Improving HIV Testing and Treatment for Mothers Living with HIV and Their Newborns in Tanzania and Mozambique to Reduce Infant HIV Transmission and Enhance Care

What this Trial Is About

This research aims to improve HIV healthcare for mothers living with HIV and their newborns in Tanzania and Mozambique, focusing on preventing HIV transmission from mother to child. The study evaluates whether adding maternal HIV viral load testing at delivery better identifies mother-child pairs at high risk of transmission and whether high-risk infants receive appropriate prevention and care. It builds on previous findings about early infant HIV treatment challenges and seeks to reduce access inequities in rural areas by expanding HIV testing services through a hub-and-spoke referral system. The study involves maternal HIV viral load testing at delivery to assess vertical HIV transmission risk, combined with WHO clinical criteria for risk classification. The intervention includes personnel support for managing high-risk cases, eHealth tools for sharing test results between health facilities, and enhanced counseling for high-risk mother-baby pairs. High-risk infants and their mothers are followed long-term for up to 12 months to monitor health outcomes and treatment adherence. Participants will undergo HIV testing at birth and follow-up visits at 4-6 weeks, 14 weeks, 6 months, and 12 months, with assessments of viral suppression, drug resistance, and clinical outcomes. The study also collects socio-behavioral data through interviews and questionnaires to understand factors affecting treatment outcomes. Researchers will measure key program indicators such as the proportion of high-risk newborns tested and started on treatment within seven days, turnaround times for testing, and cost-effectiveness of the intervention package. Continuous support and counseling are provided throughout the study duration.

Increasing Neonatal HIV Test and Treat to Maximize the Long-Term Impact on Infant Health and Novel Infant Antiretroviral Treatment