Department of Pediatrics, University of California San Francisco, San Francisco, CA, United States; Family AIDS Care and Education Services (FACES), Research, Care and Training Program, Kenya Medical Research Institute, Kisumu, Kenya; U.S. Centers for Disease Control and Prevention, Division of Global HIV/AIDS, Nairobi, Kenya; Obstetrics, Gynecology and Reproductive Sciences, University of California San Francisco, San Francisco, CA, United States
Dillabaugh, L.L., Department of Pediatrics, University of California San Francisco, San Francisco, CA, United States, Family AIDS Care and Education Services (FACES), Research, Care and Training Program, Kenya Medical Research Institute, Kisumu, Kenya; Lewis Kulzer, J., Family AIDS Care and Education Services (FACES), Research, Care and Training Program, Kenya Medical Research Institute, Kisumu, Kenya; Owuor, K., Family AIDS Care and Education Services (FACES), Research, Care and Training Program, Kenya Medical Research Institute, Kisumu, Kenya; Ndege, V., Family AIDS Care and Education Services (FACES), Research, Care and Training Program, Kenya Medical Research Institute, Kisumu, Kenya; Oyanga, A., Family AIDS Care and Education Services (FACES), Research, Care and Training Program, Kenya Medical Research Institute, Kisumu, Kenya; Ngugi, E., U.S. Centers for Disease Control and Prevention, Division of Global HIV/AIDS, Nairobi, Kenya; Shade, S.B., Family AIDS Care and Education Services (FACES), Research, Care and Training Program, Kenya Medical Research Institute, Kisumu, Kenya; Bukusi, E., Family AIDS Care and Education Services (FACES), Research, Care and Training Program, Kenya Medical Research Institute, Kisumu, Kenya, Obstetrics, Gynecology and Reproductive Sciences, University of California San Francisco, San Francisco, CA, United States; Cohen, C.R., Family AIDS Care and Education Services (FACES), Research, Care and Training Program, Kenya Medical Research Institute, Kisumu, Kenya, Obstetrics, Gynecology and Reproductive Sciences, University of California San Francisco, San Francisco, CA, United States
Many HIV-positive pregnant women and infants are still not receiving optimal services, preventing the goal of eliminating mother-to-child transmission (MTCT) and improving maternal child health overall. A Rapid Results Initiative (RRI) approach was utilized to address key challenges in delivery of prevention of MTCT (PMTCT) services including highly active antiretroviral therapy (HAART) uptake for women and infants. The RRI was conducted between April and June 2011 at 119 health facilities in five districts in Nyanza Province, Kenya. Aggregated site-level data were compared at baseline before the RRI (Oct 2010-Jan 2011), during the RRI, and post-RRI (Jul-Sep 2011) using pre-post cohort analysis. HAART uptake amongst all HIV-positive pregnant women increased by 40% (RR 1.4, 95% CI 1.2-1.7) and continued to improve post-RRI (RR 1.6, 95% CI 1.4-1.8). HAART uptake in HIV-positive infants remained stable (RR 1.1, 95% CI 0.9-1.4) during the RRI and improved by 30% (RR 1.3, 95% CI 1.0-1.6) post-RRI. Significant improvement in PMTCT services can be achieved through introduction of an RRI, which appears to lead to sustained benefits for pregnant HIV-infected women and their infants. © 2012 Lisa L. Dillabaugh et al.