HIV control in postpartum mothers: a turbulent time

We conducted an audit looking at the management of HIV positive women in the postpartum period. We found that of the women with a previous AIDS defining condition or a CD4 count <350 cells/µL, 83.0% were correctly continued on antiretroviral therapy (ART) and 84.1% of these had good virological control. ART was correctly stopped in 100% of women who had always had a CD4 count >500 cells/µL. A significant finding from our audit was that all of the women who had poor virological control or stopped ART against medical advice had social issues or self-reported depression. The main recommendation was to extend the pregnancy multidisciplinary team (MDT) meeting to include the 12-month postpartum period to offer support to women to try to improve treatment outcomes.