While there has been significant progress in preventing the transmission of HIV from mothers to infants worldwide, the decline has flattened in recent years. That progress is also not universal, leaving essential gaps in meeting global goals.
People disengaging from care is a key driver of ongoing transmission of HIV to infants. Interventions depend on keeping women and their infants in care through each step of the plan to prevent transmission. Researchers from UCSF and the Kenya Medical Research Institute explored the impact of 3 person-centered interventions in Kisumu County, Kenya to target pregnant and breastfeeding women.
The program run by Family AIDS Care Education & Services (FACES) from 2016 to 2021 included:
- Establishing a high-risk clinic with individualized services
- Case management to tailor support and monitor for risk
- A mobile phone app focused on retention and tracking mother and infant pairs
The study shows that the risk of transmission of HIV from mother to infant through the end of breastfeeding declined by more than half, to 2.5%. Loss to follow-up and failure to suppress the virus through treatment also declined by more than half.
During the same time period, Kenya-wide and Nyanza region estimates of mother-to-child transmission did not meaningfully change. The transmission rate at 18 to 24 months postpartum in this study is among the lowest reported from recent studies in predominantly breastfeeding populations.
Following the introduction of these person-centered, locally driven solutions—paired with rigorous implementation of national policies—FACES-supported health facilities nearly reached elimination of mother-to-child transmission of HIV. The researchers believe that locally driven strategies have the potential to reduce the unacceptable ongoing rates of mother-to-child transmission across the country.
