Factors associated with viral load suppression in pregnant and postpartum women living with HIV in Rwanda: an open-observational cohort study
IntroductionAchieving and maintaining HIV viral load suppression (VLS) in pregnant and postpartum women living with HIV (WLWH) is critical for their health and to prevent mother-to-child transmission. However, data on VLS in this population are limited. This study aimed to evaluate the prevalence an...
Saved in:
| Main Authors: | , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2025-04-01
|
| Series: | Frontiers in Public Health |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fpubh.2025.1544165/full |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850186053401444352 |
|---|---|
| author | Athanase Munyaneza Hae-Young Kim Qiuhu Shi Ellen Brazier Jonathan Ross Benjamin Muhoza Faustin Kanyabwisha Gallican Kubwimana Gad Murenzi Denis Nash Kathryn Anastos Marcel Yotebieng |
| author_facet | Athanase Munyaneza Hae-Young Kim Qiuhu Shi Ellen Brazier Jonathan Ross Benjamin Muhoza Faustin Kanyabwisha Gallican Kubwimana Gad Murenzi Denis Nash Kathryn Anastos Marcel Yotebieng |
| author_sort | Athanase Munyaneza |
| collection | DOAJ |
| description | IntroductionAchieving and maintaining HIV viral load suppression (VLS) in pregnant and postpartum women living with HIV (WLWH) is critical for their health and to prevent mother-to-child transmission. However, data on VLS in this population are limited. This study aimed to evaluate the prevalence and factors associated with VLS among pregnant and postpartum WLWH in Rwanda within 12 months of enrolling in antenatal care.MethodsAn open observational cohort study was conducted using routine clinical data from 10 Rwandan HIV clinics in Kigali City. Data from WLWH on ART who became pregnant and were referred to PMTCT services between 2012 and 2020 were analyzed. The primary outcomes were the proportion of WLWH achieving VLS (viral load (VL) <1,000 or <200 copies/mL) within 12 months of antenatal registration. Logistic regression models assessed associations of VLS with socio-demographic and clinical characteristics.ResultsAmong 1,002 WLWH, 532 (53%) had documented VL results. The mean age was 30.4 years, with 60% aged 25–34 years. Most (83.7%) were primigravida, and 67% initiated ART before pregnancy. At antenatal care enrollment, 58% had a CD4 count ≥500 cells/uL. Within 12 months, 92% had VL <1,000 copies/mL and 87% had a VL <200 copies/mL. Advanced HIV disease (WHO stage 3 and 4) and lower CD4 counts were associated with lower odds of VLS.ConclusionAmong those with a recorded VL results, nine out of 10 had a VLS, particularly those without advanced HIV disease. The findings underscore the need for targeted interventions for WLWH with advanced HIV entering antenatal care. |
| format | Article |
| id | doaj-art-037c09df0d814ae79cb4f0136a1f7bf5 |
| institution | OA Journals |
| issn | 2296-2565 |
| language | English |
| publishDate | 2025-04-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Public Health |
| spelling | doaj-art-037c09df0d814ae79cb4f0136a1f7bf52025-08-20T02:16:29ZengFrontiers Media S.A.Frontiers in Public Health2296-25652025-04-011310.3389/fpubh.2025.15441651544165Factors associated with viral load suppression in pregnant and postpartum women living with HIV in Rwanda: an open-observational cohort studyAthanase Munyaneza0Hae-Young Kim1Qiuhu Shi2Ellen Brazier3Jonathan Ross4Benjamin Muhoza5Faustin Kanyabwisha6Gallican Kubwimana7Gad Murenzi8Denis Nash9Kathryn Anastos10Marcel Yotebieng11Research for Development (RD Rwanda), Kigali, RwandaInstitutional Centers for Clinical and Translational Research, Boston Children's Hospital, Boston, MA, United StatesDepartment of Public Health, New York Medical College, Valhalla, NY, United StatesInstitute for Implementation Science in Population Health, City University of New York, Graduate School of Public Health and Health Policy, New York, NY, United StatesDivision of General Internal Medicine, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, NY, United StatesResearch for Development (RD Rwanda), Kigali, RwandaResearch for Development (RD Rwanda), Kigali, RwandaResearch for Development (RD Rwanda), Kigali, RwandaResearch for Development (RD Rwanda), Kigali, RwandaInstitute for Implementation Science in Population Health, City University of New York, Graduate School of Public Health and Health Policy, New York, NY, United StatesDivision of General Internal Medicine, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, NY, United StatesDivision of General Internal Medicine, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, NY, United StatesIntroductionAchieving and maintaining HIV viral load suppression (VLS) in pregnant and postpartum women living with HIV (WLWH) is critical for their health and to prevent mother-to-child transmission. However, data on VLS in this population are limited. This study aimed to evaluate the prevalence and factors associated with VLS among pregnant and postpartum WLWH in Rwanda within 12 months of enrolling in antenatal care.MethodsAn open observational cohort study was conducted using routine clinical data from 10 Rwandan HIV clinics in Kigali City. Data from WLWH on ART who became pregnant and were referred to PMTCT services between 2012 and 2020 were analyzed. The primary outcomes were the proportion of WLWH achieving VLS (viral load (VL) <1,000 or <200 copies/mL) within 12 months of antenatal registration. Logistic regression models assessed associations of VLS with socio-demographic and clinical characteristics.ResultsAmong 1,002 WLWH, 532 (53%) had documented VL results. The mean age was 30.4 years, with 60% aged 25–34 years. Most (83.7%) were primigravida, and 67% initiated ART before pregnancy. At antenatal care enrollment, 58% had a CD4 count ≥500 cells/uL. Within 12 months, 92% had VL <1,000 copies/mL and 87% had a VL <200 copies/mL. Advanced HIV disease (WHO stage 3 and 4) and lower CD4 counts were associated with lower odds of VLS.ConclusionAmong those with a recorded VL results, nine out of 10 had a VLS, particularly those without advanced HIV disease. The findings underscore the need for targeted interventions for WLWH with advanced HIV entering antenatal care.https://www.frontiersin.org/articles/10.3389/fpubh.2025.1544165/fullpregnant and postpartum womenHIVviral load suppressionIeDEAKigaliRwanda |
| spellingShingle | Athanase Munyaneza Hae-Young Kim Qiuhu Shi Ellen Brazier Jonathan Ross Benjamin Muhoza Faustin Kanyabwisha Gallican Kubwimana Gad Murenzi Denis Nash Kathryn Anastos Marcel Yotebieng Factors associated with viral load suppression in pregnant and postpartum women living with HIV in Rwanda: an open-observational cohort study Frontiers in Public Health pregnant and postpartum women HIV viral load suppression IeDEA Kigali Rwanda |
| title | Factors associated with viral load suppression in pregnant and postpartum women living with HIV in Rwanda: an open-observational cohort study |
| title_full | Factors associated with viral load suppression in pregnant and postpartum women living with HIV in Rwanda: an open-observational cohort study |
| title_fullStr | Factors associated with viral load suppression in pregnant and postpartum women living with HIV in Rwanda: an open-observational cohort study |
| title_full_unstemmed | Factors associated with viral load suppression in pregnant and postpartum women living with HIV in Rwanda: an open-observational cohort study |
| title_short | Factors associated with viral load suppression in pregnant and postpartum women living with HIV in Rwanda: an open-observational cohort study |
| title_sort | factors associated with viral load suppression in pregnant and postpartum women living with hiv in rwanda an open observational cohort study |
| topic | pregnant and postpartum women HIV viral load suppression IeDEA Kigali Rwanda |
| url | https://www.frontiersin.org/articles/10.3389/fpubh.2025.1544165/full |
| work_keys_str_mv | AT athanasemunyaneza factorsassociatedwithviralloadsuppressioninpregnantandpostpartumwomenlivingwithhivinrwandaanopenobservationalcohortstudy AT haeyoungkim factorsassociatedwithviralloadsuppressioninpregnantandpostpartumwomenlivingwithhivinrwandaanopenobservationalcohortstudy AT qiuhushi factorsassociatedwithviralloadsuppressioninpregnantandpostpartumwomenlivingwithhivinrwandaanopenobservationalcohortstudy AT ellenbrazier factorsassociatedwithviralloadsuppressioninpregnantandpostpartumwomenlivingwithhivinrwandaanopenobservationalcohortstudy AT jonathanross factorsassociatedwithviralloadsuppressioninpregnantandpostpartumwomenlivingwithhivinrwandaanopenobservationalcohortstudy AT benjaminmuhoza factorsassociatedwithviralloadsuppressioninpregnantandpostpartumwomenlivingwithhivinrwandaanopenobservationalcohortstudy AT faustinkanyabwisha factorsassociatedwithviralloadsuppressioninpregnantandpostpartumwomenlivingwithhivinrwandaanopenobservationalcohortstudy AT gallicankubwimana factorsassociatedwithviralloadsuppressioninpregnantandpostpartumwomenlivingwithhivinrwandaanopenobservationalcohortstudy AT gadmurenzi factorsassociatedwithviralloadsuppressioninpregnantandpostpartumwomenlivingwithhivinrwandaanopenobservationalcohortstudy AT denisnash factorsassociatedwithviralloadsuppressioninpregnantandpostpartumwomenlivingwithhivinrwandaanopenobservationalcohortstudy AT kathrynanastos factorsassociatedwithviralloadsuppressioninpregnantandpostpartumwomenlivingwithhivinrwandaanopenobservationalcohortstudy AT marcelyotebieng factorsassociatedwithviralloadsuppressioninpregnantandpostpartumwomenlivingwithhivinrwandaanopenobservationalcohortstudy |