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Factors associated with detectable viral load at delivery in HIV-positive pregnant women

Morris, Allyson (2016) Factors associated with detectable viral load at delivery in HIV-positive pregnant women. Master Essay, University of Pittsburgh.

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Abstract

Unsuppressed HIV-1 RNA viral load at delivery is one of the primary determinants of whether an HIV-positive mother will transmit the virus to her infant. Because of this, many of the prevention of mother-to-child transmission guidelines, such as those from the World Health Organization and the United States Department of Health and Human Services, are aimed at reducing the mother’s viral load to as low a level as possible before the end of her third trimester. In this essay, I reviewed the available literature to identify determinants of unsuppressed viral load at term among HIV-positive pregnant women in order to evaluate the current guidelines and make recommendations for improved care. The most prevalent determinants of unsuppressed viral load at term identified in this literature review were higher viral load at baseline, shorter duration of HAART, race or ethnicity, poor ART adherence, and lower baseline CD4 count. These are consistent with known determinants of vertical HIV transmission and published prevention recommendations. An identified gap in recommendations is the lack of a system of referral of women found to have poor ART adherence to interventions designed to improve adherence. This could reduce viral load in many HIV-positive pregnant women, preventing them from transmitting the virus to their infants, and thus improving the efficacy of public health efforts to prevent mother-to-child HIV transmission.


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Details

Item Type: Other Thesis, Dissertation, or Long Paper (Master Essay)
Status: Unpublished
Creators/Authors:
CreatorsEmailPitt UsernameORCID
Morris, Allysonalm297@pitt.eduALM297
Contributors:
ContributionContributors NameEmailPitt UsernameORCID
Committee ChairGlynn, Nancyglynnn@pitt.eduGLYNNNUNSPECIFIED
Committee MemberNachega, Jeanjbn16@pitt.eduJBN16UNSPECIFIED
Committee MemberFrank, Lindafrankie@pitt.eduFRANKIEUNSPECIFIED
Date: 3 January 2016
Date Type: Submission
Access Restriction: No restriction; Release the ETD for access worldwide immediately.
Publisher: University of Pittsburgh
Institution: University of Pittsburgh
Schools and Programs: Graduate School of Public Health > Epidemiology
Degree: MPH - Master of Public Health
Thesis Type: Master Essay
Refereed: Yes
Date Deposited: 19 May 2016 22:18
Last Modified: 02 May 2019 14:56
URI: http://d-scholarship.pitt.edu/id/eprint/26711

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