{"doi":"10.1093/ajeadv/uuaf017","title":"A multicomponent, peer-led intervention for pregnant and postpartum women with HIV improves viral suppression over time in rural Uganda","abstract":"<jats:title>Abstract</jats:title>\n                  <jats:p>Achieving viral suppression among pregnant and breastfeeding women with HIV is essential to promoting their health and eliminating vertical transmission of HIV. We hypothesized that a multicomponent and peer-led intervention would increase viral suppression among pregnant and breastfeeding women with HIV in the rural Southwestern Uganda. The ENHANCED-SPS intervention included the development of a counseling protocol, point-of-care viral load testing, and standardized support delivered by peer-mothers. Among 505 pregnant and postpartum women receiving the ENHANCED-SPS intervention (2019-2021), we evaluated the change in viral suppression (HIV RNA &amp;lt; 1000 c/mL) from baseline to 12 months of follow-up with targeted minimum loss-based estimation, accounting for clustering and missing outcomes. The proportion with viral suppression was 70.0% (95% CI: 65.9, 74.1%) at baseline and 94.9% (95% CI: 92.5, 97.4%) at 12 months, corresponding to a 24.9% (95% CI: 21.6, 28.2%; P &amp;lt; 0.001) absolute increase over time. Significant improvements over time were observed across age groups (15-24 years, 25-34 years, and 35+ years) and for both pregnant and postpartum women. Approximately 95% of women in all age groups and pregnant women achieved viral suppression at 12 months. However, postpartum women lagged behind with only 75.7% viral suppression at 12 months, despite a 58.9% (95% CI: 27.4, 90.3%) increase from baseline. The multicomponent, peer-led ENHANCED-SPS intervention resulted in meaningful improvements in viral suppression for pregnant and breastfeeding women with HIV; however, additional support is needed during the postpartum period.</jats:p>","journal":"AJE Advances: Research in Epidemiology","year":2025,"id":635190,"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":null,"is_data_producer":false,"deposit_databanks":null,"is_oa":false,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":null,"fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":255278,"name":"Laura B. Balzer","orcid":"0000-0002-3730-410X","position":1,"is_corresponding":false},{"id":1265607,"name":"Faith Kagoya","orcid":"0009-0002-2702-8225","position":2,"is_corresponding":false},{"id":589990,"name":"Jaffer Okiring","orcid":"0000-0003-3668-8997","position":3,"is_corresponding":false},{"id":341298,"name":"Joanita Nangendo","orcid":"0000-0002-0458-2111","position":4,"is_corresponding":false},{"id":479613,"name":"Emmanuel Ruhamyankaka","orcid":"0000-0003-0472-0657","position":5,"is_corresponding":false},{"id":797598,"name":"Peter Ssebutinde","orcid":null,"position":6,"is_corresponding":false},{"id":379512,"name":"Elijah Kakande","orcid":"0000-0001-9532-5710","position":7,"is_corresponding":false},{"id":1647847,"name":"Elizabeth Arinitwe","orcid":null,"position":8,"is_corresponding":false},{"id":1355878,"name":"John Bosco Tamu Munezero","orcid":"0009-0006-4644-4573","position":9,"is_corresponding":false},{"id":796129,"name":"Valence Mfitumukiza","orcid":"0000-0002-3106-2197","position":10,"is_corresponding":false},{"id":1094921,"name":"Stella Kabageni","orcid":null,"position":11,"is_corresponding":false},{"id":1647850,"name":"Michael Ayebare","orcid":null,"position":12,"is_corresponding":false},{"id":1647852,"name":"Anne R Katahoire","orcid":null,"position":13,"is_corresponding":false},{"id":398557,"name":"Philippa Musoke","orcid":null,"position":14,"is_corresponding":false},{"id":765008,"name":"Moses R Kamya","orcid":null,"position":15,"is_corresponding":false},{"id":255277,"name":"Jane Kabami","orcid":"0000-0002-0265-3174","position":0,"is_corresponding":false}],"reference_count":0,"raw_metadata":{"has_enrichment":true,"resolved":true,"title":"A multicomponent, peer-led intervention for pregnant and postpartum women with HIV improves viral suppression over time in rural Uganda","abstract":"<jats:title>Abstract</jats:title>\n                  <jats:p>Achieving viral suppression among pregnant and breastfeeding women with HIV is essential to promoting their health and eliminating vertical transmission of HIV. We hypothesized that a multicomponent and peer-led intervention would increase viral suppression among pregnant and breastfeeding women with HIV in the rural Southwestern Uganda. The ENHANCED-SPS intervention included the development of a counseling protocol, point-of-care viral load testing, and standardized support delivered by peer-mothers. Among 505 pregnant and postpartum women receiving the ENHANCED-SPS intervention (2019-2021), we evaluated the change in viral suppression (HIV RNA &amp;lt; 1000 c/mL) from baseline to 12 months of follow-up with targeted minimum loss-based estimation, accounting for clustering and missing outcomes. The proportion with viral suppression was 70.0% (95% CI: 65.9, 74.1%) at baseline and 94.9% (95% CI: 92.5, 97.4%) at 12 months, corresponding to a 24.9% (95% CI: 21.6, 28.2%; P &amp;lt; 0.001) absolute increase over time. Significant improvements over time were observed across age groups (15-24 years, 25-34 years, and 35+ years) and for both pregnant and postpartum women. Approximately 95% of women in all age groups and pregnant women achieved viral suppression at 12 months. However, postpartum women lagged behind with only 75.7% viral suppression at 12 months, despite a 58.9% (95% CI: 27.4, 90.3%) increase from baseline. The multicomponent, peer-led ENHANCED-SPS intervention resulted in meaningful improvements in viral suppression for pregnant and breastfeeding women with HIV; however, additional support is needed during the postpartum period.</jats:p>","is_dataset_classified":null,"base_score":0.0,"endowment":0.0,"datacite_reuse_total":0,"file_count":0,"downloads":0,"views":0,"has_version_chain":false,"is_dataset":false,"is_oa":false,"pmid":"19910364","pmcid":null,"openalex_id":"https://openalex.org/W4415468481","authors":[],"funders":[{"funder_name":"Fogarty International Center of the National Institutes of Health","grant_id":"D43 TW010037","title":null}],"total_grants":1,"fwci":0.0,"citation_percentile":0.2916374,"influential_citations":0,"citation_trend":[],"oa_status":"hybrid","license":"cc-by-nc","oa_locations":[{"url":"https://academic.oup.com/ajeadvances/advance-article-pdf/doi/10.1093/ajeadv/uuaf017/64880899/uuaf017.pdf","host_type":"journal"},{"url":"https://academic.oup.com/ajeadvances/advance-article-pdf/doi/10.1093/ajeadv/uuaf017/64880899/uuaf017.pdf","host_type":"publisher"},{"url":"https://academic.oup.com/ajeadvances/article-pdf/1/3/uuaf017/64880899/uuaf017.pdf","host_type":"publisher"},{"url":"https://doi.org/10.1093/ajeadv/uuaf017","host_type":"journal"}],"fields_of_study":["HIV/AIDS Research and Interventions","HIV/AIDS Impact and Responses","Adolescent Sexual and Reproductive Health"],"mesh_terms":[],"keywords":["Breastfeeding","Viral load","Postpartum period","Human immunodeficiency virus (HIV)","Pregnancy","Intervention (counseling)","Transmission (telecommunications)"],"sdg_mappings":[],"linked_datasets":[],"clinical_trials":[],"software_tools":[],"database_accessions":[],"source":"live","citation_network_status":"fetched"},"created_at":"2026-08-06T14:45:18.203989Z","pmid":null,"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":[]}