Retention and viral suppression of newly diagnosed and known HIV positive pregnant women on Option B+ in Western Kenya

AIDS Care. 2019 Mar;31(3):333-339. doi: 10.1080/09540121.2018.1524565. Epub 2018 Sep 27.


Kenya introduced universal antiretroviral treatment (ART) for pregnant and breastfeeding women living with HIV (Option B+) in 2014. A retrospective study was conducted to review consecutive records for HIV positive pregnant women presenting for antenatal care (ANC) at five clinics in western Kenya. Known positive women (KP :HIV diagnosis prior to current pregnancy) were compared to newly positive (NP) women regarding virologic suppression and retention in care. Among 165 women included, 71 (43%) NP and 94 (57%) KP, NP were younger (24.5 years (SD 4.6) vs. 28.1 years (SD 5.6) compared to KP (p < .001). Almost all NP (97%) were initiated on Option B+ while over half of KP (59%) started ART for clinical/immunological criteria (p < .0001). KPs were more likely than NPs to have a VL performed following Kenyan guidelines (64% vs. 31%; p < .001). Among those tested, virologic suppression was high in both groups (92% KP vs. 100% NP; p = .31). More KPs (82%) vs. NPs (66%) remained active in care at 15-18 months of follow-up (p = .02). Women newly diagnosed with HIV during pregnancy show poorer uptake of VL testing and worse retention in care than those diagnosed prior to pregnancy.

Keywords: HIV; Women; retention; routine viral load monitoring; vertical transmission.

Publication types

  • Research Support, U.S. Gov't, Non-P.H.S.
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Anti-HIV Agents / therapeutic use*
  • Anti-Retroviral Agents / therapeutic use
  • Female
  • HIV Infections / diagnosis
  • HIV Infections / drug therapy*
  • HIV Infections / transmission*
  • Humans
  • Infectious Disease Transmission, Vertical / prevention & control*
  • Kenya
  • Medication Adherence / statistics & numerical data*
  • Pregnancy
  • Pregnancy Complications, Infectious / diagnosis
  • Pregnancy Complications, Infectious / drug therapy
  • Prenatal Care
  • Retrospective Studies
  • Sustained Virologic Response*
  • Viral Load
  • Young Adult


  • Anti-HIV Agents
  • Anti-Retroviral Agents