{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T18:52:33Z","timestamp":1789757553619,"version":"4.0.1"},"reference-count":52,"publisher":"Public Library of Science (PLoS)","issue":"4","license":[{"start":{"date-parts":[[2024,4,10]],"date-time":"2024-04-10T00:00:00Z","timestamp":1712707200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000865","name":"Bill & Melinda Gates Foundation","doi-asserted-by":"crossref","award":["OPP 1017641"],"award-info":[{"award-number":["OPP 1017641"]}],"id":[{"id":"10.13039\/100000865","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100001321","name":"National Research Foundation","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100001321","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100001322","name":"South African Medical Research Council","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001322","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001322","name":"South African Medical Research Council","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001322","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001322","name":"South African Medical Research Council","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001322","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Academy of Medical Sciences Newton Advanced Fellowship","award":["NAF002\/1001"],"award-info":[{"award-number":["NAF002\/1001"]}]},{"DOI":"10.13039\/100010269","name":"Wellcome Trust","doi-asserted-by":"publisher","award":["203525\/Z\/16\/Z"],"award-info":[{"award-number":["203525\/Z\/16\/Z"]}],"id":[{"id":"10.13039\/100010269","id-type":"DOI","asserted-by":"publisher"}]},{"name":"NRF"},{"DOI":"10.13039\/100000027","name":"National Institute on Alcohol Abuse and Alcoholism","doi-asserted-by":"publisher","award":["R21AA023887"],"award-info":[{"award-number":["R21AA023887"]}],"id":[{"id":"10.13039\/100000027","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Collaborative Initiative on Fetal Alcohol Spectrum Disorders (CIFASD) developmental","award":["AA014811"],"award-info":[{"award-number":["AA014811"]}]},{"name":"US Brain and Behaviour Foundation Independent Investigator","award":["24467"],"award-info":[{"award-number":["24467"]}]},{"DOI":"10.13039\/501100000265","name":"UK Medical Research Council","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100000265","id-type":"DOI","asserted-by":"crossref"}]},{"name":"UK Department for International Development","award":["MRC\/DFID Concordat agreement"],"award-info":[{"award-number":["MRC\/DFID Concordat agreement"]}]},{"DOI":"10.13039\/501100000780","name":"European Union","doi-asserted-by":"crossref","award":["MR\/R010161\/1"],"award-info":[{"award-number":["MR\/R010161\/1"]}],"id":[{"id":"10.13039\/501100000780","id-type":"DOI","asserted-by":"crossref"}]},{"name":"SAMRC National Health Scholars programme"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>There are approximately 16 million children who are HIV-exposed and uninfected (CHEU) worldwide. Studies suggest that CHEU are at risk for developmental impairment in infancy, particularly in language domains. However, there is limited research examining neurocognitive function in CHEU older than 2 years, including important pre-school years. This study aimed to investigate associations between HIV exposure without infection and neurocognitive outcomes and to determine risk factors for neurodevelopment in CHEU at age 3\u20134 years.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The Drakenstein Child Health Study is a South African population-based birth cohort which enrolled women in pregnancy with ongoing follow up. Neurocognitive outcomes were assessed in children at 3.5 years by trained assessors blinded to HIV status including general cognitive function, language, and memory, measured using the Kaufmann Assessment Battery for Children, Second Edition (KABC-II). Data were compared between CHEU and children who were HIV-unexposed uninfected (CHUU) using multivariable logistic and linear regression, including testing for effect modification; sex-stratified risk factor analyses were performed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 497 children were included (97 [20%] CHEU; 400 [80%] CHUU; 50% male), with a mean age of 3.5 years (range 3.4\u20133.6). Groups had similar birth and household characteristics, although mothers of CHEU were older, on average. Overall, CHEU had lower expressive language scores compared to CHUU on unadjusted and adjusted analyses (effect size: -0.23 [95% CI -0.45, -0.01]). There were no group differences in general cognitive or memory function (p&gt;0.05). On sex-stratified analyses, male CHEU were found to have higher odds of suboptimal cognitive development compared to male CHUU (aOR 2.28 [95% CI 1.06, 4.87], p = 0.034). Several other factors including birthweight, maternal education, maternal ART duration and HIV viral load during pregnancy were associated with cognition, memory, or expressive language outcomes in CHEU, dependent on child sex.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Interpretation<\/jats:title>\n                    <jats:p>The findings suggest that perinatal HIV exposure continues to be associated with impaired language development across the preschool years, highlighting the importance of targeting early interventions to optimise language outcomes. Further, the results suggest the importance of demographic, biological and HIV-related variables influencing developmental outcomes in CHEU. The greater risk of suboptimal cognitive development in male CHEU requires investigation around sex-specific mechanisms.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0297471","type":"journal-article","created":{"date-parts":[[2024,4,10]],"date-time":"2024-04-10T13:30:18Z","timestamp":1712755818000},"page":"e0297471","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":6,"title":["Language outcomes of preschool children who are HIV-exposed uninfected: An analysis of a South African cohort"],"prefix":"10.1371","volume":"19","author":[{"given":"Freddy","family":"Green","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4403-4072","authenticated-orcid":true,"given":"Christopher","family":"du Plooy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9967-5822","authenticated-orcid":true,"given":"Andrea M.","family":"Rehman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raymond T.","family":"Nhapi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marilyn T.","family":"Lake","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Whitney","family":"Barnett","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nadia","family":"Hoffman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heather J.","family":"Zar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0276-9660","authenticated-orcid":true,"given":"Kirsten A.","family":"Donald","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dan J.","family":"Stein","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4887-1644","authenticated-orcid":true,"given":"Catherine J.","family":"Wedderburn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2024,4,10]]},"reference":[{"key":"pone.0297471.ref001","unstructured":"UNAIDS. AIDSinfo [cited 2023 15th December]. http:\/\/aidsinfo.unaids.org."},{"key":"pone.0297471.ref002","unstructured":"UNAIDS. Women, adolescent girls and the HIV response. 2020."},{"key":"pone.0297471.ref003","unstructured":"UNAIDS. 2022 [cited 2023 15th December]. https:\/\/www.unaids.org\/en\/resources\/fact-sheet."},{"issue":"6","key":"pone.0297471.ref004","doi-asserted-by":"crossref","first-page":"e92","DOI":"10.1016\/S1473-3099(16)00055-4","article-title":"HIV-exposed, uninfected infants: new global challenges in the era of paediatric HIV elimination","volume":"16","author":"C Evans","year":"2016","journal-title":"Lancet Infect Dis"},{"issue":"5","key":"pone.0297471.ref005","doi-asserted-by":"crossref","first-page":"e1326","DOI":"10.1542\/peds.2012-0405","article-title":"Neurodevelopment in children born to HIV-infected mothers by infection and treatment status","volume":"130","author":"K Le Doare","year":"2012","journal-title":"Pediatrics"},{"issue":"2","key":"pone.0297471.ref006","doi-asserted-by":"crossref","DOI":"10.1542\/peds.2017-2888","article-title":"Neurodevelopment in Young Children Born to HIV-Infected Mothers: A Meta-analysis","volume":"141","author":"MS McHenry","year":"2018","journal-title":"Pediatrics"},{"issue":"11","key":"pone.0297471.ref007","doi-asserted-by":"crossref","first-page":"803","DOI":"10.1016\/S2352-4642(19)30250-0","article-title":"Neurodevelopment of HIV-exposed uninfected children in South Africa: outcomes from an observational birth cohort study","volume":"3","author":"CJ Wedderburn","year":"2019","journal-title":"Lancet Child Adolesc Health"},{"issue":"6","key":"pone.0297471.ref008","doi-asserted-by":"crossref","first-page":"393","DOI":"10.1016\/S2352-4642(22)00071-2","article-title":"Early neurodevelopment of HIV-exposed uninfected children in the era of antiretroviral therapy: a systematic review and meta-analysis","volume":"6","author":"CJ Wedderburn","year":"2022","journal-title":"Lancet Child Adolesc Health"},{"key":"pone.0297471.ref009","article-title":"Neurodevelopmental effects of ante-partum and post-partum antiretroviral exposure in HIV-exposed and uninfected children versus HIV-unexposed and uninfected children in Uganda and Malawi: a prospective cohort study","author":"MJ Boivin","year":"2019","journal-title":"Lancet HIV"},{"issue":"2","key":"pone.0297471.ref010","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1097\/QAD.0000000000001683","article-title":"Neuropsychological performance in African children with HIV enrolled in a multisite antiretroviral clinical trial","volume":"32","author":"MJ Boivin","year":"2018","journal-title":"AIDS"},{"issue":"18","key":"pone.0297471.ref011","doi-asserted-by":"crossref","first-page":"2749","DOI":"10.1097\/QAD.0000000000002023","article-title":"Neurodevelopmental outcomes in HIV-infected and uninfected African children","volume":"32","author":"P Debeaudrap","year":"2018","journal-title":"AIDS"},{"issue":"1","key":"pone.0297471.ref012","doi-asserted-by":"crossref","first-page":"e123","DOI":"10.1542\/peds.2007-2558","article-title":"Impact of the HIV\/AIDS epidemic on the neurodevelopment of preschool-aged children in Kinshasa, Democratic Republic of the Congo","volume":"122","author":"A Van Rie","year":"2008","journal-title":"Pediatrics"},{"issue":"11","key":"pone.0297471.ref013","doi-asserted-by":"crossref","first-page":"1327","DOI":"10.1080\/09540121.2014.920949","article-title":"Neurodevelopmental outcomes in HIV-exposed-uninfected children versus those not exposed to HIV","volume":"26","author":"SJ Kerr","year":"2014","journal-title":"AIDS care"},{"issue":"9","key":"pone.0297471.ref014","doi-asserted-by":"crossref","first-page":"e1002920","DOI":"10.1371\/journal.pmed.1002920","article-title":"Risk and protective factors for child development: An observational South African birth cohort","volume":"16","author":"KA Donald","year":"2019","journal-title":"PLoS Med"},{"issue":"S4","key":"pone.0297471.ref015","doi-asserted-by":"crossref","first-page":"e26165","DOI":"10.1002\/jia2.26165","article-title":"Lower academic performance among children with perinatal HIV exposure","volume":"26","author":"KM Powis","year":"2023","journal-title":"Botswana. J Int AIDS Soc"},{"issue":"6","key":"pone.0297471.ref016","doi-asserted-by":"crossref","first-page":"592","DOI":"10.1136\/thoraxjnl-2014-206242","article-title":"Investigating the early-life determinants of illness in Africa: the Drakenstein Child Health Study","volume":"70","author":"HJ Zar","year":"2015","journal-title":"Thorax"},{"issue":"11","key":"pone.0297471.ref017","doi-asserted-by":"crossref","first-page":"e0222399","DOI":"10.1371\/journal.pone.0222399","article-title":"Maternal health and birth outcomes in a South African birth cohort study","volume":"14","author":"HJ Zar","year":"2019","journal-title":"PloS One"},{"key":"pone.0297471.ref018","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1016\/j.jneumeth.2015.03.016","article-title":"Investigating the psychosocial determinants of child health in Africa: The Drakenstein Child Health Study","volume":"252","author":"DJ Stein","year":"2015","journal-title":"J Neurosci Methods"},{"issue":"1","key":"pone.0297471.ref019","doi-asserted-by":"crossref","first-page":"e000282","DOI":"10.1136\/bmjpo-2018-000282","article-title":"Drakenstein Child Health Study (DCHS): investigating determinants of early child development and cognition","volume":"2","author":"KA Donald","year":"2018","journal-title":"BMJ Paediatr Open"},{"issue":"12","key":"pone.0297471.ref020","doi-asserted-by":"crossref","first-page":"e033259","DOI":"10.1136\/bmjopen-2019-033259","article-title":"Implementation of prevention of mother-to-child transmission of HIV (PMTCT) guidelines in South Africa: Outcomes from a population-based birth cohort study in Paarl, Western Cape","volume":"9","author":"JA Pellowski","year":"2019","journal-title":"BMJ Open"},{"key":"pone.0297471.ref021","unstructured":"Kaufman AS, Lichtenberger, E. O., Fletcher-Janzen, E., & Kaufman, N. L.. Essentials of KABC-II assessment Sons JW, editor2005."},{"key":"pone.0297471.ref022","unstructured":"Kaufman AS, & Kaufman, N. L. Manual for the Kaufman Assessment Battery for Children, Second Edition (KABC-II): Circle Pines: American Guidance Service Publishing\/Pearson Products; 2004."},{"issue":"1","key":"pone.0297471.ref023","doi-asserted-by":"crossref","first-page":"21412","DOI":"10.7448\/IAS.20.1.21412","article-title":"Cross-cultural assessment of HIV-associated cognitive impairment using the Kaufman assessment battery for children: a systematic review","volume":"20","author":"KS van Wyhe","year":"2017","journal-title":"J Int AIDS Soc"},{"issue":"3","key":"pone.0297471.ref024","doi-asserted-by":"crossref","first-page":"185","DOI":"10.1055\/s-0038-1637020","article-title":"Validity of Neuropsychological Testing in Young African Children Affected by HIV","volume":"13","author":"MC Chernoff","year":"2018","journal-title":"J Pediatric Infect Dis"},{"issue":"4","key":"pone.0297471.ref025","doi-asserted-by":"crossref","first-page":"434","DOI":"10.1177\/0081246317741822","article-title":"Confirmatory factor analysis of the Kaufman assessment battery in a sample of primary school-aged children in rural South Africa","volume":"48","author":"JM Mitchell","year":"2017","journal-title":"S Afr J Psychol"},{"issue":"5 Pt 2","key":"pone.0297471.ref026","first-page":"337","article-title":"The South African Stress and Health (SASH) study: a scientific base for mental health policy","volume":"99","author":"DJ Stein","year":"2009","journal-title":"S Afr Med J"},{"issue":"10064","key":"pone.0297471.ref027","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1016\/S0140-6736(16)31389-7","article-title":"Early childhood development coming of age: science through the life course","volume":"389","author":"MM Black","year":"2017","journal-title":"Lancet"},{"issue":"6","key":"pone.0297471.ref028","doi-asserted-by":"crossref","first-page":"501","DOI":"10.1007\/s11904-019-00459-0","article-title":"Growth and Neurodevelopment of HIV-Exposed Uninfected Children: a Conceptual Framework","volume":"16","author":"CJ Wedderburn","year":"2019","journal-title":"Curr HIV\/AIDS Rep"},{"key":"pone.0297471.ref029","unstructured":"World Health Organisation, UNICEF, World Bank Group. Nurturing care for early childhood development: a framework for helping children survive and thrive to transform health and human potential. 2018."},{"key":"pone.0297471.ref030","doi-asserted-by":"crossref","first-page":"586","DOI":"10.3389\/fpsyg.2013.00586","article-title":"Effects of early language, speech, and cognition on later reading: a mediation analysis","volume":"4","author":"VN Durand","year":"2013","journal-title":"Front Psychol"},{"issue":"suppl 1","key":"pone.0297471.ref031","doi-asserted-by":"crossref","first-page":"S33","DOI":"10.1093\/jpids\/piw045","article-title":"Longitudinal Evaluation of Language Impairment in Youth With Perinatally Acquired Human Immunodeficiency Virus (HIV) and Youth With Perinatal HIV Exposure","volume":"5","author":"SM Redmond","year":"2016","journal-title":"J Pediatric Infect Dis Soc"},{"issue":"4","key":"pone.0297471.ref032","doi-asserted-by":"crossref","first-page":"441","DOI":"10.1097\/QAI.0000000000002881","article-title":"Lower Neurocognitive Functioning in HIV-Exposed Uninfected Children Compared With That in HIV-Unexposed Children","volume":"89","author":"SF Benki-Nugent","year":"2022","journal-title":"J Acquir Immune Defic Syndr"},{"issue":"S4","key":"pone.0297471.ref033","doi-asserted-by":"crossref","first-page":"e26149","DOI":"10.1002\/jia2.26149","article-title":"Neurodevelopment of children who are HIV-exposed and uninfected","volume":"26","author":"MA Bulterys","year":"2023","journal-title":"Kenya. J Int AIDS Soc"},{"issue":"3","key":"pone.0297471.ref034","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1016\/S2352-4642(17)30073-1","article-title":"Gender disparities in child development in the east Asia-Pacific region: a cross-sectional, population-based, multicountry observational study","volume":"1","author":"A Weber","year":"2017","journal-title":"Lancet Child Adolesc Health"},{"issue":"4","key":"pone.0297471.ref035","doi-asserted-by":"crossref","first-page":"1065","DOI":"10.1016\/j.neuroimage.2007.03.053","article-title":"Sexual dimorphism of brain developmental trajectories during childhood and adolescence","volume":"36","author":"RK Lenroot","year":"2007","journal-title":"NeuroImage"},{"issue":"8","key":"pone.0297471.ref036","doi-asserted-by":"crossref","first-page":"2741","DOI":"10.1093\/cercor\/bhx154","article-title":"A Key Characteristic of Sex Differences in the Developing Brain: Greater Variability in Brain Structure of Boys than Girls","volume":"28","author":"Pediatric Imaging N","year":"2018","journal-title":"Cereb Cortex"},{"issue":"1","key":"pone.0297471.ref037","doi-asserted-by":"crossref","first-page":"e25863","DOI":"10.1002\/jia2.25863","article-title":"Early structural brain development in infants exposed to HIV and antiretroviral therapy in utero in a South African birth cohort","volume":"25","author":"CJ Wedderburn","year":"2022","journal-title":"J Int AIDS Soc"},{"issue":"2","key":"pone.0297471.ref038","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1093\/tropej\/fmp057","article-title":"Severe infections in HIV-exposed uninfected infants: clinical evidence of immunodeficiency","volume":"56","author":"AL Slogrove","year":"2010","journal-title":"J Trop Pediatr"},{"issue":"10","key":"pone.0297471.ref039","doi-asserted-by":"crossref","first-page":"1421","DOI":"10.1097\/QAD.0000000000000292","article-title":"In-utero exposure to maternal HIV infection alters T-cell immune responses to vaccination in HIV-uninfected infants","volume":"28","author":"EB Kidzeru","year":"2014","journal-title":"AIDS"},{"key":"pone.0297471.ref040","doi-asserted-by":"crossref","first-page":"1271","DOI":"10.1097\/INF.0000000000002082","article-title":"Infectious Morbidity, Mortality and Nutrition in HIV-exposed, Uninfected, Formula-fed Infants","volume":"37","author":"M WD Yeagneh","year":"2018","journal-title":"Pediatr Infect Dis J"},{"issue":"9","key":"pone.0297471.ref041","doi-asserted-by":"crossref","first-page":"e0185632","DOI":"10.1371\/journal.pone.0185632","article-title":"Nutrition after preterm birth and adult neurocognitive outcomes","volume":"12","author":"S Sammallahti","year":"2017","journal-title":"PLoS One"},{"key":"pone.0297471.ref042","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1186\/1758-5996-5-49","article-title":"Low birth weight: causes and consequences","volume":"5","author":"CA Negrato","year":"2013","journal-title":"Diabetol Metab Syndr"},{"key":"pone.0297471.ref043","article-title":"HIV Viremia During Pregnancy and Neurodevelopment of HIV-Exposed Uninfected Children in the Context of Universal Antiretroviral Therapy and Breastfeeding: A Prospective Study","author":"SM le Roux","year":"2018","journal-title":"Pediatr Infect Dis J"},{"key":"pone.0297471.ref044","doi-asserted-by":"crossref","first-page":"1085589","DOI":"10.3389\/fnins.2023.1085589","article-title":"Maternal ART throughout gestation prevents caudate volume reductions in neonates who are HIV exposed but uninfected","volume":"17","author":"A Ibrahim","year":"2023","journal-title":"Front Neurosci"},{"issue":"5","key":"pone.0297471.ref045","doi-asserted-by":"crossref","first-page":"529","DOI":"10.1177\/0022022108321176","article-title":"Constructing tests of cognitive abilities for schooled and unschooled children","volume":"39","author":"KJ Alcock","journal-title":"J Cross-Cult Psychol"},{"issue":"9567","key":"pone.0297471.ref046","doi-asserted-by":"crossref","first-page":"1107","DOI":"10.1016\/S0140-6736(07)60283-9","article-title":"Mother-to-child transmission of HIV-1 infection during exclusive breastfeeding in the first 6 months of life: an intervention cohort study","volume":"369","author":"HM Coovadia","year":"2007","journal-title":"Lancet"},{"key":"pone.0297471.ref047","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1016\/S0079-6123(09)17808-1","article-title":"Neuropsychological assessment of African children: evidence for a universal brain\/behavior omnibus within a coconstructivist paradigm","volume":"178","author":"MJ Boivin","year":"2009","journal-title":"Prog Brain Res"},{"issue":"2","key":"pone.0297471.ref048","doi-asserted-by":"crossref","first-page":"307","DOI":"10.1097\/QAD.0000000000002733","article-title":"Achieving maternal viral load suppression for elimination of mother-to-child transmission of HIV in South Africa","volume":"35","author":"F Moyo","year":"2021","journal-title":"AIDS"},{"key":"pone.0297471.ref049","unstructured":"General Household Survey S.A. 2019."},{"key":"pone.0297471.ref050","article-title":"Evaluating Neurodevelopmental Consequences of Perinatal Exposure to Antiretroviral Drugs: Current Challenges and New Approaches","author":"JG Schnoll","year":"2019","journal-title":"J Neuroimmune Pharmacol"},{"issue":"8","key":"pone.0297471.ref051","doi-asserted-by":"crossref","first-page":"828","DOI":"10.1097\/INF.0000000000002332","article-title":"In Utero Efavirenz Exposure and Neurodevelopmental Outcomes in HIV-exposed Uninfected Children in Botswana","volume":"38","author":"AR Cassidy","year":"2019","journal-title":"Pediatr Infect Dis J"},{"key":"pone.0297471.ref052","unstructured":"World Health Organization. Consolidated guidelines on HIV prevention, testing, treatment, service delivery and monitoring: recommendations for a public health approach. 2021."}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0297471","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,4,10]],"date-time":"2024-04-10T13:31:06Z","timestamp":1712755866000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0297471"}},"subtitle":[],"editor":[{"given":"Andrea L.","family":"Conroy","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2024,4,10]]},"references-count":52,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2024,4,10]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0297471","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,4,10]]}}}