Publication Spotlight: Lessons Learned From Early Implementation of Option B+

December 1, 2014 - Volume 67 - Supplement 4


On Dec. 1, 2014, World AIDS Day, the Journal of Acquired Immune Deficiency Syndromes (JAIDS) published a supplement, Bridging Gaps Between HIV, Maternal and Reproductive Healthcare in Sub-Saharan Africa: Evidence for Action.

The Elizabeth Glaser Pediatric AIDS Foundation (EGPAF) contributed an article to this JAIDS supplement analyzing early lessons learned with the implementation of Option B+, as recommended in the World Health Organization (WHO) 2013 Consolidated Antiretroviral Guidelines. Option B+ recommends initiation of lifelong antiretroviral treatment (ART) for all pregnant and lactating women living with HIV to reduce risk of mother-to-child transmission of HIV and to maintain the good health of mothers.

Meghan Mattingly, a technical officer with EGPAF’s department of Medical and Scientific Affairs, was one of the authors of the published manuscript, “Lessons Learned from Early Implementation of Option B+: The Elizabeth Glaser Pediatric AIDS Foundation Experience in 11 African Countries.” Below, she shares some of the article’s key takeaways.

What prompted the development of this manuscript?

The WHO has emphasized the need to closely monitor the implementation of Option B+ to identify programmatic and health system challenges. In light of this, we reviewed EGPAF’s multicountry experience supporting ministries of health with Option B+ implementation across 11 African countries. This review and analysis is intended to inform stakeholders involved in scaling up Option B+.

What have been some of the findings?

EGPAF’s early experiences with Option B+ implementation demonstrate promise. Continued program evaluation is needed, as is attention to counseling and support for HIV-positive women around initiation of lifetime antiretroviral therapy (ART) in pregnancy and lactation. These are some of our specific findings:

How will these findings affect the focus of future program implementation or further areas of research?

EGPAF will continue to support country programs to achieve optimal outcomes in their PMTCT programs through national level policy discussions, health care worker capacity building, supportive supervision, and community engagement. Option B+ holds potential to facilitate country-level movement toward eliminating pediatric HIV and AIDS.

For more information on how EGPAF supports countries in the adaptation and implementation of Option B+, read the Option B+ issue of EGPAF’s technical newsletter, Haba Na Haba.