{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T21:09:42Z","timestamp":1785791382044,"version":"3.56.0"},"reference-count":79,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2021,8,27]],"date-time":"2021-08-27T00:00:00Z","timestamp":1630022400000},"content-version":"vor","delay-in-days":26,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Int AIDS Soc"],"published-print":{"date-parts":[[2021,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Young pregnant and postpartum women living with HIV (WLHIV) are at high risk of poor outcomes in prevention of mother\u2010to\u2010child transmission services. The aim of this systematic review was to collate evidence on strategies to improve retention in antenatal and\/or postpartum care in this population. We also conducted a secondary review of strategies to increase attendance at antenatal care (ANC) and\/or facility delivery among pregnant adolescents, regardless of HIV status, to identify approaches that could be adapted for adolescents and young WLHIV.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Selected databases were searched on 1 December 2020, for studies published between January 2006 and November 2020, with screening and data abstraction by two independent reviewers. We identified papers that reported age\u2010disaggregated results for adolescents and young WLHIV aged &lt;25\u00a0years at the full\u2010text review stage. For the secondary search, we included studies among female adolescents aged 10 to 19\u00a0years.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results and discussion<\/jats:title><jats:p>Of 37 papers examining approaches to increase retention among pregnant and postpartum WLHIV, only two reported age\u2010disaggregated results: one showed that integrated care during the postpartum period increased retention in HIV care among women aged 18 to 24\u00a0years; and another showed that a lay counsellor\u2010led combination intervention did not reduce attrition among women aged 16 to 24\u00a0years; one further study noted that age did not modify the effectiveness of a combination intervention. Mobile health technologies, enhanced support, active follow\u2010up and tracing and integrated services were commonly examined as standalone interventions or as part of combination approaches, with mixed evidence for each strategy. Of 10 papers identified in the secondary search, adolescent\u2010focused services and continuity of care with the same provider appeared to be effective in improving attendance at ANC and\/or facility delivery, while home visits and group ANC had mixed results.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>This review highlights the lack of evidence regarding effective strategies to improve retention in antenatal and\/or postpartum care among adolescents and young WLHIV specifically, as well as a distinct lack of age\u2010disaggregated results in studies examining retention interventions for pregnant WLHIV of all ages. Identifying and prioritizing approaches to improve retention of adolescents and young WLHIV are critical for improving maternal and child health.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jia2.25770","type":"journal-article","created":{"date-parts":[[2021,8,27]],"date-time":"2021-08-27T13:47:42Z","timestamp":1630072062000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["Improving retention in antenatal and postnatal care: a systematic review of evidence to inform strategies for adolescents and young women living with HIV"],"prefix":"10.1002","volume":"24","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3940-1242","authenticated-orcid":false,"given":"Kirsty","family":"Brittain","sequence":"first","affiliation":[{"name":"Division of Epidemiology &amp; Biostatistics School of Public Health &amp; Family Medicine University of Cape Town Cape Town South Africa"},{"name":"Centre for Infectious Disease Epidemiology &amp; 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