthening for EID. METHODS: We conducted a serial cross-sectional study using facility-level quarterly (Q) program data and individual-level infant HIV-1 DNA PCR data to evaluate STF performance on PMTCT indicators for project years (Y) 1 (April-December 2011) through 3 (January-December 2013), and compared these results to national averages. RESULTS: Facility-level uptake of HTC, ART, infant nevirapine prophylaxis, and infant DNA PCR testing increased significantly from quarterly baselines of 66 % (n/N = 32,433/48,804), 23 % (n/N = 442/1,958), 1 % (n/N = 10/1,958), and 52 % (n/N = 1,385/2,644) to 87 % (n/N = 39,458/45,324), 96 % (n/N = 2,046/2,121), 100 % (n/N = 2,121/2,121), and 62 % (n/N = 1,462/2,340), respectively, by project end (all p <0.001). Quarterly HTC, ART, and infant nevirapine prophylaxis uptake outperformed national averages over years 2-3. While transitioning EID laboratory services to MoH, STF provided first-time HIV-1 DNA PCR testing for 2,226 of 11,261 HIV-exposed infants (20 %) tested in the MoH EID program in STF districts from program inception (Y2) through Y3. Of these, 78 (3.5 %) tested HIV-positive. Among infants with complete documentation (n = 608), median age at first testing decreased from 112 days (interquartile range, IQR: 57-198) in Y2 to 76 days (IQR: 46-152) in Y3 (p <0.001). During Y3 (only year with national data for comparison), non-significantly fewer exposed infants tested HIV-positive (3.6 %) at first testing in STF districts than nationally (4.1 %) (p = 0.4). CONCLUSIONS: STF interventions, integrated within the MoH Option B+ program, achieved favorable HTC, maternal ART, infant prophylaxis, and EID services uptake, and a low proportion of infants found HIV-infected at first DNA PCR testing. Continued investments are needed to strengthen the PMTCT cascade, particularly around EID.

AB - BACKGROUND: We established Safeguard the Family (STF) to support Ministry of Health (MoH) scale-up of universal antiretroviral therapy (ART) for HIV-infected pregnant and breastfeeding women (Option B+) and to strengthen the prevention of mother-to-child transmission (PMTCT) cascade from HIV testing and counseling (HTC) through maternal ART provision and post-delivery early infant HIV diagnosis (EID). To these ends, we implemented the following interventions in 5 districts: 1) health worker training and mentorship; 2) couples' HTC and male partner involvement; 3) women's psychosocial support groups; and 4) health and laboratory system strengthening for EID. METHODS: We conducted a serial cross-sectional study using facility-level quarterly (Q) program data and individual-level infant HIV-1 DNA PCR data to evaluate STF performance on PMTCT indicators for project years (Y) 1 (April-December 2011) through 3 (January-December 2013), and compared these results to national averages. RESULTS: Facility-level uptake of HTC, ART, infant nevirapine prophylaxis, and infant DNA PCR testing increased significantly from quarterly baselines of 66 % (n/N = 32,433/48,804), 23 % (n/N = 442/1,958), 1 % (n/N = 10/1,958), and 52 % (n/N = 1,385/2,644) to 87 % (n/N = 39,458/45,324), 96 % (n/N = 2,046/2,121), 100 % (n/N = 2,121/2,121), and 62 % (n/N = 1,462/2,340), respectively, by project end (all p <0.001). Quarterly HTC, ART, and infant nevirapine prophylaxis uptake outperformed national averages over years 2-3. While transitioning EID laboratory services to MoH, STF provided first-time HIV-1 DNA PCR testing for 2,226 of 11,261 HIV-exposed infants (20 %) tested in the MoH EID program in STF districts from program inception (Y2) through Y3. Of these, 78 (3.5 %) tested HIV-positive. Among infants with complete documentation (n = 608), median age at first testing decreased from 112 days (interquartile range, IQR: 57-198) in Y2 to 76 days (IQR: 46-152) in Y3 (p <0.001). During Y3 (only year with national data for comparison), non-significantly fewer exposed infants tested HIV-positive (3.6 %) at first testing in STF districts than nationally (4.1 %) (p = 0.4). CONCLUSIONS: STF interventions, integrated within the MoH Option B+ program, achieved favorable HTC, maternal ART, infant prophylaxis, and EID services uptake, and a low proportion of infants found HIV-infected at first DNA PCR testing. Continued investments are needed to strengthen the PMTCT cascade, particularly around EID.

KW - 35

KW - 72

KW - AIDS

KW - Adult

KW - Africa

KW - Antiretroviral Therapy

KW - Antiretroviral therapy (ART)

KW - Breast Feeding

KW - Breastfeeding

KW - Children

KW - Cross-Sectional Studies

KW - Early Diagnosis

KW - Female

KW - HIV

KW - HIV Infections

KW - HIV Infections: drug therapy

KW - HIV Infections: transmission

KW - HIV/PMTCT

KW - Highly Active

KW - Humans

KW - Infant

KW - Infectious

KW - Infectious Disease Transmission

KW - Infectious: drug therapy

KW - Kenya

KW - Malawi

KW - Male

KW - Mobile health (m-health)

KW - Modelling

KW - Mother-to-child transmission

KW - Newborn

KW - Post-Exposure Prophylaxis

KW - Postpartum Period

KW - Pregnancy

KW - Pregnancy Complications

KW - Prenatal Care

KW - Program Evaluation

KW - Retention

KW - Vertical

KW - Vertical: prevention & control

KW - Young Adult

KW - adolescents

KW - africa

KW - aids

KW - antiretroviral therapy

KW - art

KW - awiti

KW - barriers

KW - breastfeeding

KW - children

KW - com

KW - correspondence

KW - decrease in new hiv

KW - early diagnosis and public

KW - effective

KW - exercises were conducted

KW - fi c syndr 2016

KW - gaps

KW - gmail

KW - have contributed to a

KW - health campaigns

KW - hermine

KW - hiv

KW - hiv screening

KW - implementa-

KW - implementation strategies

KW - india

KW - infections

KW - j acquir immune de

KW - kenya

KW - ki

KW - lives since fi rst

KW - m-health

KW - methods

KW - mobile health

KW - modelling

KW - more than 34 million

KW - mother-to-child transmission

KW - nguena

KW - nigeria

KW - option b þ

KW - patricia

KW - pediatric

KW - perinatal hiv infection

KW - pmtct

KW - pregnancy

KW - prophylactic treatment of hiv

KW - recognized

KW - retention

KW - s161

KW - s166

KW - se

KW - testing and counselling

KW - tion research

KW - transmission

KW - treatment

KW - two 1-hour structured group

KW - women

U2 - 10.1016/S2352-3018(16)30038-8

DO - 10.1016/S2352-3018(16)30038-8

M3 - Chapter

C2 - 27365202

SN - 0000000000000

T3 - The lancet. HIV

SP - e297-306

BT - The lancet. HIV

PB - BMC Infectious Diseases

ER -

Providing a conceptual framework for HIV prevention cascades and assessing feasibility of empirical measurement with data from east Zimbabwe: a case study.

Abstract

Publication series

Keywords

UN SDGs

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