{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,11]],"date-time":"2026-07-11T04:16:31Z","timestamp":1783743391965,"version":"3.55.0"},"reference-count":51,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2018,6,14]],"date-time":"2018-06-14T00:00:00Z","timestamp":1528934400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Tropical Med Int Health"],"published-print":{"date-parts":[[2018,7]]},"abstract":"Summary<\/jats:title>Objective<\/jats:title>To evaluate mother and infant outcomes in the largest prevention of mother\u2010to\u2010child\u2010transmission (PMTCT<\/jats:styled-content>) programme in Haiti in order to identify gaps towards elimination of HIV<\/jats:styled-content> and syphilis.<\/jats:p><\/jats:sec>Methods<\/jats:title>Based on retrospective data from HIV<\/jats:styled-content>+ pregnant women and their infants enrolled in PMTCT<\/jats:styled-content> care from 1999 to 2014, we assessed maternal enrolment in PMTCT<\/jats:styled-content>, receipt of antiretrovirals before delivery, maternal retention through delivery as well as infant enrolment in PMTCT<\/jats:styled-content>, HIV<\/jats:styled-content> testing and HIV<\/jats:styled-content> infection. Four PMTCT<\/jats:styled-content> programme periods were compared: period 1 (1999\u20132004, mono ARV<\/jats:styled-content>), period 2 (2005\u20132009, dual ARV<\/jats:styled-content>), period 3 (2010\u20132012, Option B) and period 4 (Oct 2012\u20132014, Option B+). Kaplan\u2013Meier methods were used to assess retention in PMTCT<\/jats:styled-content> care.<\/jats:p><\/jats:sec>Results<\/jats:title>Among 4665 pregnancies, median age was 27\u00a0years and median CD<\/jats:styled-content>4+ was 494 cells\/\u03bcl (IQR<\/jats:styled-content> 328\u2013691). A total of 75% of women received antiretrovirals before delivery, and 73% were retained in care through delivery. Twenty\u2010two percent of women were lost before delivery, <1% died and 6% had stillbirths or abortions. Ninety\u2010four percent of infants who were born alive enrolled in PMTCT<\/jats:styled-content>, of whom 92% had complete HIV<\/jats:styled-content> testing. One hundred and sixty\u2010one infants were HIV<\/jats:styled-content>+, giving a 5.4% HIV<\/jats:styled-content> transmission rate (9.8%, 4.6%, 5.8% and 3.6% in periods 1\u20134). Retention among women through 12\u00a0months after PMTCT<\/jats:styled-content> enrolment did not significantly differ across periods. However, among women who received antiretrovirals at the time of enrolment, retention 12\u00a0months later was lower in the Option B+ period (83%) than in periods 2 and 3 (94% and 93%) (P<\/jats:italic>\u00a0<\u00a00.001). Syphilis infection among women decreased from 16% in period 1 to 8% in period 4, whereas syphilis testing of infants increased from 17% to 91%.<\/jats:p><\/jats:sec>Conclusion<\/jats:title>Despite dramatic reductions in MTCT<\/jats:styled-content> in Haiti, interventions are needed to improve retention to achieve MTCT<\/jats:styled-content> elimination of HIV<\/jats:styled-content> and syphilis.<\/jats:p><\/jats:sec>","DOI":"10.1111\/tmi.13075","type":"journal-article","created":{"date-parts":[[2018,5,20]],"date-time":"2018-05-20T01:17:12Z","timestamp":1526779032000},"page":"724-737","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Fifteen years of HIV and syphilis outcomes among a prevention of mother\u2010to\u2010child transmission program in Haiti: from monotherapy to Option B+"],"prefix":"10.1111","volume":"23","author":[{"given":"Marie Marcelle","family":"Deschamps","sequence":"first","affiliation":[{"name":"Haitian Group for the Study of Kaposi's Sarcoma and Opportunistic Infections (GHESKIO) Port au Prince Haiti"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deanna","family":"Jannat\u2010Khah","sequence":"additional","affiliation":[{"name":"Division of General Internal Medicine Weill Cornell Medicine New York NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vanessa","family":"Rouzier","sequence":"additional","affiliation":[{"name":"Haitian Group for the Study of Kaposi's Sarcoma and Opportunistic Infections (GHESKIO) Port au Prince Haiti"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jerry","family":"Bonhomme","sequence":"additional","affiliation":[{"name":"Haitian Group for the Study of Kaposi's Sarcoma and Opportunistic Infections (GHESKIO) Port au Prince Haiti"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julma","family":"Pierrot","sequence":"additional","affiliation":[{"name":"Haitian Group for the Study of Kaposi's Sarcoma and Opportunistic Infections (GHESKIO) Port au Prince Haiti"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Myung Hee","family":"Lee","sequence":"additional","affiliation":[{"name":"Center for Global Health Weill Cornell Medicine New York NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elaine","family":"Abrams","sequence":"additional","affiliation":[{"name":"ICAP and Department of Epidemiology Mailman School of Public Health Columbia University New York NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean","family":"Pape","sequence":"additional","affiliation":[{"name":"Haitian Group for the Study of Kaposi's Sarcoma and Opportunistic Infections (GHESKIO) Port au Prince Haiti"},{"name":"Center for Global Health Weill Cornell Medicine New York NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margaret L.","family":"McNairy","sequence":"additional","affiliation":[{"name":"Division of General Internal Medicine Weill Cornell Medicine New York NY USA"},{"name":"Center for Global Health Weill Cornell Medicine New York NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,6,14]]},"reference":[{"key":"e_1_2_6_2_1","unstructured":"UNAIDS.UNAIDS Fact Sheet November 2017 Global HIV Statistics 2017. 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