{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T18:40:55Z","timestamp":1772217655639,"version":"3.50.1"},"reference-count":29,"publisher":"Public Library of Science (PLoS)","issue":"4","license":[{"start":{"date-parts":[[2024,4,18]],"date-time":"2024-04-18T00:00:00Z","timestamp":1713398400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000865","name":"Bill and Melinda Gates Foundation","doi-asserted-by":"publisher","award":["OPP1191327"],"award-info":[{"award-number":["OPP1191327"]}],"id":[{"id":"10.13039\/100000865","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Accurate measurement of antenatal antiretroviral treatment (ART) coverage in pregnancy is imperative in tracking progress towards elimination of vertical HIV transmission. In the Western Cape, South Africa, public-sector individual-level routine data are consolidated from multiple sources, enabling the description of temporal changes in population-wide antenatal antiretroviral coverage. We evaluated the validity of different methods for measuring ART coverage among pregnant women.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We compared self-reported ART data from a 2014 antenatal survey with laboratory assay data from a sub-sample within the survey population. Thereafter, we conducted a retrospective cohort analysis of all pregnancies consolidated in the Provincial Health Data Centre (PHDC) from January 2011 to December 2020. Evidence of antenatal and HIV care from electronic platforms were linked using a unique patient identifier. ART coverage estimates were triangulated with available antenatal survey estimates, aggregated programmatic data from registers recorded in the District Health Information System (DHIS) and Thembisa modelling estimates.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Self-reported ART in the 2014 sentinel antenatal survey (n = 1434) had high sensitivity (83.5%), specificity (94.5%) and agreement (k = 0.8) with the gold standard of laboratory analysis of ART. Based on linked routine data, ART coverage by the time of delivery in mothers of live births increased from 67.4% in 2011 to 94.7% by 2019. This pattern of increasing antenatal ART coverage was also seen in the DHIS data, and estimated by the Thembisa model, but was less consistent in the antenatal survey data.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This study is the first in a high-burden HIV setting to compare sentinel ART surveillance data with consolidated individuated administrative data. Although self-report in survey conditions showed high validity, more recent data sources based on self-report and medical records may be uncertain with increasing ART coverage over time. Linked individuated data may offer a promising option for ART coverage estimation with greater granularity and efficiency.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0291844","type":"journal-article","created":{"date-parts":[[2024,4,18]],"date-time":"2024-04-18T14:08:08Z","timestamp":1713449288000},"page":"e0291844","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":2,"title":["Can routine antenatal data be used to assess HIV antiretroviral therapy coverage among pregnant women? Evaluating the validity of different data sources in the Western Cape, South Africa"],"prefix":"10.1371","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7028-5772","authenticated-orcid":true,"given":"Nisha","family":"Jacob","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brian","family":"Rice","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2430-5194","authenticated-orcid":true,"given":"Alexa","family":"Heekes","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Leigh F.","family":"Johnson","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Samantha","family":"Brinkmann","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9797-616X","authenticated-orcid":true,"given":"Tendesayi","family":"Kufa","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew","family":"Boulle","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2024,4,18]]},"reference":[{"key":"pone.0291844.ref001","first-page":"155","article-title":"Global guidelines on criteria and processes for validation: elimination of mother-to-child transmission of HIV and Syphilis monitoring","volume":"143","author":"World Health Organization","year":"2014","journal-title":"Int J Gynecol Obstet"},{"key":"pone.0291844.ref002","unstructured":"UNAIDS\/World Health Organisation Working Group on Global HIV\/AIDS and STI surveillance. 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Consolidated guidelines on HIV testing services [Internet]. 2015 [cited 2019 Jul 24]. https:\/\/www.who.int\/hiv\/pub\/guidelines\/hiv-testing-services\/en\/"},{"issue":"1","key":"pone.0291844.ref009","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12879-017-2740-y","article-title":"A comparison of self-report and antiretroviral detection to inform estimates of antiretroviral therapy coverage, viral load suppression and HIV incidence in Kwazulu-Natal, South Africa","volume":"17","author":"H Huerga","year":"2017","journal-title":"BMC Infect Dis"},{"key":"pone.0291844.ref010","volume-title":"South Africa Demographic and Health Survey 2016","author":"National Department of Health South Africa","year":"2019"},{"key":"pone.0291844.ref011","volume-title":"HIV surveillance: a 12 year analysis of HIV prevalence trends and comparing HIV prevalence from sentinel antenatal clinic surveys and prevention of mother-to-child programmes","author":"V. 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Thembisa Version 4.6 [Internet]. 2023. https:\/\/www.thembisa.org\/downloads"},{"issue":"July 2019","key":"pone.0291844.ref019","first-page":"21","article-title":"Effect of HIV Infection and Antiretroviral Treatment on Pregnancy Rates in the Western Cape Province of South Africa","author":"LF Johnson","year":"2020","journal-title":"J Infect Dis"},{"issue":"3","key":"pone.0291844.ref020","doi-asserted-by":"crossref","first-page":"503","DOI":"10.1097\/QAD.0000000000002759","article-title":"Accuracy of self-reported HIV-testing history and awareness of HIV-positive status in four sub-Saharan African countries","volume":"35","author":"Y Xia","year":"2021","journal-title":"Aids"},{"issue":"1","key":"pone.0291844.ref021","doi-asserted-by":"crossref","first-page":"1","DOI":"10.4102\/sajhivmed.v22i1.1200","article-title":"Undisclosed exposure to antiretrovirals prior to treatment initiation: An exploratory analysis","volume":"22","author":"LG Mavhandu-Ramarumo","year":"2021","journal-title":"South Afr J HIV Med"},{"issue":"11","key":"pone.0291844.ref022","doi-asserted-by":"crossref","first-page":"3695","DOI":"10.1007\/s10461-021-03319-4","article-title":"Undisclosed Antiretroviral Therapy Use at Primary Health Care Clinics in Rural KwaZulu Natal South Africa: A DO-ART Trial Sub-study","volume":"25","author":"N Sithole","year":"2021","journal-title":"AIDS Behav"},{"issue":"11","key":"pone.0291844.ref023","first-page":"1","article-title":"Trends in HIV Prevention, Treatment, and Incidence in a Hyperendemic Area of KwaZulu-Natal, South Africa","volume":"2","author":"ABM Kharsany","year":"2019","journal-title":"JAMA Netw Open"},{"issue":"11","key":"pone.0291844.ref024","doi-asserted-by":"crossref","first-page":"e505","DOI":"10.1016\/S2352-3018(17)30122-4","article-title":"Progress of UNAIDS 90-90-90 targets in a district in KwaZulu-Natal, South Africa, with high HIV burden, in the HIPSS study: a household-based complex multilevel community survey","volume":"4","author":"A Grobler","year":"2017","journal-title":"Lancet HIV"},{"key":"pone.0291844.ref025","doi-asserted-by":"crossref","first-page":"2072","DOI":"10.1007\/s10461-018-2351-7","article-title":"ART denial: results of a home-based study to validate self-reported antiretroviral use in rural South Africa","volume":"23","author":"TM-G Jennifer","year":"2019","journal-title":"AIDS Behav"},{"issue":"3","key":"pone.0291844.ref026","doi-asserted-by":"crossref","first-page":"363","DOI":"10.1097\/QAD.0000000000001706","article-title":"The validity of self-reported antiretroviral use in persons living with HIV: a population-based study","volume":"32","author":"MK Grabowski","year":"2018","journal-title":"AIDS"},{"issue":"17","key":"pone.0291844.ref027","doi-asserted-by":"crossref","first-page":"2685","DOI":"10.1097\/QAD.0000000000001227","article-title":"Undisclosed HIV infection and ART use in the Kenya AIDS Indicator Survey 2012: relevance to targets for HIV diagnosis and treatment in Kenya","volume":"30","author":"A Kim","year":"2016","journal-title":"AIDS"},{"key":"pone.0291844.ref028","first-page":"1","article-title":"Utility of digitising point of care HIV test results to accurately measure, and improve performance towards, the UNAIDS 90-90-90 targets","author":"N Jacob","year":"2020","journal-title":"PLoS One"},{"key":"pone.0291844.ref029","first-page":"1","article-title":"Trends and effects of antiretroviral therapy coverage during pregnancy on mother\u2014to \u2011 child transmission of HIV in Sub\u2014Saharan Africa. Evidence from panel data analysis","author":"FH Astawesegn","year":"2022","journal-title":"BMC Infect Dis"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0291844","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,4,18]],"date-time":"2024-04-18T14:08:31Z","timestamp":1713449311000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0291844"}},"subtitle":[],"editor":[{"given":"Muhammad","family":"Osman","sequence":"first","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2024,4,18]]},"references-count":29,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2024,4,18]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0291844","relation":{"has-preprint":[{"id-type":"doi","id":"10.1101\/2023.09.08.23295270","asserted-by":"object"}]},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,4,18]]}}}