HIV treatment in pregnancy

Area of Science:

• Public Health
• Infectious Diseases
• Maternal Health

Background:

• Antiretroviral therapy (ART) has been pivotal in preventing mother-to-child HIV transmission for nearly 25 years.
• Universal ART scale-up has reached 76% of pregnant women living with HIV globally, particularly in low- and middle-income countries.
• Despite successes, challenges persist including ART adherence, retention in care, and equitable access.

Purpose of the Study:

• To review the current status and impact of ART in pregnant women living with HIV.
• To identify persistent challenges and areas requiring further research in ART implementation.
• To emphasize the importance of optimizing ART for pregnant women and HIV-exposed infants.

Main Methods:

• Review of existing literature and implementation research on ART for pregnant women.
• Analysis of ART coverage, benefits, and persistent challenges.
• Discussion of ongoing research needs for understanding biological mechanisms and drug safety.

Main Results:

• High ART coverage (76%) achieved for pregnant women living with HIV, demonstrating significant public health success.
• Persistent challenges identified: ART adherence, retention in care, and unequal access remain barriers.
• Gaps in understanding biological mechanisms linking antenatal ART to adverse pregnancy/birth outcomes noted.

Conclusions:

• Pregnant women remain a priority population for ART optimization, especially in the 'treat-all' era.
• Further research is crucial to understand ART's biological effects and ensure drug safety for mothers and infants.
• Strengthening healthcare systems is essential to address implementation challenges and improve outcomes.