Oral Abstract Session 01 - Global HIV Vaccine Enterprise
Oral Abstract Session 01 - Global HIV Vaccine Enterprise
Oral Abstract Session 01 - Global HIV Vaccine Enterprise
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POSTERS<br />
Posters<br />
Topic 9: Non-<strong>Vaccine</strong> Prevention<br />
P09.05<br />
<strong>HIV</strong>-Free Children Born to <strong>HIV</strong>-Seropositive Mothers<br />
in Bamako, Mali:A Six-Year Perspective on Providing<br />
MTCTP at the Front Line of AIDS<br />
Y. Koné 1 , B. Aboubacar 2 , L. Levitz 2 , C. Gomez Mira 2 , J. Toffoli 2 ,<br />
N. Ryback 2 , E. Kossow 2 , T. Huang 2 , A. Bicki 2 , K. Tounkara 2 ,<br />
Y. Traoré 3 , F. Siby Diallo 4 , M. Rochas 2 , A.S. De Groot 5<br />
1 Community Health Center, ASACOMSI / GAIA <strong>Vaccine</strong><br />
Foundation, Mékin-Sikoro/ Bamoko, Mali; 2 GAIA <strong>Vaccine</strong><br />
Foundation, Bamako, Mali; 3 Department of Obstetrics<br />
and Gynecology, Hôpital Touré, Bamako, Mali; 4 Regional<br />
Department of Health, Bamako, Mali; 5 GAIA <strong>Vaccine</strong><br />
Foundation, Institute for Immunology and Informatics,<br />
Providence, RI, USA<br />
Background: GAIA <strong>Vaccine</strong> Foundation (GAIA VF) conducted<br />
a six-year retrospective assessment of its Mother To Child<br />
Transmission Prevention (MTCTP) program for effectiveness as a<br />
non-vaccine <strong>HIV</strong> prevention tool.<br />
Methods: The MTCTP program at the Sikoro prenatal care center<br />
(Chez Rosalie) opened in 2005. We evaluated MTCTP acceptance<br />
and <strong>HIV</strong> test results of babies born in the MTCTP program from<br />
2005-2<strong>01</strong>1. We also surveyed <strong>HIV</strong>+ mothers at the clinic about<br />
MTCTP risk in July 2<strong>01</strong>1.<br />
Results: 10,471 women were counseled about <strong>HIV</strong> infection<br />
during the study period (average 145/month). An overwhelming<br />
majority (99.1%) agreed to <strong>HIV</strong> testing: 202 (2.15%) were <strong>HIV</strong>+, of<br />
whom 125 (61.9%) accepted MTCTP treatment. Ninety-two <strong>HIV</strong>+<br />
women delivered at Chez Rosalie. Most used the baby formula<br />
provided at the clinic, and a minority chose breastfeeding (as<br />
per national policy since 2<strong>01</strong>0). Notably, 100% of babies born<br />
to MTCTP-adherent mothers were <strong>HIV</strong>-seronegative. Thirtyfive<br />
<strong>HIV</strong>+ mothers were interviewed about MTCTP for their<br />
150 children. Of the seven polygamous women interviewed,<br />
none informed their husbands about their <strong>HIV</strong>+ status; single<br />
and monogamous mothers were significantly more likely to<br />
communicate their status.<br />
Conclusion: The number of women accepting treatment and<br />
remaining in care decreased over the 6-year period. Women<br />
moved to another clinic after testing positive and also returned<br />
to their home villages to deliver, despite having been educated<br />
about risks. Two children of mothers who were followed at Chez<br />
Rosalie but not enrolled in MTCTP were born <strong>HIV</strong>+; risk factors<br />
for transmitting <strong>HIV</strong> included late diagnosis (during pregnancy),<br />
breast feeding without concomitant ARV treatment, and single<br />
parent status. Lack of disclosure was worrisome, considering<br />
the number of polygamous relationships. GAIA is working on<br />
improving methods to reduce new <strong>HIV</strong> infections in Sikoro by<br />
destigmatizing <strong>HIV</strong> and MTCTP, and by scaling-up existing peereducation<br />
programs to improve willingness to participate in and<br />
adhere to MTCTP.<br />
202<br />
AIDS <strong>Vaccine</strong> 2<strong>01</strong>2<br />
P09.06<br />
Performance of Self-Reported Adherence to <strong>Oral</strong><br />
Pre-Exposure Prophylaxis (PrEP) Among <strong>HIV</strong><br />
Heterosexual Serodiscordant Couples in Rural<br />
Uganda<br />
F.M. Kibengo 1 , E. Ruzagira 1 , U.M. Bahemuka 1 , D. Katende 1 ,<br />
A. Abaasa 1 , B. Barin 2 , F. Priddy 3 , J. Haberer 4 , A. Kampala 1<br />
1 Medical Research Council/Uganda Virus Research Institute,<br />
Entebbe, Uganda; 2 The EMMES Corporation, New York, NY,<br />
USA; 3 International AIDS <strong>Vaccine</strong> Initiative, New York, USA;<br />
4 Massachusetts General Hospital Center for <strong>Global</strong> Health,<br />
Boston, MA, USA<br />
Background: Adherence is one of the main determinants of<br />
PrEP efficacy. Most PrEP studies applied subjective adherence<br />
measures, which often produce overestimates and problematic<br />
efficacy data interpretation; creating a need for more objective<br />
measures. This study examines self-reported adherence to oral<br />
PrEP compared to Medical Events Monitoring System (MEMS).<br />
Methods: Seventy-two <strong>HIV</strong>-uninfected partners (50% women)<br />
in Uganda were randomized to daily or intermittent (Monday,<br />
Friday and within 2 hours after sex, not exceeding 1 dose/day)<br />
oral emtricitabine/tenofovir or placebo in a 2:1:2:1 ratio for four<br />
months. Adherence was assessed monthly by MEMS and selfreported<br />
taken or missed doses by timeline follow-back calendar.<br />
MEMS data was adjusted for extra openings without pill removal<br />
and removal of multiple pills. Non-fixed days within intermittent<br />
regimen were classified as adherent/non-adherent based on selfreported<br />
sex by SMS. Adherence rates by taken/missed doses<br />
were compared to raw MEMS data using Spearman correlation.<br />
Results: Treatment and placebo groups were combined since<br />
adherence rates were similar. Daily raw MEMS adherence rate<br />
was significantly higher than fixed Intermittent rate (p=0.04) and<br />
post-coital dosing rate (p
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