Clinical and programmatic outcomes of HIV-exposed infants enrolled in care at geographically diverse clinics, 1997–2021: A cohort study

What is it about?

In a large dataset of >82,000 HIV-exposed infants born over a 25-year period at 198 clinics providing routine HIV services in 10 countries, we examined HIV testing, loss to follow-up, HIV diagnosis, and death through 24 months of age. We also examined associations between these outcomes and maternal and infant characteristics.

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Photo by Danie Franco on Unsplash

Photo by Danie Franco on Unsplash

Why is it important?

Our work expands on previous evidence which is largely limited to single-program or single-country reports with small sample sizes, lack of mother–infant linkages, or restricted geographical or temporal breadth. This study generated novel information on clinical characteristics and programmatic outcomes among HIV-exposed infants, notably finding that while mortality and HIV diagnosis decreased over time globally, infant retention at 2 years did not exceed 60% in any period in any region. Our finding of widespread and persistent loss to follow-up across disparate settings should motivate changes in policy and practice to improve patient retention, as maintaining infants in care will facilitate not only HIV testing and prevention, but also the provision of other services essential for the achievement of long-term health.