The Wise Infant study: impact of a maternal prevention of mother-to-child transmission of HIV (PMTCT) intervention on infant outcomes in Uganda
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BACKGROUND: The Wise Mama (WM) study was a randomized trial to assess the effectiveness of real-time electronic drug monitoring (EDM) on antiretroviral therapy (ART) adherence for prevention of mother-to-child transmission of HIV (PMTCT) for newly diagnosed, ART-naive HIV+ pregnant women in Uganda. Intervention mothers received real-time ART reminders via EDM technology and control mothers received standard of care. All infants born to women in the WM study were to receive standard PMTCT care: 6 weeks of nevirapine (NVP) ART prophylaxis following birth and HIV DNA testing at 6 weeks of life. OBJECTIVE: To test whether infants born to intervention mothers would have improved adherence to infant PMTCT guidelines. Methods: Information on delivery, infant NVP prophylaxis, and timing to first infant HIV test were abstracted from medical registers. Descriptive statistics and differences in 1) infant prophylaxis administration, and 2) time to infant HIV testing were generated and analyzed. RESULTS: Of the 121 WM women eligible for WIN, 97 consented and enrolled (80%). There were no differences in receipt of 6-week NVP supply (86.7% of control infants, 82.0% of intervention infants, p=0.53). Infants delivered at non-study health facilities were less likely to receive any NVP prophylaxis. There was no difference in mean days to infant's first HIV test (control 51.9, intervention 51.3, p=0.86). CONCLUSION: There were no significant differences in infant adherence to PMTCT guidelines between intervention and control groups, though all infants could have had improved access to NVP prophylaxis and decreased time to first HIV test.