In 2016, 89% of pregnant women living with HIV in Eastern and Southern Africa received antiretroviral treatment to prevent vertical transmission of HIV. Despite this scale-up, in the same region, an estimated 77,000 children (0-14 years) acquired HIV in 2016. AIDS-related illness remains the leading cause of death for women of reproductive age (15-49 years) globally. With countries now providing lifelong treatment to pregnant women living with HIV, one of the biggest challenges is for healthcare systems to retain women living with HIV in lifelong care. But investments in programmes to prevent vertical transmissoin of HIV decreased by 7% from 2015-16 to US$41 million. While many studies have explored and defined the challenges faced by women living with HIV in accessing and being retained in care and studies, such as INSPIRE, have focused on approaches to improve retention in care, few studies have focused on the perspectives and lived experiences of women living with HIV in evaluating and identifying factors that facilitate retention.

This community-led study was coordinated by the Global Network of People Living with HIV (GNP+) and the International Community of Women Living with HIV (ICW). The research was conducted in country by peer researchers from ICW Malawi, ICW Eastern Africa and the Network of Zambian People Living with HIV/AIDS (NZP+). The study sought to understand the factors that facilitate women to adhere to treatment and return to health facilities for routine care from their own perspective. The researchers focused on Malawi, Uganda and Zambia, early adopters of the global guidance to provide lifelong treatment for pregnant women living with HIV (Option B+) and spoke to women living with HIV, healthcare workers and programme managers to discover which factors and practices show promise in supporting women to initiate and remain in care.