Factors associated with HIV viral load control in the early postpartum period – a Canadian prospective cohort study

Bibliographic Data

ID19438918
AuthorsNadège Zanré (Université de Montréal), Sabrina Carvalho (0000-0001-7645-0292, Université de Montréal), Chelsea Elwood (0000-0003-2196-1348, University of British Columbia), Hélène C F Côté (0000-0002-0399-5141, Women’s Health Research Institute, BC Women’s Hospital & Health Centre, Vancouver, BC, Canada), Fatima Kakkar (0000-0001-7408-4399, Mother and Children Infectious Disease Center, Centre Hospitalier Universitaire Sainte-Justine, University of Montreal, Montreal, QC, Canada), Manuel Boucher (0000-0003-1835-7342, Université de Montréal), Marc Boucher (Centre Hospitalier Universitaire Sainte-Justine), Deborah Money (0000-0003-4411-7473, University of British Columbia), Isabelle Boucoiran (0000-0001-9545-6024, Université de Montréal, corresponding author), for the CARMA-PREG Study Team
Year2024
Volume36
Issue9
Pages1272-1279
Publication date2024-09-01
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueAIDS Care (JOURNAL)
Journal identifiersISSN: 0954-0121 • E-ISSN: 1360-0451
PublisherInforma UK Limited (PUBLISHER • GB)
DOI10.1080/09540121.2024.2325082
PMID38500011
OpenAlexW4392966120
LanguageEN
References cited19

Despite success in managing HIV during pregnancy, challenges remain around sustained adherence with antiretroviral therapy (ART), and the suboptimal viral load (VL) suppression during the postpartum period. The objective of this study was to compare VL levels at delivery and during the postpartum period and assess factors associated with lack of viral suppression during the postpartum period in Canada. We combined data from two Canadian prospective cohorts, which included 286 HIV-positive women (352 pregnancies) who delivered between 2012 and 2020. Delivery VL, postpartum VL, and potential factors associated with an undetectable VL (<50 copies/mL), 2–18 weeks after delivery were assessed. To account for the correlation between multiple pregnancies from the same woman, generalized estimating equations were used to assess bivariate associations. Ninety-nine per cent of pregnant women were on ART during pregnancy compared to 93% during the postpartum period. Of those with available VL results (n = 214 pregnancies), 94% of women achieved an undetectable VL at delivery compared to 87% during the postpartum period. The postpartum period is a challenging time for ART use and VL control. Qualitative studies are needed to better understand these challenges and guide us in designing adequate interventions

Antiretroviral therapy · Cohort · Cohort study · Gynecology · Obstetrics · Postpartum period · Pregnancy · Prospective cohort study · Psychological intervention · Viral load · Adolescent Sexual and Reproductive Health · HIV, Drug Use, Sexual Risk · HIV/AIDS Research and Interventions · Medicine · Nursing · Immunology · Internal Medicine