Rosa Chemwey Ndiema, MBChB, MMed

GHES LMIC Fellow 2017-2018

Home Institution: Kenyatta National Hospital, Nairobi, Kenya
U.S. Institution: Yale University

Project Title: Uptake and outcomes of HIV preconception care package to discordant couples expressing fertility desire at Kenyatta National Hospital.

Preconception care for people living with HIV aims to promote planned pregnancies, support safer conception strategies for discordant partners, prevent mother-to-child, HIV transmission (MTCT), and optimize maternal and infant health outcomes. A large proportion of the HIV infection in sub-Saharan Africa occur between couples in established relationships, making HIV serodiscordance a major contributor to the spread of HIV.

In Kenya 5% of couples are discordant and HIV-negative members of discordant couples have an annual incidence of infection between 10-20% higher than their counterparts in HIV concordant-negative relationships. Despite new HIV infections among children reducing by 49% from 2013 to 2015, MTCT remains high at 8.3%. Lastly, Kenya targets to reduce new child HIV infections by 90% thus eliminating MTCT to below 5%. Preconception care is a cornerstone to this strategy; this study aims to describe the impact of preconception care on rates of MTCT.