Effect of Test- and -Treat Strategy on Antiretroviral Drugs Uptake in a Prevention of Mother to Child Transmission Programme in Southwest Nigeria

Abstract

A multicenter retrospective case-control study. Study subjects were HIV positive pregnant women enrolled in a prevention of mother to child transmission of HIV(PMTCT) programme in southwest Nigeria. The objective was to see if the introduction of ‘Test- and -Treat strategy’ would lead to placing higher number of HIV-POSITIVE pregnant women on antiretroviral drugs. There was a significant difference (OR=1.4;CI=1.35-1.55,P=0.0) in the proportions of HIV-POSITIVE pregnant women initiated on ARV between the control arm(60%) and the case group(81%)with the implementation of the strategy. In other words, an HIV POSITIVE woman in a PMTCT setting has a 40% greater chance of being placed on ARV with test-and-treat strategy than without the strategy.The test- and -treat strategy is a treatment approach in which HIV positive clients are initiated on prophylactic antiretroviral drugs immediately after HIV diagnosis without waiting for the CD4 count test result. Hence, implementing Test and Treat Strategy in a PMTCT programme increases the antiretroviral drug uptake by HIV-POSITIVE women which in turn could lead to a reduced rate of vertical transmission of HIV, as a result of the suppressed maternal viral load.