Integration of Antiretroviral Therapy Services into Antenatal Care Increases Treatment Initiation during Pregnancy: A Cohort Study

摘要: Objectives Initiation of antiretroviral therapy (ART) during pregnancy is critical to promote maternal health and prevent mother-to-child HIV transmission (PMTCT). The separation services for antenatal care (ANC) ART may hinder initiation. We evaluated initiation under different service delivery models in Cape Town, South Africa. Methods A retrospective cohort study was conducted using routinely collected clinic data. Three were ‘integrated’ into ANC, located ‘proximal’ some distance away from ANC (‘distal’). Kaplan-Meier methods Poisson regression used examine the association between model initiation. Results Among 14 617 women seeking three services, 30% HIV-infected 17% eligible based on CD4 cell count <200 cells/µL. A higher proportion started antenatally integrated compared proximal or distal (55% vs 38% 45%, respectively, global p = 0.003). After adjusting age gestation at first visit, who significantly more likely initiate (rate ratio 1.33; 95% confidence interval: 1.09–1.64) attending model; there no difference however (p 0.704). Conclusions Integration associated with levels pregnancy. This other forms integration represent a valuable intervention enhance PMTCT health.