Slow Acceptance of Universal Antiretroviral Therapy (ART) Among Mothers Enrolled in IMPAACT PROMISE Studies Across the Globe.
Lynda Stranix-ChibandaS BrummelJ PilottoM MutambanengweV ChanaiwaT MhembereM KamateekaJ AizireG MashetoR ChamangaM MaluwaS HanleyE JoaoG TheronN NevrekarM NyatiB SantosL AurpibulM Mubiana-MbeweR OliveiraT AnekthananonP MlayK AngelidouC TierneyL ZiembaA ColettiK McCarthyM BasarN ChakhtouraR BrowningJ CurrierM G FowlerP Flynnnull nullPublished in: AIDS and behavior (2019)
The PROMISE trial enrolled asymptomatic HIV-infected pregnant and postpartum women not eligible for antiretroviral treatment (ART) per local guidelines and randomly assigned proven antiretroviral strategies to assess relative efficacy for perinatal prevention plus maternal/infant safety and maternal health. The START study subsequently demonstrated clear benefit in initiating ART regardless of CD4 count. Active PROMISE participants were informed of results and women not receiving ART were strongly recommended to immediately initiate treatment to optimize their own health. We recorded their decision and the primary reason given for accepting or rejecting the universal ART offer after receiving the START information. One-third of participants did not initiate ART after the initial session, wanting more time to consider. Six sessions were required to attain 95% uptake. The slow uptake of universal ART highlights the need to prepare individuals and sensitize communities regarding the personal and population benefits of the "Treat All" strategy.
Keyphrases
- hiv infected
- antiretroviral therapy
- human immunodeficiency virus
- hiv infected patients
- hiv positive
- hiv aids
- healthcare
- pregnancy outcomes
- public health
- pregnant women
- polycystic ovary syndrome
- big data
- clinical trial
- machine learning
- health information
- mental health
- body mass index
- randomized controlled trial
- adipose tissue
- type diabetes
- climate change
- working memory
- physical activity
- combination therapy
- insulin resistance
- social media
- skeletal muscle
- birth weight
- metabolic syndrome
- transcranial direct current stimulation
- cervical cancer screening
- decision making
- smoking cessation
- open label
- replacement therapy
- phase iii
- peripheral blood
- breast cancer risk