title: Improving retention in the early infant diagnosis of HIV program in rural Mozambique by better service integration.
abstract: Low mother/infant retention has impeded early infant diagnosis of HIV in rural Mozambique. We enhanced the referral process for postpartum HIV-infected women by offering direct accompaniment to the location of exposed infant testing before discharge. Retrospective record review for 395 women/infants (September 2009 to June 2010) found enhanced referral was associated with higher odds of follow-up (adjusted odds ratio = 3.18, 95% confidence interval: 1.76 to 5.73, P < 0.001); and among those followed-up, earlier infant testing (median follow-up: 33 days vs. 59 days, P = 0.01) compared with women receiving standard referral. This simple intervention demonstrates benefits gleaned from attention to system improvement through service integration without increasing staff.
authors.affiliation: Vanderbilt Institute for Global Health, Nashville, TN 37203, USA. philip.ciampa@vanderbilt.edu
authors.forename: Philip J
authors.initials: PJ
authors.lastname: Ciampa
authors.forename: Janeen R
authors.initials: JR
authors.lastname: Burlison
authors.forename: Meridith
authors.initials: M
authors.lastname: Blevins
authors.forename: Mohsin
authors.initials: M
authors.lastname: Sidat
authors.forename: Troy D
authors.initials: TD
authors.lastname: Moon
authors.forename: Russell L
authors.initials: RL
authors.lastname: Rothman
authors.forename: Sten H
authors.initials: SH
authors.lastname: Vermund
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use; D003695:Delivery of Health Care / Q000379:methods* / Q000458:organization & administration*; D004359:Drug Therapy, Combination; D005260:Female; D015658:HIV Infections / Q000175:diagnosis* / Q000453:epidemiology / Q000517:prevention & control*; D006801:Humans; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control*; D019259:Lamivudine / Q000008:administration & dosage / Q000627:therapeutic use; D009073:Mozambique / Q000453:epidemiology; D019829:Nevirapine / Q000008:administration & dosage / Q000627:therapeutic use; D011247:Pregnancy; D012189:Retrospective Studies; D012424:Rural Population; D055815:Young Adult; D015215:Zidovudine / Q000008:administration & dosage / Q000627:therapeutic use
chemical_list: D019380:Anti-HIV Agents; D019259:Lamivudine; D015215:Zidovudine; D019829:Nevirapine