"Young Mothers Clubs": Prevention of Mother-to-Child HIV Transmission Among Pregnant Adolescent Girls and Young Women in Haiti.

Background

Pregnant adolescent girls and young women (AGYW) living with HIV face substantial barriers to antiretroviral therapy (ART) adherence, retention in care, and prevention of mother-to-child transmission (PMTCT), especially in resource-limited settings. Stigma, limited social support, and fragmented services contribute to suboptimal maternal and infant outcomes.

Setting

This pilot intervention was implemented at the GHESKIO HIV clinic in Port-au-Prince, Haiti.

Methods

We analyzed routinely collected clinical data from 50 pregnant AGYW aged 15-24 years living with HIV who were enrolled in Young Mothers Clubs between February 2018 and August 2019. Young Mothers Clubs are a midwife-led, cohort-based PMTCT care model providing biweekly community-based sessions that integrated peer support, reproductive health counseling, parenting and HIV education, and individual clinical assessments. All participants initiated or continued ART at enrollment. The primary outcome was a composite of maternal retention in HIV care and infant HIV-negative status at 18 months postpartum.

Results

The median maternal age was 21 years; 64% were ART-experienced and 43% were virally suppressed at enrollment. At 18 months postpartum, 85% of mothers were retained in HIV care, and 69% among all eliegible mothers were virally suppressed. Among 45 live-born infants, one acquired HIV, and 69% were retained in care at 18 months. Overall, 60% of mother-infant pairs achieved the primary outcome. Eight infants (18%) died from non-HIV causes, and six (13%) were lost to follow-up.

Conclusion

Young Mothers Clubs demonstrated high maternal retention and low HIV transmission. Persistent infant mortality and attrition underscore the need for enhanced postnatal support.