{"doi":"10.1016/j.ijid.2020.08.068","title":"Cultivating a universal understanding of ART adherence: Comments on “A meta-analysis of effectiveness of interventions to improve adherence in pregnant women receiving antiretroviral therapy in sub-Saharan Africa”","abstract":"We would like to congratulate the authors of “A meta-analysis of effectiveness of interventions to improve adherence in pregnant women receiving antiretroviral therapy in sub-Saharan Africa,” (Omonaiye et al., 2018Omonaiye O. Nicholson P. Kusljic S. Manias E. A meta-analysis of effectiveness of interventions to improve adherence in pregnant women receiving antiretroviral therapy in sub-Saharan Africa.Int J Infect Dis. 2018; 74 (Elsevier B.V.): 71-82Abstract Full Text Full Text PDF PubMed Scopus (16) Google Scholar) on their efforts to summarize a body of literature crucial to improving HIV care for pregnant women living with HIV (WLWH) in sub-Saharan Africa. This work makes important contributions to the field. However, there are two critical points we would like to highlight for reader and author consideration. First, the authors do not incorporate date restrictions into meta-analysis inclusion criteria. Thus, included studies span multiple anti-retroviral treatment (ART) eras (Omonaiye et al., 2018Omonaiye O. Nicholson P. Kusljic S. Manias E. A meta-analysis of effectiveness of interventions to improve adherence in pregnant women receiving antiretroviral therapy in sub-Saharan Africa.Int J Infect Dis. 2018; 74 (Elsevier B.V.): 71-82Abstract Full Text Full Text PDF PubMed Scopus (16) Google Scholar). In 2013, the World Health Organization updated ART guidelines for the prevention of mother to child transmission (PMTCT) of HIV, recommending implementation of Option B+, or lifelong ART, for all pregnant WLWH. Prior to Option B+, single-dose Nevirapine and short-course ART treatment regimens, such as daily monotherapy from 14 weeks gestation through seven days post-partum, were utilized in PMTCT programs (Pricilla et al., 2018Pricilla R.A. Brown M. Wexler C. Maloba M. Gautney B.J. Finocchario-Kessler S. Progress toward eliminating mother to child transmission of HIV in Kenya: review of treatment guidelines uptake and pediatric transmission between 2013 and 2016—a follow up.Matern Child Health J. 2018; 22: 1685-1692Crossref PubMed Scopus (10) Google Scholar). Given the meaningful differences in treatment recommendations across these eras, disaggregating this meta-analysis by treatment era, or restricting inclusion criteria to studies conducted during the implementation of Option B+, would improve the relevance of study findings for implementation under current treatment paradigms. Differences in treatment recommendations also yielded changes in measurement of PMTCT outcomes, our second point for consideration. In the era of single-dose and short course ART treatments, PMTCT programs often captured PMTCT service or treatment uptake. In the era of lifelong ART, programs often measure ART initiation or adherence. Omonaiye and colleagues identified ART adherence as the outcome of interest in this meta-analysis (Omonaiye et al., 2018Omonaiye O. Nicholson P. Kusljic S. Manias E. A meta-analysis of effectiveness of interventions to improve adherence in pregnant women receiving antiretroviral therapy in sub-Saharan Africa.Int J Infect Dis. 2018; 74 (Elsevier B.V.): 71-82Abstract Full Text Full Text PDF PubMed Scopus (16) Google Scholar). However, they appear to have included studies capturing other care outcomes, such as ART initiation (Dillabaugh et al., 2012Dillabaugh L.L. Lewis Kulzer J. Owuor K. Ndege V. Oyanga A. Ngugi E. et al.Towards elimination of mother-to-child transmission of HIV: the impact of a rapid results initiative in nyanza province, Kenya.AIDS Res Treat [Internet]. 2012; ([cited 2020 May 29] Available from:): 2012https://pubmed.ncbi.nlm.nih.gov/22548155/Google Scholar, ENHAT-CS, 2014ENHAT-CS The Role of Mother Mentors in Supporting HIV-Positive Mothers The Ethiopia Network for HIV/AIDS Treatment, Care and Support Program, Feburary 2014.2014https://www.msh.org/sites/msh.org/files/or_march_2014.pdfGoogle Scholar, Stinson et al., 2013Stinson K. Jennings K. Myer L. Integration of antiretroviral therapy services into antena","journal":"International Journal of Infectious Diseases","year":2020,"id":130901,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":0,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9595,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2020-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":342163,"name":"Angela M. Parcesepe","orcid":"0000-0002-4321-125X","position":1,"is_corresponding":false},{"id":425966,"name":"Danielle Giovenco","orcid":"0000-0002-2137-5309","position":2,"is_corresponding":false},{"id":584110,"name":"Lindsey M. Filiatreau","orcid":"0000-0002-0355-4477","position":0,"is_corresponding":true}],"reference_count":11,"raw_metadata":null,"created_at":"2026-07-18T23:16:00.235845Z","pmid":"32866637","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}