Prevalence and risk factors of unsuppressed viral load among pregnant and breastfeeding women in sub-Saharan Africa: analysis from population-based surveys

Leah Schrubbe*, Heidi Stoeckl, Abigail Hatcher, Milly Marston, Salome Kuchukhidze, Clara Calvert

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract / Description of output

Objective: To examine the prevalence of viral suppression and risk factors for unsuppressed viral load among pregnant and breastfeeding women living with HIV (WLH).

Design: Pooled analysis among pregnant and breastfeeding WLH from Population-Based HIV Impact Assessment (PHIA) cross-sectional surveys from 10 sub-Saharan African countries.

Methods: Questionnaires included sociodemographic, relationship-related, and HIV-related items, while blood tests examined HIV serostatus and viral load (data collected 2015-2018). The weighted prevalence of viral suppression was calculated. Logistic regression was used to examine risk factors for unsuppressed viral load (≥1000 copies/mL).

Results: Of 1685 pregnant or breastfeeding WLH with viral load results, 63.8% (95% CI:60.8-66.7%) were virally suppressed at the study visit. Among all included women, adolescence (aOR: 4.85, 95% CI:2.58-9.14, p
Conclusion: Viral suppression among pregnant and breastfeeding WLH in sub-Saharan Africa remains suboptimal. Relationship dynamics around non-disclosure of HIV-positive status to partners was an important risk factor for unsuppressed viral load. Improving HIV care via sensitive discussions around partner dynamics in pregnant and breastfeeding women could improve maternal HIV outcomes and prevention of mother-to-child transmission of HIV (PMTCT).
Original languageEnglish
JournalAIDS
Early online date12 Dec 2022
DOIs
Publication statusE-pub ahead of print - 12 Dec 2022

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