PLoS ONE (Jan 2012)

Integrating prevention of mother-to-child HIV transmission programs to improve uptake: a systematic review.

  • Lorainne Tudor Car,
  • Michelle H M M T Van Velthoven,
  • Serena Brusamento,
  • Hoda Elmoniry,
  • Josip Car,
  • Azeem Majeed,
  • Peter Tugwell,
  • Vivian Welch,
  • Ana Marusic,
  • Rifat Atun

DOI
https://doi.org/10.1371/journal.pone.0035268
Journal volume & issue
Vol. 7, no. 4
p. e35268

Abstract

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BackgroundWe performed a systematic review to assess the effect of integrated perinatal prevention of mother-to-child transmission of HIV interventions compared to non- or partially integrated services on the uptake in low- and middle-income countries.MethodsWe searched for experimental, quasi-experimental and controlled observational studies in any language from 21 databases and grey literature sources.ResultsOut of 28 654 citations retrieved, five studies met our inclusion criteria. A cluster randomized controlled trial reported higher probability of nevirapine uptake at the labor wards implementing HIV testing and structured nevirapine adherence assessment (RRR 1.37, bootstrapped 95% CI, 1.04-1.77). A stepped wedge design study showed marked improvement in antiretroviral therapy (ART) enrolment (44.4% versus 25.3%, pConclusionLimited, non-generalizable evidence supports the effectiveness of integrated PMTCT programs. More research measuring coverage and other relevant outcomes is urgently needed to inform the design of services delivering PMTCT programs.