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AIDS Behav ; 23(9): 2522-2531, 2019 Sep.
Article in English | MEDLINE | ID: mdl-31399793

ABSTRACT

The PROMISE trial enrolled asymptomatic HIV-infected pregnant and postpartum women not eligible for antiretroviral treatment (ART) per local guidelines and randomly assigned proven antiretroviral strategies to assess relative efficacy for perinatal prevention plus maternal/infant safety and maternal health. The START study subsequently demonstrated clear benefit in initiating ART regardless of CD4 count. Active PROMISE participants were informed of results and women not receiving ART were strongly recommended to immediately initiate treatment to optimize their own health. We recorded their decision and the primary reason given for accepting or rejecting the universal ART offer after receiving the START information. One-third of participants did not initiate ART after the initial session, wanting more time to consider. Six sessions were required to attain 95% uptake. The slow uptake of universal ART highlights the need to prepare individuals and sensitize communities regarding the personal and population benefits of the "Treat All" strategy.


Subject(s)
Antiretroviral Therapy, Highly Active , HIV Infections/drug therapy , Infectious Disease Transmission, Vertical/prevention & control , Mothers/psychology , Patient Acceptance of Health Care/psychology , Pregnancy Complications, Infectious/drug therapy , Adult , Anti-HIV Agents/therapeutic use , Antiretroviral Therapy, Highly Active/psychology , CD4 Lymphocyte Count , Female , HIV Infections/prevention & control , HIV Infections/transmission , Humans , Infant , Maternal Health , Postpartum Period , Pregnancy , Young Adult
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