Abstract:

Background: Studies have been done on retention in care for the general population but little is known of this phenomenon for HIV positive pregnant and breastfeeding women (PPBW). St Albert’s Mission Hospital data showed that 10% PPBW were lost to follow up. We determined retention in care in this population.

Methods: We conducted a cross sectional descriptive study using records of PPBW receiving care at the hospital from January 2016 to December 2018. We manually abstracted data from registers and from electronic records for analysis onto an Excel based abstraction sheet. We generated survival curves for the PPBW. We obtained waiver of informed consent for analysis of PPBW records.

Results: All pregnant women initiated in ART before ANC were retained up to between 25 and 30 months, where about 75% remained in care. Among those initiated during pregnancy, about 70% were no longer in care by 10 months of follow up. Retention rates were better for pregnant women initiated before ANC (p-value = 0.0272. log rank chi square test). Most breastfeeding women were still in care up to between 30 and 40 months for both who were initiated in pregnancy and before ANC for their current pregnancy. Thereafter a small drop in retention rates for those initiated on ART during pregnancy is noted (log rank chi square test p-value= 0.2183). Women initiated before ANC and those initiated during had generally the same retention rates.

Conclusion: Retention in care is high among PPBW but lower if ART initiation was due to the current pregnancy.

Keywords: retention in care, pregnant, breastfeeding, survival rate.

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