The multi-country promote HIV antiretroviral treatment observational cohort in sub-Saharan Africa: Objectives, design, and baseline findings

Taha E Taha, Nonhlanhla Yende-Zuma, Jim Aizire, Tsungai Chipato, Lillian Wambuzi Ogwang, Bonus Makanani, Lameck Chinula, Mandisa M. Nyati, Sherika Hanley, Sean S. Brummel, Mary Glenn Fowler

Research output: Contribution to journalArticle

Abstract

Background The PROMOTE study aims to measure long-term antiretroviral treatment (ART) safety and adherence; compare HIV disease progression; assess subsequent adverse pregnancy outcomes; evaluate effect of ART exposure on growth and development in HIV-exposed uninfected children; and assess long-term survival of mothers and children. This report primarily describes cohort characteristics at baseline to better understand long-term outcomes. Methods and findings This is a prospective study. HIV-infected mothers and their children originally recruited in a multisite randomized clinical trial for prevention of perinatal HIV transmission were re-enrolled in PROMOTE. A total of 1987 mothers and 1784 children were enrolled from eight sites in Uganda, Malawi, Zimbabwe and South Africa. Most women (75%) reported being married in Malawi and Zimbabwe compared to low proportions in South Africa (4.4% in Durban and 15% in Soweto), and 43.5% in Uganda (p<0.001). There were variabilities in contraceptive practices: injectable contraceptive was the commonest reported method (40.9% overall); implant was the second commonest (15.7% overall); oral contraceptives were common in Zimbabwe; and tubal ligation was common in Malawi and South Africa. At baseline, 97.8% of women reported currently using ART; 96.4% were in WHO clinical class 1 or 2; median CD4 cell count was 825 cells per uL; and viral load was undetectable in 1637 (~85%) of the women. Approximately, 14% of women did not inform their primary partners of their own HIV status, 18% reported that they knew their partners were not HIV tested, and 9% did not know if partner was tested. Overall mean age of children at enrollment was 3.5 years; and 5.7% and 25.0% had weight-for-age and height-for-age z-scores <2 standard deviations, respectively. Conclusions These baseline data show high adherence to ART use. However, issues of HIV disclosure and reproductive intentions remain important. In addition to ART and ensuring high adherence, other preventive measures should be included.

Original languageEnglish (US)
Article numbere0208805
JournalPLoS One
Volume13
Issue number12
DOIs
StatePublished - Dec 1 2018

Fingerprint

Africa South of the Sahara
Sub-Saharan Africa
Contraceptive Agents
HIV
Malawi
Zimbabwe
Oral Contraceptives
contraceptives
South Africa
Uganda
Mothers
oral contraceptives
Therapeutics
prostheses
pregnancy outcome
randomized clinical trials
viral load
prospective studies
disease course
Tubal Sterilization

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)

Cite this

The multi-country promote HIV antiretroviral treatment observational cohort in sub-Saharan Africa : Objectives, design, and baseline findings. / Taha, Taha E; Yende-Zuma, Nonhlanhla; Aizire, Jim; Chipato, Tsungai; Ogwang, Lillian Wambuzi; Makanani, Bonus; Chinula, Lameck; Nyati, Mandisa M.; Hanley, Sherika; Brummel, Sean S.; Fowler, Mary Glenn.

In: PLoS One, Vol. 13, No. 12, e0208805, 01.12.2018.

Research output: Contribution to journalArticle

Taha, Taha E ; Yende-Zuma, Nonhlanhla ; Aizire, Jim ; Chipato, Tsungai ; Ogwang, Lillian Wambuzi ; Makanani, Bonus ; Chinula, Lameck ; Nyati, Mandisa M. ; Hanley, Sherika ; Brummel, Sean S. ; Fowler, Mary Glenn. / The multi-country promote HIV antiretroviral treatment observational cohort in sub-Saharan Africa : Objectives, design, and baseline findings. In: PLoS One. 2018 ; Vol. 13, No. 12.
@article{724e5c6d20284357afdf5fc1091aeb96,
title = "The multi-country promote HIV antiretroviral treatment observational cohort in sub-Saharan Africa: Objectives, design, and baseline findings",
abstract = "Background The PROMOTE study aims to measure long-term antiretroviral treatment (ART) safety and adherence; compare HIV disease progression; assess subsequent adverse pregnancy outcomes; evaluate effect of ART exposure on growth and development in HIV-exposed uninfected children; and assess long-term survival of mothers and children. This report primarily describes cohort characteristics at baseline to better understand long-term outcomes. Methods and findings This is a prospective study. HIV-infected mothers and their children originally recruited in a multisite randomized clinical trial for prevention of perinatal HIV transmission were re-enrolled in PROMOTE. A total of 1987 mothers and 1784 children were enrolled from eight sites in Uganda, Malawi, Zimbabwe and South Africa. Most women (75{\%}) reported being married in Malawi and Zimbabwe compared to low proportions in South Africa (4.4{\%} in Durban and 15{\%} in Soweto), and 43.5{\%} in Uganda (p<0.001). There were variabilities in contraceptive practices: injectable contraceptive was the commonest reported method (40.9{\%} overall); implant was the second commonest (15.7{\%} overall); oral contraceptives were common in Zimbabwe; and tubal ligation was common in Malawi and South Africa. At baseline, 97.8{\%} of women reported currently using ART; 96.4{\%} were in WHO clinical class 1 or 2; median CD4 cell count was 825 cells per uL; and viral load was undetectable in 1637 (~85{\%}) of the women. Approximately, 14{\%} of women did not inform their primary partners of their own HIV status, 18{\%} reported that they knew their partners were not HIV tested, and 9{\%} did not know if partner was tested. Overall mean age of children at enrollment was 3.5 years; and 5.7{\%} and 25.0{\%} had weight-for-age and height-for-age z-scores <2 standard deviations, respectively. Conclusions These baseline data show high adherence to ART use. However, issues of HIV disclosure and reproductive intentions remain important. In addition to ART and ensuring high adherence, other preventive measures should be included.",
author = "Taha, {Taha E} and Nonhlanhla Yende-Zuma and Jim Aizire and Tsungai Chipato and Ogwang, {Lillian Wambuzi} and Bonus Makanani and Lameck Chinula and Nyati, {Mandisa M.} and Sherika Hanley and Brummel, {Sean S.} and Fowler, {Mary Glenn}",
year = "2018",
month = "12",
day = "1",
doi = "10.1371/journal.pone.0208805",
language = "English (US)",
volume = "13",
journal = "PLoS One",
issn = "1932-6203",
publisher = "Public Library of Science",
number = "12",

}

TY - JOUR

T1 - The multi-country promote HIV antiretroviral treatment observational cohort in sub-Saharan Africa

T2 - Objectives, design, and baseline findings

AU - Taha, Taha E

AU - Yende-Zuma, Nonhlanhla

AU - Aizire, Jim

AU - Chipato, Tsungai

AU - Ogwang, Lillian Wambuzi

AU - Makanani, Bonus

AU - Chinula, Lameck

AU - Nyati, Mandisa M.

AU - Hanley, Sherika

AU - Brummel, Sean S.

AU - Fowler, Mary Glenn

PY - 2018/12/1

Y1 - 2018/12/1

N2 - Background The PROMOTE study aims to measure long-term antiretroviral treatment (ART) safety and adherence; compare HIV disease progression; assess subsequent adverse pregnancy outcomes; evaluate effect of ART exposure on growth and development in HIV-exposed uninfected children; and assess long-term survival of mothers and children. This report primarily describes cohort characteristics at baseline to better understand long-term outcomes. Methods and findings This is a prospective study. HIV-infected mothers and their children originally recruited in a multisite randomized clinical trial for prevention of perinatal HIV transmission were re-enrolled in PROMOTE. A total of 1987 mothers and 1784 children were enrolled from eight sites in Uganda, Malawi, Zimbabwe and South Africa. Most women (75%) reported being married in Malawi and Zimbabwe compared to low proportions in South Africa (4.4% in Durban and 15% in Soweto), and 43.5% in Uganda (p<0.001). There were variabilities in contraceptive practices: injectable contraceptive was the commonest reported method (40.9% overall); implant was the second commonest (15.7% overall); oral contraceptives were common in Zimbabwe; and tubal ligation was common in Malawi and South Africa. At baseline, 97.8% of women reported currently using ART; 96.4% were in WHO clinical class 1 or 2; median CD4 cell count was 825 cells per uL; and viral load was undetectable in 1637 (~85%) of the women. Approximately, 14% of women did not inform their primary partners of their own HIV status, 18% reported that they knew their partners were not HIV tested, and 9% did not know if partner was tested. Overall mean age of children at enrollment was 3.5 years; and 5.7% and 25.0% had weight-for-age and height-for-age z-scores <2 standard deviations, respectively. Conclusions These baseline data show high adherence to ART use. However, issues of HIV disclosure and reproductive intentions remain important. In addition to ART and ensuring high adherence, other preventive measures should be included.

AB - Background The PROMOTE study aims to measure long-term antiretroviral treatment (ART) safety and adherence; compare HIV disease progression; assess subsequent adverse pregnancy outcomes; evaluate effect of ART exposure on growth and development in HIV-exposed uninfected children; and assess long-term survival of mothers and children. This report primarily describes cohort characteristics at baseline to better understand long-term outcomes. Methods and findings This is a prospective study. HIV-infected mothers and their children originally recruited in a multisite randomized clinical trial for prevention of perinatal HIV transmission were re-enrolled in PROMOTE. A total of 1987 mothers and 1784 children were enrolled from eight sites in Uganda, Malawi, Zimbabwe and South Africa. Most women (75%) reported being married in Malawi and Zimbabwe compared to low proportions in South Africa (4.4% in Durban and 15% in Soweto), and 43.5% in Uganda (p<0.001). There were variabilities in contraceptive practices: injectable contraceptive was the commonest reported method (40.9% overall); implant was the second commonest (15.7% overall); oral contraceptives were common in Zimbabwe; and tubal ligation was common in Malawi and South Africa. At baseline, 97.8% of women reported currently using ART; 96.4% were in WHO clinical class 1 or 2; median CD4 cell count was 825 cells per uL; and viral load was undetectable in 1637 (~85%) of the women. Approximately, 14% of women did not inform their primary partners of their own HIV status, 18% reported that they knew their partners were not HIV tested, and 9% did not know if partner was tested. Overall mean age of children at enrollment was 3.5 years; and 5.7% and 25.0% had weight-for-age and height-for-age z-scores <2 standard deviations, respectively. Conclusions These baseline data show high adherence to ART use. However, issues of HIV disclosure and reproductive intentions remain important. In addition to ART and ensuring high adherence, other preventive measures should be included.

UR - http://www.scopus.com/inward/record.url?scp=85058490580&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85058490580&partnerID=8YFLogxK

U2 - 10.1371/journal.pone.0208805

DO - 10.1371/journal.pone.0208805

M3 - Article

C2 - 30543692

AN - SCOPUS:85058490580

VL - 13

JO - PLoS One

JF - PLoS One

SN - 1932-6203

IS - 12

M1 - e0208805

ER -