Original Research

Retrospective review of maternal HIV viral load electronic gatekeeping codes in South Africa

Siphesihle K. Mahanjana, Tladi Ledibane, Gayle G. Sherman, Tanya Y. Murray, Ahmad F. Haeri Mazanderani
Southern African Journal of HIV Medicine | Vol 25, No 1 | a1539 | DOI: https://doi.org/10.4102/sajhivmed.v25i1.1539 | © 2024 Siphesihle K. Mahanjana, Tladi Ledibane, Gayle G. Sherman, Tanya Y. Murray, Ahmad F. Haeri Mazanderani | This work is licensed under CC Attribution 4.0
Submitted: 29 September 2023 | Published: 20 February 2024

About the author(s)

Siphesihle K. Mahanjana, Department of Public Health Medicine, Faculty of Health Sciences, School of Medicine, Sefako Makgatho Health Sciences University, Pretoria, South Africa
Tladi Ledibane, Department of Public Health Medicine, Faculty of Health Sciences, School of Medicine, Sefako Makgatho Health Sciences University, Pretoria, South Africa
Gayle G. Sherman, Centre for HIV and STIs, National Institute for Communicable Diseases, Division of National Health Laboratory Service, Johannesburg Department of Paediatrics and Child Health, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
Tanya Y. Murray, Centre for HIV and STIs, National Institute for Communicable Diseases, Division of National Health Laboratory Service, Johannesburg Department of Paediatrics and Child Health, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
Ahmad F. Haeri Mazanderani, Centre for HIV and STIs, National Institute for Communicable Diseases, Division of National Health Laboratory Service, Johannesburg Department of Paediatrics and Child Health, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa

Abstract

Background: Maternal electronic gatekeeping (eGK) codes for HIV viral load (VL) testing of pregnant and breastfeeding women were developed to permit increased frequency of maternal HIV VL testing without automated gatekeeping cancellation, and to enable virological surveillance.

Objectives: This study describes the national uptake of maternal eGK codes and VL suppression (VLS) rates disaggregated by age during antenatal, delivery and postnatal periods in South Africa during 2022.

Method: HIV VL tests associated with C#PMTCT (used for antenatal and postnatal testing) and C#DELIVERY (used at delivery) eGK codes between 01 January and 31 December 2022, were extracted from the National Institute for Communicable Diseases Data Warehouse. Uptake of eGK codes was calculated using indicators from the District Health Information System as denominators while HIV VLS rates (< 1000 copies/mL) were calculated as monthly and annual percentages.

Results: Overall, national maternal eGK code uptake was 41.8%, 24.5% and 0.12% for the antenatal, delivery and postnatal periods, respectively. The monthly antenatal eGK uptake increased from 27.5% to 58.5% while delivery uptake increased from 17.3% to 30.0%. The overall annual maternal HIV VLS rate was 86.7% antenatally and 87.2% during delivery. The monthly average HIV VLS for adolescent girls and young women (AGYW) was 76.1% antenatally and 79.6% during delivery.

Conclusion: Although overall national uptake of maternal HIV VL eGK codes was low, antenatal and delivery uptake improved over time, thereby facilitating use of eGK codes for programmatic monitoring of maternal VLS rates for the first time. Quality of care among pregnant AGYW requires urgent attention.


Keywords

maternal HIV; electronic gatekeeping codes; viral load; surveillance; vertical transmission prevention

Sustainable Development Goal

Goal 3: Good health and well-being

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