HIV remains responsible for an estimated 40% of mortality in South African pregnant women and their children. To address these avoidable deaths, eligibility criteria antiretroviral therapy (ART) were revised 2010 to enhance ART coverage. With greater availability services public health settings increasing government attention poor maternal-child outcomes, this study used the patient's journey through continuum maternal child care as a framework track document women's experiences accessing...

Background Increased fertility rates in HIV-infected women receiving antiretroviral therapy (ART) have been attributed to improved immunological function; it is unknown what extent the rise pregnancy due unintended pregnancies. Methods Non-pregnant ages 18–35 from four public-sector ART clinics Johannesburg, South Africa, were enrolled into a prospective cohort and followed August 2009–March 2011. Fertility intentions, contraception status measured longitudinally at participants' routine...

Background: Limited information exists about effects of different highly active antiretroviral therapy (HAART) regimens and duration on mother-to-child transmission (MTCT) HIV among women in Africa who start treatment for advanced immunosuppression. Methods: Between January 2004 to August 2008, 1142 were followed at antenatal clinics Johannesburg. Predictors MTCT (positive infant DNA polymerase chain reaction 4-6 weeks) assessed with multivariate logistic regression. Results: Mean age was...

We conducted a retrospective study to investigate the effectiveness of an mHealth messaging intervention aiming improve maternal health and HIV outcomes. Maternal SMSs were sent 235 HIV-infected pregnant women twice per week in pregnancy continued until infant's first birthday. The messages timed stage pregnancy/infant age covered HIV-support information. Outcomes, measured as antenatal care (ANC) visits, birth outcomes infant testing, compared control group 586 who received no SMS...

The Southern African HIV Clinicians Society published its first set of oral pre-exposure prophylaxis (PrEP) guidelines in June 2012 for men who have sex with (MSM) are at risk infection. With the flurry data that has been generated PrEP clinical research since guideline, it became evident there was a need to revise and expand new evidence safety efficacy several populations, including MSM, transgender persons, heterosexual women, HIV-serodiscordant couples people inject drugs. This is...

Ninety years ago the isolation of insulin transformed lives people with type 1 diabetes. Now, models based on empirical data estimate that a 25-year-old person HIV, when appropriately treated antiretroviral therapy, can expect to enjoy median survival 35 years, remarkably similar for someone same age It is high time we normalised living positively HIV. This includes basic human right conceive and raise children. HIV-positive individuals may be in serodiscordant relationships or...

Background: In the era of more efficacious prevention mother-to-child transmission (PMTCT) regimens, documenting profile drug resistance in HIV-infected infants and young children is critical to our efforts improve care treatment for children. Methods: HIV mutations plasma virus were ascertained using population sequencing among 230 newly diagnosed under 2 years age recruited Johannesburg, South Africa, during 2011. By this time, effective PMTCT including combination antiretroviral therapy...

Use of highly active antiretroviral therapy (HAART), a triple-drug combination, in HIV-infected pregnant women markedly reduces mother to child transmission HIV and decreases maternal morbidity. However, there remains uncertainty about the effects utero exposure HAART on foetal development.Our objectives were investigate whether is associated with low birth weight and/or preterm population South African advanced disease. A retrospective observational study was performed CD4 counts ≤250...

To assess women's experience of public antenatal care (ANC) services and reasons for late attendance in inner-city Johannesburg, South Africa. This cross-sectional study was conducted at three labour wards Johannesburg. Interviews were with 208 women who had a live-birth October 2009. Women interviewed the post-delivery about their ANC experience. Gestational age first clinic visit compared to gestational booking (ANC service provided). high (97.0 %) 46.0 % seeking before 20 weeks gestation...

In Brief OBJECTIVE: To review facility-based maternal deaths at a tertiary-level center in Johannesburg, South Africa, during 5-year period (2003 to 2007) and investigate the proportion of attributable human immunodeficiency virus (HIV), etiology deaths, effects antiretroviral treatment introduced late 2004. METHODS: Patient case files, birth registers, death certificates, mortality summaries were reviewed. Cause was assigned through clinical discussion. Annual ratios calculated...

Abstract Background There are high expectations that mobile health (mHealth) strategies will increase uptake of care services, especially in resource strained settings. Our study aimed to evaluate effects an mHealth intervention on maternal services. Methods This was cohort conducted at six public antenatal and postnatal clinics inner-city Johannesburg, South Africa. The consisted twice-weekly informative pregnancy stage-based information text messages sent women during until their child one...

To describe the safety and efficacy of highly active antiretroviral therapy (HAART) in pregnant women treated an integrated antenatal clinic (ANC ARV).A retrospective analysis was performed on patients attending ANC ARV from August 2004 through February 2007.Data were collected 689 treatment-naive initiated HAART. The mean age 29.2 years. baseline CD4 count 154 cells per microliter, HIV viral load 101,561 copies milliliter. Tuberculosis most prevalent presenting opportunistic infection...

By 2011, South African prevention of mother-to-child transmission (PMTCT) HIV programs had reduced perinatal at 6 weeks age to 2.7%. We investigated the profile newly diagnosed vertically infected children and their mothers identify shortfalls in PMTCT program.In this operational follow-up study, fieldworkers enrolled HIV-infected up 2 years 5 major health care facilities Johannesburg. Structured questionnaires clinical record reviews were conducted analyzed describe population assess...

<h3>Background</h3> Point-of-care tests provide immediate results with the opportunity for same-day interventions improved public health outcomes. A dual HIV/syphilis test enables early treatment of both diseases. <h3>Methods</h3> We conducted a field evaluation Standard Diagnostics9 SD Bioline HIV/Syphilis Duo (SD Bioline) among female sex workers. was on finger-prick blood according to manufacturer9s instructions and compared (i) Genscreen HIV1/2 (third generation) Vironostika Ag/Ab...

Adolescents living with HIV comprise a significant patient population in sub Saharan Africa but are poorly retained care consequent increased mortality and morbidity. We conducted in-depth interviews 25 adolescents engaged from five clinics Johannesburg regarding their recommendations for the healthcare system. Findings included advocating adolescent clinics, recognizing importance of clinic-based support groups, valuing influence lay counselors have providing to adolescents, improving...

For pregnancy to result in a healthy mother and infant, women require adequate nutrition be able access antenatal care, both of which finances. While most working the formal sector South Africa obtain some form maternity leave, unemployed receive no such support. Additional interventions expanded social assistance vulnerable pregnant are needed. To help inform an approach, we undertook series qualitative interviews with low-income Johannesburg.Qualitative, in-depth were held 22 at public...

Background: Safer conception strategies may be used by people living with HIV to reduce transmission partners resulting from condomless sex for conception. The extent which receive safer messages and use risk reduction is largely unknown. Methods: We prospective data a clinic-based cohort study in Johannesburg, South Africa. Women (WLWH) aged 18–35 on antiretroviral therapy (n = 831) completed baseline survey ≥1 follow-up visits assessing fertility intentions pregnancy incidence; an endline...

Background Using mobile technology to support health care (mobile [mHealth]) has been shown improve outcomes across a multitude of specialties and the world. Exploring mHealth user experiences can aid in understanding how why an intervention was successful. The Mobile Alliance for Maternal Action (MAMA) free maternal SMS text messaging service that offered pregnant women Johannesburg, South Africa, with goal improving maternal, fetal, infant outcomes. We conducted focus group discussions...

We validated rapid HIV tests among pregnant women in a clinical setting. Field testing was performed using First Response 1,2,3 or Standard Diagnostic and Pareekshak tests. Results were confirmed by third generation ELISA. Discordant negative, specimens RNA PCR fourth ELISA test. Sensitivity specificity 94.5% (CI: 85.8-98.2) 100% for Response; 87.5% 46.7-99.3) 87.7-100%) 90.2% 81.2-95.4) 98-100%) Pareekshak. These sensitivities lower than laboratory validation which approached 100%. The...

While violence against women is a recognised global health problem, women's agency in marginalised settings poorly understood, particularly relation to systems. We explored as practical and theoretical construct through qualitative research among 20 nurses with direct or indirect experiences of intimate partner (IPV) Johannesburg. Interviews conducted from August 2013 March 2014 generated rich descriptions respondents five facilities. Nurses' self-reported IPV matched national prevalence...

Antenatal care (ANC) clinics serve as key gateways to screening and treatment interventions that improve pregnancy outcomes, are especially important for HIV-infected women. By disaggregating data on access ANC, we aimed identify variation in ANC attendance by level of across vulnerable groups inner-city Johannesburg, document the impact non-attendance birth outcomes. This record review routine health service involved manual extraction 2 years from registers at a primary-, secondary-...

Fertility intentions and contraceptive use are often not assessed in the context of clinical HIV care, representing a possible programming gap if women's family planning needs change over time. We aimed to identify longitudinal patterns unmet need for contraception 12-month period among women living with taking antiretroviral therapy (ART).850 non-pregnant, HIV-positive aged 18-35 on or initiating ART Johannesburg, South Africa, were enrolled into prospective cohort study 2009-2010. during...