"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.