Provision of services and care for HIV-exposed infants: A comparison of maternal and child health clinic and HIV comprehensive care clinic models

John Odero Ong'ech, Heather J. Hoffman, Judith Kose, Michael Audo, Lucy Matu, Peter Savosnick, Laura Guay

Research output: Contribution to journalArticle

Abstract

Objective: Prevention of Mother-to-Child Transmission of HIV programs require follow-up of HIV-exposed infants (HEI) for infant feeding support, prophylactic medicines, and HIV diagnosis for at least 18 months. Retention in care and receipt of HIV services are challenging in resource-limited settings. This study compared infant follow-up results when HEI services were provided within Maternal and Child Health (MCH) clinics or in specialized HIV Comprehensive Care Clinics (CCCs) in Kenya. Methods: This observational prospective cohort study enrolled HEI at 6-8 weeks of age in 2 purposively selected hospitals with similar characteristics but different models of service delivery. In the CCC model, HEI received immunization and growth monitoring in MCH but cotrimoxazole prophylaxis and infant HIV testing in the CCC. In the MCH model, all services were provided in the MCH. Data were collected at enrollment, 14 weeks, and 6, 9, and 12 months. Results: From April 2008 to April 2009, 184 HEI were enrolled in the CCC cohort and 179 in the MCH cohort. Infants in MCH were 1.14, 1.42, 1.95, and 1.29 times more likely to attend 14-week, 6-, 9-, and 12-month postnatal visits, respectively, and 2.24 times (95% confidence interval: 1.57 to 3.18) more likely to attend all 4 visits. Although infants in MCH were 1.33 times (95% confidence interval: 1.10 to 1.62) more likely to have HIV antibody testing at 1 year than CCC, there were no differences for polymerase chain reaction test or cotrimoxazole initiation at 6-8 weeks. Conclusions: HIV services integrated in MCH yield better follow-up of HEI than CCC.

Original languageEnglish (US)
Pages (from-to)83-89
Number of pages7
JournalJournal of Acquired Immune Deficiency Syndromes
Volume61
Issue number1
DOIs
StatePublished - Sep 1 2012
Externally publishedYes

Fingerprint

HIV
Sulfamethoxazole Drug Combination Trimethoprim
Maternal Health
Child Health
Confidence Intervals
Infant Care
HIV Antibodies
Kenya
Immunization
Cohort Studies
Mothers
Prospective Studies
Polymerase Chain Reaction
Growth

Keywords

  • HIV care and treatment
  • HIV-exposed infants
  • Kenya
  • MCH
  • PMTCT
  • service delivery models

ASJC Scopus subject areas

  • Infectious Diseases
  • Pharmacology (medical)

Cite this

Provision of services and care for HIV-exposed infants : A comparison of maternal and child health clinic and HIV comprehensive care clinic models. / Ong'ech, John Odero; Hoffman, Heather J.; Kose, Judith; Audo, Michael; Matu, Lucy; Savosnick, Peter; Guay, Laura.

In: Journal of Acquired Immune Deficiency Syndromes, Vol. 61, No. 1, 01.09.2012, p. 83-89.

Research output: Contribution to journalArticle

Ong'ech, John Odero ; Hoffman, Heather J. ; Kose, Judith ; Audo, Michael ; Matu, Lucy ; Savosnick, Peter ; Guay, Laura. / Provision of services and care for HIV-exposed infants : A comparison of maternal and child health clinic and HIV comprehensive care clinic models. In: Journal of Acquired Immune Deficiency Syndromes. 2012 ; Vol. 61, No. 1. pp. 83-89.
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