Research Article

HIV Care Continuum among Postpartum Women Living with HIV in Atlanta

Table 1

Demographic and clinical characteristics of WLWH in Atlanta, GA (n=207)1.

VariableN (%) except as noted

Age, (years), mean ± SD28.1 ± 6.2

Race/ethnicity
 White (non-Hispanic)11 (5.3%)
 African-American (non-Hispanic)162 (78.3%)
 Hispanic14 (6.8%)
 Other20 (9.6%)

Year of delivery
 2011-201283 (40.1%)
 2013-201471 (34.3%)
 2015-210653 (25.6%)

HIV Transmission Risk Factor
 Sexual122 (58.9%)
 Perinatal22 (10.6%)
 Other (IVDU, iatrogenic)5 (2.4%)
 Unknown58 (28.0%)

HIV diagnosis during pregnancy47 (22.7%)

Time since HIV diagnosis (years), median (Q1, Q3)3 (1, 8)

In HIV care prior to pregnancy114 (55.3%)

On ART prior to pregnancy74 (36.8%)

Number of previous live births, median (Q1, Q3)1 (0, 2)

Number of prenatal care visits, median (Q1, Q3)9 (6, 11)

CD4 cell count at presentation (cells/mm3), mean ± SD412.9 ± 264.4

Viral Loads
 Viral load <1000 c/mL during entire pregnancy85 (42.1%)
 Viral load <200 c/mL during entire pregnancy62 (30.7%)
 Viral load <1000 c/mL in third trimester150 (75.8%)
 Viral load <200 c/mL in third trimester127 (64.1%)
 Viral load <200 c/mL at delivery147 (71.0%)

ART interruption during pregnancy133 (64.9%)

Cesarean delivery99 (48.1%)

Perinatal HIV infection3 (1.5%)

Contraceptive plan at delivery (mutually exclusive)1
 Tubal Ligation20 (9.8%)
 Hormonal intrauterine device17 (8.3%)
 Copper intrauterine device4 (2.0%)
 Implant30 (14.6%)
 DMPA62 (30.2%)
 Oral contraceptives19 (9.3%)
 Hormonal patch or ring3 (1.5%)
 Condoms alone20 (9.8%)
 None15 (7.3%)

Contraceptive provided at time of delivery126 (62.1%)

Attended 6 week obstetric postpartum appointment156 (76.4%)

Subsequent pregnancy44 (23.5%)

Postpartum transition to HIV Care
 Time (days), median (Q1, Q3)124 (70, 357)
 <90 days73 (37.1%)
 90-180 days54 (27.4%)
  > 180 days70 (35.5%)
 No postpartum HIV visit10 (4.8%)

ART interruption after delivery97 (64.2%)

Change in ART regimen postpartum90 (59.2%)

Viral suppression2
 12 months postpartum76 (41.3%)
 24 months postpartum46 (30.1%)

Retention in HIV care2
 12 months postpartum86 (46.5%)
 24 months postpartum52 (34.0%)

Abbreviations. IVDU: intravenous drug use; DMPA: Depo Medroxyprogesterone acetate; IUD: intrauterine device.
Some women with a contraceptive plan did not receive planned contraception at the time of delivery.
Changes in denominator occurred because only 185 women were least 12 months postpartum, and only 153 of the women were at least 24 months postpartum, at the time of analysis.