title: HIV testing uptake and retention in care of HIV-infected pregnant and breastfeeding women initiated on 'Option B+' in rural Zimbabwe.
abstract: OBJECTIVE
  Zimbabwe has started to scale up Option B+ for the prevention of mother-to-child transmission of HIV, but there is little published information about uptake or retention in care. This study determined the number and proportion of pregnant and lactating women in rural districts diagnosed with HIV infection and started on Option B+ along with six-month antiretroviral treatment (ART) outcomes.
  
  
  METHODS
  This was a retrospective record review of women presenting to antenatal care or maternal and child health services at 34 health facilities in Chikomba and Gutu rural districts, Zimbabwe, between January and March 2014.
  
  
  RESULTS
  A total of 2728 women presented to care of whom 2598 were eligible for HIV testing: 76% presented to antenatal care, 20% during labour and delivery and 4% while breastfeeding. Of 2097 (81%) HIV-tested women, 7% were HIV positive. Lower HIV testing uptake was found with increasing parity, late presentation to antenatal care, health centre attendance and in women tested during labour. Ninety-one per cent of the HIV-positive women were started on Option B+. Six-month ART retention in care, including transfers, was 83%. Loss to follow-up was the main cause of attrition. Increasing age and gravida status ≥2 were associated with higher six-month attrition.
  
  
  CONCLUSIONS
  The uptake of HIV testing and Option B+ is high in women attending antenatal and post-natal clinics in rural Zimbabwe, suggesting that the strategy is feasible for national scale-up in the country.
authors.affiliation: National AIDS and Tuberculosis Unit, Ministry of Health and Child Care, Harare, Zimbabwe.
authors.forename: Janet
authors.initials: J
authors.lastname: Dzangare
authors.affiliation: National AIDS and Tuberculosis Unit, Ministry of Health and Child Care, Harare, Zimbabwe.|International Union Against Tuberculosis and Lung Disease, Paris, France.
authors.forename: Kudakwashe C
authors.initials: KC
authors.lastname: Takarinda
authors.affiliation: International Union Against Tuberculosis and Lung Disease, Paris, France.|London School of Hygiene & Tropical Medicine, London, UK.
authors.forename: Anthony D
authors.initials: AD
authors.lastname: Harries
authors.affiliation: Operational Centre Brussels, Medecins Sans Frontieres, 68 Rue de Gasperich, Luxembourg.
authors.forename: Katie
authors.initials: K
authors.lastname: Tayler-Smith
authors.affiliation: National AIDS and Tuberculosis Unit, Ministry of Health and Child Care, Harare, Zimbabwe.
authors.forename: Mutsa
authors.initials: M
authors.lastname: Mhangara
authors.affiliation: National AIDS and Tuberculosis Unit, Ministry of Health and Child Care, Harare, Zimbabwe.
authors.forename: Tsitsi Mutasa
authors.initials: TM
authors.lastname: Apollo
authors.affiliation: National AIDS and Tuberculosis Unit, Ministry of Health and Child Care, Harare, Zimbabwe.
authors.forename: Angela
authors.initials: A
authors.lastname: Mushavi
authors.affiliation: National AIDS and Tuberculosis Unit, Ministry of Health and Child Care, Harare, Zimbabwe.
authors.forename: Anesu
authors.initials: A
authors.lastname: Chimwaza
authors.affiliation: National AIDS and Tuberculosis Unit, Ministry of Health and Child Care, Harare, Zimbabwe.
authors.forename: Ngwarai
authors.initials: N
authors.lastname: Sithole
authors.affiliation: National AIDS Council, Harare, Zimbabwe.
authors.forename: Tapiwa
authors.initials: T
authors.lastname: Magure
authors.affiliation: National AIDS Council, Harare, Zimbabwe.
authors.forename: Amon
authors.initials: A
authors.lastname: Mpofu
authors.affiliation: National AIDS Council, Harare, Zimbabwe.
authors.forename: Freeman
authors.initials: F
authors.lastname: Dube
authors.affiliation: National AIDS and Tuberculosis Unit, Ministry of Health and Child Care, Harare, Zimbabwe.
authors.forename: Owen
authors.initials: O
authors.lastname: Mugurungi
mesh_terms: D000293:Adolescent; D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D001942:Breast Feeding; D005260:Female; D020073:Gravidity; D015658:HIV Infections / Q000175:diagnosis / Q000188:drug therapy; D006801:Humans; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control*; D007774:Lactation; D059012:Lost to Follow-Up; D008403:Mass Screening; D008427:Maternal Health Services; D010298:Parity; D010342:Patient Acceptance of Health Care; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000175:diagnosis / Q000188:drug therapy; D012189:Retrospective Studies; D012424:Rural Population; D055815:Young Adult; D015030:Zimbabwe
chemical_list: D019380:Anti-HIV Agents
keywords: Investigación de Operaciones; Opción B+; Operational Research; Option B+; SORT IT; Zimbabue; Zimbabwe; recherche opérationnelle