Good practices for retention in the circuit of prevention of Mother-Child Transmission of HIV in Sub-Saharan Africa: a systematic review of the literature.

Abstract

This review assesses the effectiveness of interventions to improve Prevention of Mother-to-Child Transmission (PMTCT) retention and adherence to treatment in Sub-Saharan Africa since the adoption of Option B +. PubMed, Cochrane, African Index Medicus and the graey literature were used to select articles that used as endpoints whose judgement criteria were retention in the PMTCT circuit and compliance with antiretroviral ARV treatment. Only studies with a comparison group published in or after from 2013 were eligible. Fourteen studies meeting the eligibility criteria were included. Nine studies have a high or moderate level of GRADE evidence. Six studies assessing retention in the PMTCT circuit showed significantly betterhigher outcomes for the intervention group: peer support (n = 1), couple screening (n = 1), text message use (n = 1), financial transfer (n = 1) and integration of maternal and child health services (n = 2). Integration of maternal and child health services, peer support within the community, involvement of male partners, and the use of mobile health techniques can improve PMTCT indicators.