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. 2023 Nov 3;15(6):692-701.
doi: 10.1093/inthealth/ihad001.

Mobility during the post-partum period and viraemia in women living with HIV in South Africa

Jasantha Odayar  1 , Tamsin K Phillips  1 , Siti Kabanda  1 , Thokozile R Malaba  1 , Elton Mukonda  1 , Nei-Yuan Hsiao  2 , Maia Lesosky  1 , Landon Myer  1
Affiliations

Mobility during the post-partum period and viraemia in women living with HIV in South Africa

Jasantha Odayar et al. Int Health. .

Abstract

Background: We investigated the association between travel and viraemia in post-partum women with human immunodeficiency virus on antiretroviral therapy (ART).

Methods: Data are from a trial of post-partum ART delivery strategies. Women who initiated ART during pregnancy, were clinically stable with a viral load (VL) <400 copies/ml and were <10 weeks post-partum were enrolled at a primary care antenatal clinic in Cape Town, South Africa. Study visits at 3, 6, 12, 18 and 24 months post-partum included questions about travel, defined as ≥1 night spent outside of the city, and VL testing. Generalised mixed effects models assessed the association between travel and subsequent VL ≥400 copies/ml.

Results: Among 402 women (mean age 29 y, 35% born in the Western Cape), 69% reported one or more travel events over 24 months. Being born beyond the Western Cape (adjusted odds ratio [aOR] 2.03 [95% confidence interval {CI} 1.49 to 2.77]), duration post-partum in months (aOR 1.03 [95% CI 1.02 to 1.05]) and living with the child (aOR 0.60 [95% CI 0.38 to 0.93]) were associated with travel. In multivariable analyses, a travel event was associated with a 92% increase in the odds of a VL ≥400 copies/ml (aOR 1.92 [95% CI 1.19 to 3.10]).

Conclusions: Interventions to support women on ART who travel are urgently required.

Keywords: adherence; antiretroviral therapy; mobility; post-partum; travel; viral load.

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Conflict of interest statement

None declared.

Figures

Figure 1.
Figure 1.
Inclusion of visits in the analysis.
See this image and copyright information in PMC

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