Skip to main content

Advertisement

SpringerLink
Log in

Implementation Research for the Prevention of Mother-to-Child HIV Transmission in Sub-Saharan Africa: Existing Evidence, Current Gaps, and New Opportunities

  • The Global Epidemic (SH Vermund, Section Editor)
  • Published:
Current HIV/AIDS Reports Aims and scope Submit manuscript

Abstract

Tremendous gains have been made in the prevention of mother-to-child HIV transmission (PMTCT) in sub-Saharan Africa. Ambitious goals for the “virtual elimination” of pediatric HIV appear increasingly feasible, driven by new scientific advances, forward-thinking health policy, and substantial donor investment. To fulfill this promise, however, rapid and effective implementation of evidence-based practices must be brought to scale across a diversity of settings. The discipline of implementation research can facilitate this translation from policy into practice; however, to date, its core principles and frameworks have been inconsistently applied in the field. We reviewed the recent developments in implementation research across each of the four “prongs” of a comprehensive PMTCT approach. While significant progress continues to be made, a greater emphasis on context, fidelity, and scalability—in the design and dissemination of study results—would greatly enhance current efforts and provide the necessary foundation for future evidence-based programs.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. Chi BH, Stringer JS, Moodley D. Antiretroviral drug regimens to prevent mother-to-child transmission of HIV: A Review of Scientific, Program, and Policy Advances for Sub-Saharan Africa. Curr HIV/AIDS Rep. 2013;10:124–33.

  2. World Health Organization. Consolidated guidelines on the use of antiretroviral drugs for treating and preventing HIV infection: recommendations for a public health approach. http://www.who.int/hiv/pub/guidelines/arv2013/download/en/index.html. Accessed March 8, 2015.

  3. Chi BH, Adler MR, Bolu O, Mbori-Ngacha D, Ekouevi DK, Gieselman A, et al. Progress, challenges, and new opportunities for the prevention of mother-to-child transmission of HIV under the US President's Emergency Plan for AIDS Relief. J Acquir Immune Defic Syndr. 2012;60 Suppl 3:S78–87.

    Article  PubMed  Google Scholar 

  4. Joint United Nations Programme on HIV/AIDS. 2014 progress report on the global plan towards the elimination of new HIV infections among children by 2015 and keeping their mothers alive. http://www.unaids.org/sites/default/files/media_asset/JC2385_ProgressReportGlobalPlan_en_0.pdf. Accessed March 7, 2015.

  5. Woolf SH, Johnson RE. Inattention to the fidelity of health care delivery is costing lives. Am J Public Health. 2007;97:1732–3. author reply 1733.

    Article  PubMed Central  PubMed  Google Scholar 

  6. Leroy JL, Habicht JP, Pelto G, Bertozzi SM. Current priorities in health research funding and lack of impact on the number of child deaths per year. Am J Public Health. 2007;97:219–23.

    Article  PubMed Central  PubMed  Google Scholar 

  7. Schackman BR. Implementation science for the prevention and treatment of HIV/AIDS. J Acquir Immune Defic Syndr. 2010;55 Suppl 1:S27–31.

    Article  PubMed Central  PubMed  Google Scholar 

  8. Glasgow RE, Eckstein ET, Elzarrad MK. Implementation science perspectives and opportunities for HIV/AIDS research: integrating science, practice, and policy. J Acquir Immune Defic Syndr. 2013;63 Suppl 1:S26–31.

    Article  PubMed  Google Scholar 

  9. Padian NS, Holmes CB, McCoy SI, Lyerla R, Bouey PD, Goosby EP. Implementation science for the US President's Emergency Plan for AIDS Relief (PEPFAR). J Acquir Immune Defic Syndr. 2011;56:199–203.

    Article  PubMed  Google Scholar 

  10. Rabin BA, Brownson RC, Haire-Joshu D, Kreuter MW, Weaver NL. A glossary for dissemination and implementation research in health. J Public Health Manag Pract. 2008;14:117–23.

    Article  PubMed  Google Scholar 

  11. Glasgow RE, Vinson C, Chambers D, Khoury MJ, Kaplan RM, Hunter C. National Institutes of Health approaches to dissemination and implementation science: current and future directions. Am J Public Health. 2012;102:1274–81. This paper outlines a conceptual framework for dissemination and implementation science, reviews the terminology used within the discipline, and describes core values that should underpin future work in the field.

    Article  PubMed Central  PubMed  Google Scholar 

  12. Peters DH, Tran NT, Adam T. Implementation research in health: a practical guide. Geneva: WHO Press; 2013.

    Google Scholar 

  13. Vermund SH, Hayes RJ. Combination prevention: new hope for stopping the epidemic. Curr HIV/AIDS Rep. 2013;10:169–86.

    Article  PubMed Central  PubMed  Google Scholar 

  14. Brown JL, Sales JM, DiClemente RJ. Combination HIV prevention interventions: the potential of integrated behavioral and biomedical approaches. Curr HIV/AIDS Rep. 2014;11:363–75.

    Article  PubMed  Google Scholar 

  15. Roxby AC, Unger JA, Slyker JA, Kinuthia J, Lewis A, John-Stewart G, et al. A lifecycle approach to HIV prevention in African women and children. Curr HIV/AIDS Rep. 2014;11:119–27.

    Article  PubMed  Google Scholar 

  16. Drake AL, Wagner A, Richardson B, John-Stewart G. Incident HIV during pregnancy and postpartum and risk of mother-to-child HIV transmission: a systematic review and meta-analysis. PLoS Med. 2014;11:e1001608. This paper reviews the emerging literature about HIV acquisition during pregnancy and breastfeeding and, through a meta-analysis, provides pooled estimates for HIV incidence over these at-risk periods.

    Article  PubMed Central  PubMed  Google Scholar 

  17. Mugo NR, Hong T, Celum C, Donnell D, Bukusi EA, John-Stewart G, et al. Pregnancy incidence and outcomes among women receiving preexposure prophylaxis for HIV prevention: a randomized clinical trial. JAMA. 2014;312:362–71.

    Article  PubMed  Google Scholar 

  18. Ralph LJ, McCoy SI, Shiu K, Padian NS. Hormonal contraceptive use and women’s risk of HIV acquisition: a meta-analysis of observational studies. Lancet Infect Dis. 2015;14:181–9.

  19. Morrison CS, Chen PL, Kwok C, Baeten JM, Brown J, Crook AM, et al. Hormonal contraception and the risk of HIV acquisition: an individual participant data meta-analysis. PLoS Med. 2015;12:e1001778.

    Article  PubMed Central  PubMed  Google Scholar 

  20. Colvin CJ, Harrison A. Broadening the debate over HIV and hormonal contraception. Lancet Infect Dis. 2015;15:135–6.

  21. McCoy SI, Ralph LJ, Padian NS, Minnis AM. Are hormonal contraceptive users more likely to misreport unprotected sex? Evidence from a biomarker validation study in Zimbabwe. AIDS Behav. 2014;18:2259–64.

    Article  PubMed  Google Scholar 

  22. Rees H. The Echo Consortium. DMPA and HIV: why we need a trial. Contraception. 2014;90:354–6.

    Article  Google Scholar 

  23. Ramirez-Avila L, Nixon K, Noubary F, Giddy J, Losina E, Walensky RP, et al. Routine HIV testing in adolescents and young adults presenting to an outpatient clinic in Durban, South Africa. PLoS One. 2012;7:e45507.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  24. Nkala B, Khunwane M, Dietrich J, Otwombe K, Sekoane I, Sonqishe B, et al. Kganya Motsha Adolescent Centre: a model for adolescent friendly HIV management and reproductive health for adolescents in Soweto, South Africa. AIDS Care. 2015;27:697–702.

  25. Stanton B, Wang B, Deveaux L, Lunn S, Rolle G, Li X, et al. Assessing the effects of a complementary parent intervention and prior exposure to a preadolescent program of HIV risk reduction for mid-adolescents. Am J Public Health. 2015;105:575–83.

    Article  PubMed Central  PubMed  Google Scholar 

  26. Pettifor A, Nguyen NL, Celum C, Cowan FM, Go V, Hightow-Weidman L. Tailored combination prevention packages and PrEP for young key populations. J Int AIDS Soc. 2015;18:19434.

    Article  PubMed Central  PubMed  Google Scholar 

  27. Dellar RC, Dlamini S, Karim QA. Adolescent girls and young women: key populations for HIV epidemic control. J Int AIDS Soc. 2015;18:19408.

    Article  PubMed Central  PubMed  Google Scholar 

  28. Santelli JS, Edelstein ZR, Wei Y, Mathur S, Song X, Schuyler A, et al. Trends in HIV acquisition, risk factors and prevention policies among youth in Uganda, 1999-2011. AIDS. 2015;29:211–9.

    Article  PubMed  Google Scholar 

  29. Dunbar MS, Kang Dufour MS, Lambdin B, Mudekunye-Mahaka I, Nhamo D, Padian NS. The SHAZ! project: results from a pilot randomized trial of a structural intervention to prevent HIV among adolescent women in Zimbabwe. PLoS One. 2014;9:e113621.

    Article  PubMed Central  PubMed  Google Scholar 

  30. Sarnquist CC, Rahangdale L, Maldonado Y. Reproductive health and family planning needs among HIV-infected women in Sub-Saharan Africa. Curr HIV Res. 2013;11:160–8.

    Article  CAS  PubMed  Google Scholar 

  31. Khu NH, Vwalika B, Karita E, Kilembe W, Bayingana RA, Sitrin D, et al. Fertility goal-based counseling increases contraceptive implant and IUD use in HIV-discordant couples in Rwanda and Zambia. Contraception. 2013;88:74–82.

    Article  PubMed Central  PubMed  Google Scholar 

  32. Wall KM, Vwalika B, Haddad L, Khu NH, Vwalika C, Kilembe W, et al. Impact of long-term contraceptive promotion on incident pregnancy: a randomized controlled trial among HIV-positive couples in Lusaka, Zambia. J Acquir Immune Defic Syndr. 2013;63:86–95.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  33. Imbuki K, Todd CS, Stibich MA, Shaffer DN, Sinei SK. Factors influencing contraceptive choice and discontinuation among HIV-positive women in Kericho, Kenya. Afr J Reprod Health. 2010;14:98–109.

    PubMed  Google Scholar 

  34. Laryea DO, Amoako YA, Spangenberg K, Frimpong E, Kyei-Ansong J. Contraceptive use and unmet need for family planning among HIV positive women on antiretroviral therapy in Kumasi, Ghana. BMC Womens Health. 2014;14:126.

    Article  PubMed Central  PubMed  Google Scholar 

  35. Haddad L, Wall KM, Vwalika B, Khu NH, Brill I, Kilembe W, et al. Contraceptive discontinuation and switching among couples receiving integrated HIV and family planning services in Lusaka, Zambia. AIDS. 2013;27 Suppl 1:S93–103.

    Article  PubMed Central  PubMed  Google Scholar 

  36. Patel R, Baum S, Grossman D, Steinfeld R, Onono M, Cohen C, et al. HIV-positive men's experiences with integrated family planning and HIV services in western Kenya: integration fosters male involvement. AIDS Patient Care STDS. 2014;28:418–24.

    Article  PubMed  Google Scholar 

  37. Raifman J, Chetty T, Tanser F, Mutevedzi T, Matthews P, Herbst K, et al. Preventing unintended pregnancy and HIV transmission: effects of the HIV treatment cascade on contraceptive use and choice in rural KwaZulu-Natal. J Acquir Immune Defic Syndr. 2014;67 Suppl 4:S218–227.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  38. Grossman D, Onono M, Newmann SJ, Blat C, Bukusi EA, Shade SB, et al. Integration of family planning services into HIV care and treatment in Kenya: a cluster-randomized trial. AIDS. 2013;27 Suppl 1:S77–85.

    Article  PubMed  Google Scholar 

  39. Malarcher S, Meirik O, Lebetkin E, Shah I, Spieler J, Stanback J. Provision of DMPA by community health workers: what the evidence shows. Contraception. 2011;83:495–503.

    Article  PubMed  Google Scholar 

  40. Malangu N. The future of community pharmacy practice in South Africa in the light of the proposed new qualification for pharmacists: implications and challenges. Glob J Health Sci. 2014;6:226–33.

    PubMed  Google Scholar 

  41. Schouten EJ, Jahn A, Midiani D, Makombe SD, Mnthambala A, Chirwa Z, et al. Prevention of mother-to-child transmission of HIV and the health-related Millennium Development Goals: time for a public health approach. Lancet. 2011;378:282–4.

    Article  PubMed  Google Scholar 

  42. Kieffer MP, Mattingly M, Giphart A, van de Ven R, Chouraya C, Walakira M, et al. Lessons learned from early implementation of option B+: the Elizabeth Glaser Pediatric AIDS Foundation experience in 11 African countries. J Acquir Immune Defic Syndr. 2014;67 Suppl 4:S188–194.

    Article  PubMed Central  PubMed  Google Scholar 

  43. Ahmed S, Kim MH, Abrams EJ. Risks and benefits of lifelong antiretroviral treatment for pregnant and breastfeeding women: a review of the evidence for the Option B+ approach. Curr Opin HIV AIDS. 2013;8:473–88.

    Article  CAS  Google Scholar 

  44. Ngarina M, Tarimo EA, Naburi H, Kilewo C, Mwanyika-Sando M, Chalamilla G, et al. Women’s preferences regarding infant or maternal antiretroviral prophylaxis for prevention of mother-to-child transmission of HIV during breastfeeding and their views on Option B+ in Dar es Salaam, Tanzania. PLoS One. 2014;9:e85310.

    Article  PubMed Central  PubMed  Google Scholar 

  45. Kim MH, Ahmed S, Kazembe PN, Hosseinipour M, Giordano TP, Chiao EY, et al. Impact of Option B+ on uptake, retention, and transmission: a pre/post study in Lilongwe, Malawi [Abstract 883]. 2014 Conference on Retroviruses and Opportunistic Infections. 2014.

  46. Tweya H, Gugsa S, Hosseinipour M, Speight C, Ng'ambi W, Bokosi M, et al. Understanding factors, outcomes and reasons for loss to follow-up among women in Option B+ PMTCT programme in Lilongwe, Malawi. Trop Med Int Health. 2014;19:1360–6.

  47. Dryden-Peterson S, Lockman S, Zash R, Lei Q, Chen JY, Souda S, et al. Initial programmatic implementation of WHO Option B in Botswana associated with increased projected MTCT. J Acquir Immune Defic Syndr. 2015;68:245–9.

    Article  PubMed  Google Scholar 

  48. Gourlay A, Birdthistle I, Mburu G, Iorpenda K, Wringe A. Barriers and facilitating factors to the uptake of antiretroviral drugs for prevention of mother-to-child transmission of HIV in sub-Saharan Africa: a systematic review. J Int AIDS Soc. 2013;16:18588. This systematic review synthesizes the existing medial literature around uptake, initiation, and adherence to PMTCT services in African settings.

    Article  PubMed Central  PubMed  Google Scholar 

  49. Kohler PK, Ondenge K, Mills LA, Okanda J, Kinuthia J, Olilo G, et al. Shame, guilt, and stress: community perceptions of barriers to engaging in prevention of mother to child transmission (PMTCT) programs in western Kenya. AIDS Patient Care STDS. 2014;28:643–51.

    Article  PubMed  Google Scholar 

  50. Gourlay A, Wringe A, Birdthistle I, Mshana G, Michael D, Urassa M. "It is like that, we didn't understand each other": exploring the influence of patient-provider interactions on prevention of mother-to-child transmission of HIV service use in rural Tanzania. PLoS One. 2014;9:e106325.

    Article  PubMed Central  PubMed  Google Scholar 

  51. Stringer EM, Chi BH, Chintu N, Creek TL, Ekouevi DK, Coetzee D, et al. Monitoring effectiveness of programmes to prevent mother-to-child HIV transmission in lower-income countries. Bull World Health Organ. 2008;86:57–62.

    Article  PubMed Central  PubMed  Google Scholar 

  52. Heemelaar S, Habets N, Makukula Z, van Roosmalen J, van den Akker T. Repeat HIV testing during pregnancy and delivery: missed opportunities in a rural district hospital in Zambia. Trop Med Int Health. 2015;20:277–83.

    Article  PubMed  Google Scholar 

  53. Technau KG, Kalk E, Coovadia A, Black V, Pickerill S, Mellins CA, et al. Timing of maternal HIV testing and uptake of prevention of mother-to-child transmission interventions among women and their infected infants in Johannesburg, South Africa. J Acquir Immune Defic Syndr. 2014;65:e170–178.

    Article  PubMed Central  PubMed  Google Scholar 

  54. Osoti AO, John-Stewart G, Kiarie J, Richardson B, Kinuthia J, Krakowiak D, et al. Home visits during pregnancy enhance male partner HIV counselling and testing in Kenya: a randomized clinical trial. AIDS. 2014;28:95–103. This randomized study evaluated a home-based strategy for HIV counseling and testing as a means to increase male partner engagement and mutual disclosure of HIV status.

    Article  PubMed Central  PubMed  Google Scholar 

  55. Tomlinson M, Doherty T, Ijumba P, Jackson D, Lawn J, Persson LA, et al. Goodstart: a cluster randomised effectiveness trial of an integrated, community-based package for maternal and newborn care, with prevention of mother-to-child transmission of HIV in a South African township. Trop Med Int Health. 2014;19:256–66.

    Article  PubMed  Google Scholar 

  56. Ezeanolue EE, Obiefune MC, Yang W, Obaro SK, Ezeanolue CO, Ogedegbe GG. Comparative effectiveness of congregation- versus clinic-based approach to prevention of mother-to-child HIV transmission: study protocol for a cluster randomized controlled trial. Implement Sci. 2013;8:62.

    Article  PubMed Central  PubMed  Google Scholar 

  57. Hamela G, Kabondo C, Tembo T, Zimba C, Kamanga E, Mofolo I, et al. Evaluating the benefits of incorporating traditional birth attendants in HIV prevention of mother to child transmission service delivery in Lilongwe, Malawi. Afr J Reprod Health. 2014;18:27–34.

    PubMed  Google Scholar 

  58. Audet CM, Salato J, Blevins M, Amsalem D, Vermund SH, Gaspar F. Educational intervention increased referrals to allopathic care by traditional healers in three high HIV-prevalence rural districts in Mozambique. PLoS One. 2013;8:e70326.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  59. Stinson K, van Zyl D, Mdebuka H, Zeelie JP, Boateng M, Colvin CJ, et al. Lay health worker support to strengthen PMTCT: a randomised controlled trial in South Africa [Abstract 886]. 2014 Conference on Retroviruses and Opportunistic Infections. 2014.

  60. Stringer EM, Ekouevi DK, Coetzee D, Tih PM, Creek TL, Stinson K, et al. Coverage of nevirapine-based services to prevent mother-to-child HIV transmission in 4 African countries. JAMA. 2010;304:293–302.

    Article  CAS  PubMed  Google Scholar 

  61. Stringer JS, Stinson K, Tih PM, Giganti MJ, Ekouevi DK, Creek TL, et al. Measuring coverage in MNCH: population HIV-free survival among children under two years of age in four African countries. PLoS Med. 2013;10:e1001424.

    Article  PubMed Central  PubMed  Google Scholar 

  62. Goga AE, Dinh TH, Jackson DJ, Lombard C, Delaney KP, Puren A, et al. First population-level effectiveness evaluation of a national programme to prevent HIV transmission from mother to child, South Africa. J Epidemiol Community Health. 2015;69:240–8.

    Article  PubMed Central  PubMed  Google Scholar 

  63. Gimbel S, Voss J, Mercer MA, Zierler B, Gloyd S, Coutinho Mde J, et al. The prevention of mother-to-child transmission of HIV cascade analysis tool: supporting health managers to improve facility-level service delivery. BMC Res Notes. 2014;7:743.

    Article  PubMed Central  PubMed  Google Scholar 

  64. Bhardwaj S, Barron P, Pillay Y, Treger-Slavin L, Robinson P, Goga A, et al. Elimination of mother-to-child transmission of HIV in South Africa: rapid scale-up using quality improvement. S Afr Med J. 2014;104:239–43.

    Article  CAS  PubMed  Google Scholar 

  65. Mate KS, Ngubane G, Barker PM. A quality improvement model for the rapid scale-up of a program to prevent mother-to-child HIV transmission in South Africa. Int J Qual Health Care. 2013;25:373–80.

    Article  PubMed  Google Scholar 

  66. Sherr K, Gimbel S, Rustagi A, Nduati R, Cuembelo F, Farquhar C, et al. Systems analysis and improvement to optimize pMTCT (SAIA): a cluster randomized trial. Implement Sci. 2014;9:55.

    Article  PubMed Central  PubMed  Google Scholar 

  67. Tenthani L, Haas AD, Tweya H, Jahn A, van Oosterhout JJ, Chimbwandira F, et al. Retention in care under universal antiretroviral therapy for HIV-infected pregnant and breastfeeding women ('Option B + ') in Malawi. AIDS. 2014;28:589–98.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  68. Phillips T, Thebus E, Bekker LG, McIntyre J, Abrams EJ, Myer L. Disengagement of HIV-positive pregnant and postpartum women from antiretroviral therapy services: a cohort study. J Int AIDS Soc. 2014;17:19242.

    Article  PubMed Central  PubMed  Google Scholar 

  69. Clouse K, Schwartz S, Van Rie A, Bassett J, Yende N, Pettifor A. "What they wanted was to give birth; nothing else": barriers to retention in option B+ HIV care among postpartum women in South Africa. J Acquir Immune Defic Syndr. 2014;67:e12–18.

    Article  PubMed  Google Scholar 

  70. Myer L, Phillips T, Zerbe A, Hsiao M, McIntyre J, Abrams E. Detectable viremia among pregnant women on antiretroviral therapy initiating antenatal care [Abstract 874]. 2014 Conference on Retroviruses and Opportunistic Infections. 2014.

  71. van Lettow M, Bedell R, Mayuni I, Mateyu G, Landes M, Chan AK, et al. Towards elimination of mother-to-child transmission of HIV: performance of different models of care for initiating lifelong antiretroviral therapy for pregnant women in Malawi (Option B+). J Int AIDS Soc. 2014;17:18994. This novel study compared different models of service delivery across key indicators of PMTCT site performance.

    PubMed Central  PubMed  Google Scholar 

  72. Govindasamy D, Meghij J, Kebede Negussi E, Clare Baggaley R, Ford N, Kranzer K. Interventions to improve or facilitate linkage to or retention in pre-ART (HIV) care and initiation of ART in low- and middle-income settings—a systematic review. J Int AIDS Soc. 2014;17:19032.

    Article  PubMed Central  PubMed  Google Scholar 

  73. Rollins N, Chanza H, Chimbwandira F, Eliya M, Nyasulu I, Thom E, et al. Prioritizing the PMTCT implementation research agenda in 3 African countries: INtegrating and Scaling up PMTCT through Implementation REsearch (INSPIRE). J Acquir Immune Defic Syndr. 2014;67 Suppl 2:S108–113.

    Article  PubMed  Google Scholar 

  74. Sturke R, Harmston C, Simonds RJ, Mofenson LM, Siberry GK, Watts DH, et al. A multi-disciplinary approach to implementation science: the NIH-PEPFAR PMTCT implementation science alliance. J Acquir Immune Defic Syndr. 2014;67 Suppl 2:S163–167.

    Article  PubMed  Google Scholar 

  75. Violari A, Cotton MF, Gibb DM, Babiker AG, Steyn J, Madhi SA, et al. Early antiretroviral therapy and mortality among HIV-infected infants. N Engl J Med. 2008;359:2233–44.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  76. Ciaranello AL, Park JE, Ramirez-Avila L, Freedberg KA, Walensky RP, Leroy V. Early infant HIV-1 diagnosis programs in resource-limited settings: opportunities for improved outcomes and more cost-effective interventions. BMC Med. 2011;9:59.

    Article  PubMed Central  PubMed  Google Scholar 

  77. Sutcliffe CG, van Dijk JH, Hamangaba F, Mayani F, Moss WJ. Turnaround time for early infant HIV diagnosis in rural Zambia: a chart review. PLoS One. 2014;9:e87028.

    Article  PubMed Central  PubMed  Google Scholar 

  78. Mugambi ML, Deo S, Kekitiinwa A, Kiyaga C, Singer ME. Do diagnosis delays impact receipt of test results? Evidence from the HIV early infant diagnosis program in Uganda. PLoS One. 2013;8:e78891.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  79. Preidis GA, McCollum ED, Kamiyango W, Garbino A, Hosseinipour MC, Kazembe PN, et al. Routine inpatient provider-initiated HIV testing in Malawi, compared with client-initiated community-based testing, identifies younger children at higher risk of early mortality. J Acquir Immune Defic Syndr. 2013;63:e16–22.

    Article  PubMed Central  PubMed  Google Scholar 

  80. McCollum ED, Johnson DC, Chasela CS, Siwande LD, Kazembe PN, Olson D, et al. Superior uptake and outcomes of early infant diagnosis of HIV services at an immunization clinic versus an "under-five" general pediatric clinic in Malawi. J Acquir Immune Defic Syndr. 2012;60:e107–110.

    Article  PubMed Central  PubMed  Google Scholar 

  81. Seidenberg P, Nicholson S, Schaefer M, Semrau K, Bweupe M, Masese N, et al. Early infant diagnosis of HIV infection in Zambia through mobile phone texting of blood test results. Bull World Health Organ. 2012;90:348–56.

    Article  PubMed Central  PubMed  Google Scholar 

  82. Jani IV, Meggi B, Mabunda N, Vubil A, Sitoe NE, Tobaiwa O, et al. Accurate early infant HIV diagnosis in primary health clinics using a point-of-care nucleic acid test. J Acquir Immune Defic Syndr. 2014;67:e1–4.

    Article  CAS  PubMed  Google Scholar 

  83. Reid SD, Fidler SJ, Cooke GS. Tracking the progress of HIV: the impact of point-of-care tests on antiretroviral therapy. Clin Epidemiol. 2013;5:387–96.

    Article  PubMed Central  PubMed  Google Scholar 

  84. Sibanda EL, Weller IV, Hakim JG, Cowan FM. The magnitude of loss to follow-up of HIV-exposed infants along the prevention of mother-to-child HIV transmission continuum of care: a systematic review and meta-analysis. AIDS. 2013;27:2787–97.

    Article  PubMed Central  PubMed  Google Scholar 

  85. Hsiao NY, Stinson K, Myer L. Linkage of HIV-infected infants from diagnosis to antiretroviral therapy services across the Western Cape, South Africa. PLoS One. 2013;8:e55308.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  86. Scarsi KK, Darin KM, Nakalema S, Back D, Byakika-Kibwika P, Else L, et al. Levonorgestrel implant + EFV-based ART: unintended pregnancies and associated PK data [Abstract 85LB]. 2015 Conference on Retroviruses and Opportunistic Infections. 2015.

  87. Fowler MG, Qin M, Fiscus SA, Currier JS, Makanani B, Martinson F, et al. PROMISE: efficacy and safety of 2 strategies to prevent perinatal HIV transmission [Abstract 31LB]. 2015 Conference on Retroviruses and Opportunistic Infections. 2015.

  88. Van Damme L, Corneli A, Ahmed K, Agot K, Lombaard J, Kapiga S, et al. Preexposure prophylaxis for HIV infection among African women. N Engl J Med. 2012;367:411–22.

    Article  PubMed Central  PubMed  Google Scholar 

  89. Marrazzo JM, Ramjee G, Richardson BA, Gomez K, Mgodi N, Nair G, et al. Tenofovir-based preexposure prophylaxis for HIV infection among African women. N Engl J Med. 2015;372:509–18.

    Article  CAS  PubMed  Google Scholar 

  90. Rees H, Delany-Moretlwe SA, Lombard C, Baron D, Panchia R, Myer L, et al. FACTS 001 Phase III trial of pericoital tenofovir 1 % gel for HIV prevention in women [Abstract 26LB]. 2015 Conference on Retroviruses and Opportunistic Infections. 2015.

  91. van der Straten A, Stadler J, Montgomery E, Hartmann M, Magazi B, Mathebula F, et al. Women's experiences with oral and vaginal pre-exposure prophylaxis: the VOICE-C qualitative study in Johannesburg, South Africa. PLoS One. 2014;9:e89118. This ancillary study to the VOICE trial provides key insights about women’s experience with pre-exposure prophylaxis (both oral and vaginal) along a socio-ecological framework.

    Article  PubMed Central  PubMed  Google Scholar 

  92. Nyondo AL, Choko AT, Chimwaza AF, Muula AS. Invitation cards during pregnancy enhance male partner involvement in prevention of mother to child transmission (PMTCT) of human immunodeficiency virus (HIV) in Blantyre, Malawi: a randomized controlled open label trial. PLoS One. 2015;10:e0119273.

    Article  PubMed Central  PubMed  Google Scholar 

  93. Edwards N, Barker PM. The importance of context in implementation research. J Acquir Immune Defic Syndr. 2014;67 Suppl 2:S157–162.

    Article  PubMed  Google Scholar 

  94. Woolf SH, Johnson RE. The break-even point: when medical advances are less important than improving the fidelity with which they are delivered. Ann Fam Med. 2005;3:545–52.

    Article  PubMed Central  PubMed  Google Scholar 

  95. Basch CE, Sliepcevich EM, Gold RS, Duncan DF, Kolbe LJ. Avoiding type III errors in health education program evaluations: a case study. Health Educ Q. 1985;12:315–31.

    Article  CAS  PubMed  Google Scholar 

  96. Proctor EK, Powell BJ, McMillen JC. Implementation strategies: recommendations for specifying and reporting. Implement Sci. 2013;8:139.

    Article  PubMed Central  PubMed  Google Scholar 

  97. Powell BJ, McMillen JC, Proctor EK, Carpenter CR, Griffey RT, Bunger AC, et al. A compilation of strategies for implementing clinical innovations in health and mental health. Med Care Res Rev. 2012;69:123–57.

    Article  PubMed Central  PubMed  Google Scholar 

  98. Wiltsey Stirman S, Kimberly J, Cook N, Calloway A, Castro F, Charns M. The sustainability of new programs and innovations: a review of the empirical literature and recommendations for future research. Implement Sci. 2012;7:17.

    Article  PubMed Central  PubMed  Google Scholar 

Download references

Acknowledgments

This work was funded in part by the Eunice Kennedy Shriver National Institute of Child Health and Human Development (R01 HD075131). Trainee support was provided by the Doris Duke Charitable Foundation Clinical Research Mentorship Program.

Compliance with Ethics Guidelines

ᅟ

Conflict of Interest

Sanjana Bhardwaj, Bryan Carter, Gregory A. Aarons, and Benjamin H. Chi declare that they have no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

Author information

Authors and Affiliations

  1. UNICEF, Pretoria, South Africa

    Sanjana Bhardwaj

  2. Icahn School of Medicine at Mount Sinai, New York, NY, USA

    Bryan Carter

  3. Department of Psychiatry, University of California - San Diego, La Jolla, CA, USA

    Gregory A. Aarons

  4. Department of Obstetrics and Gynecology, University of North Carolina at Chapel Hill, Campus Box 7577, 3004 Old Clinic Building, Chapel Hill, NC, 27590, USA

    Benjamin H. Chi

Authors
  1. Sanjana Bhardwaj
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Bryan Carter
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Gregory A. Aarons
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Benjamin H. Chi
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Benjamin H. Chi.

Additional information

This article is part of the Topical Collection on The Global Epidemic

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Bhardwaj, S., Carter, B., Aarons, G.A. et al. Implementation Research for the Prevention of Mother-to-Child HIV Transmission in Sub-Saharan Africa: Existing Evidence, Current Gaps, and New Opportunities. Curr HIV/AIDS Rep 12, 246–255 (2015). https://doi.org/10.1007/s11904-015-0260-1

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11904-015-0260-1

Keywords

Search

Navigation