Www.aids2014.org Retention in care among HIV-infected women initiating ART during pregnancy: a cohort study Tamsin Phillips 1, Elizabeth Thebus 2, Linda-Gail.

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Retention in care among HIV-infected women initiating ART during pregnancy: a cohort study Tamsin Phillips 1, Elizabeth Thebus 2, Linda-Gail Bekker 2, James McIntyre 1,3, Elaine J. Abrams 4 and Landon Myer 1,2 1 Division of Epidemiology & Biostatistics, University of Cape Town, Cape Town, South Africa, 2 Desmond Tutu HIV Centre, University of Cape Town, Cape Town, 3 Anova Health Institute, Johannesburg, South Africa, 4 ICAP-Columbia University, New York, NY USA. Authors have no financial conflicts of interest to disclose This work was supported by the Elizabeth Glaser Pediatric AIDS Foundation

BACKGROUND increasing numbers of women initiating ART during pregnancy concerns about potentially high levels of disengagement from care and/or non-adherence METHODS retrospective cohort study of 358 women initiating ART during pregnancy in Cape Town, South Africa investigated disengagement & missed visits after ART initiation up to 6 months postpartum. Jan-Dec eligible women referred out of ANC for ART(n=142) Jan-Sept 2012 – eligible women started ART in the ANC(n=216)

RESULTS 24% of women (n=86) missed at least one visit (14-56 days late) 32% (n=115) disengaged from care (>56 days late) Disengagement & missed visits more common post delivery than antenatally (rate of disengagement 6.17 vs per 100 woman months) Similar rates of disengagement at both ART sites Kaplan Meier curves of retention by site overall(a), antenatally(b) and postpartum(c)

disengaging from care was higher in the postpartum period regardless of ART initiation site. predictors of disengagement: ‒ starting ART at a later gestational age (HR:1.04; 95% CI: ) ‒ being diagnosed with HIV in the current pregnancy (HR:1.57; 95% CI: ) CONCLUSION a ‘real-world’ estimate missed visits & disengagement are common in this setting highlights need for interventions to promote retention, particularly postpartum Kaplan Meier curve of retention by site and pregnancy status (log rank p<0.001)