Marilyn Nyabuti, MBChB, MPH
MARILYN NYABUTI
Nominated From: University of Washington
Research Site: Kenyatta National Hospital
Research Area: HIV Maternal and Child Health
Primary Mentor: Kristin Beima-Sofie, PhD, MPH
Research Project
Strengthening HIV care transition from Prevention of Mother to Child Transmission Program (PMTCT) to general HIV care to enhance care continuity for WLHIV
Despite the success of the Prevention of Mother to Child Transmission (PMTCT) program in improving retention and viral suppression of women living with HIV (WLHIV) during follow-up, there is limited evidence on whether these outcomes are sustained post transition when returning to general HIV care. Data from a pilot study conducted in Homabay Kenya, indicated that 34.6% of WLHIV miss their initial post transition visit at the general HIV care clinic suggesting diminishing retention and health outcomes post transition. Objectives: To assess one-year retention and viral suppression among WLHIV after transition from the PMTCT program to general HIV care clinics in Kenya, and to identify system-level barriers and facilitators of successful transition and retention. Methods: Leveraging an ongoing cluster randomized clinical trial (the ATTACH-Scale study), we will conduct a multi-method study in 32 Kenya Ministry of Health facilities. In Aim 1, clinic records of ~6,400 WLHIV who transitioned from PMTCT to general HIV care between June 2024–June 2025 will be reviewed to determine rates and correlates of post transition retention and viral suppression. In Aim 2, we will conduct focus group discussions (n=8) with HCWs from selected facilities using semi-structured guides to explore transition processes, key influences on transition experiences, and opportunities to improve patient outcomes. Expected outcomes: The study will provide timely evidence on post transition treatment outcomes for WLHIV and identify system gaps, informing strategies to strengthen transition and retention among WLHIV after transition to general HIV care clinics in Kenya.
Research Significance
This study will generate evidence on gaps and opportunities to improve transition care for WLHIV moving from the MCH to the general HIV care clinic and inform the design of strategies to strengthen care engagement and treatment outcomes for WLHIV in the reproductive age in the context of changing HIV funding landscape.
Publications
Mentors
