Pediatric HIV/AIDS Cohort Study (PHACS): Understanding Maternal HIV Disease through Pregnancy and the Postpartum Period and its Role in Child Health Outcomes

The existing PHACS study infrastructure positions us well to investigate focused aspects of the health of women living with HIV before, during, and after pregnancy. Although the primary aim of SMARTT is to investigate the impact of in utero antiretroviral (ARV) exposure on the health of HIV-exposed uninfected (HEU) newborns and children, the study currently collects rich antepartum, peripartum and postpartum maternal data that could be used immediately to answer important maternal physical and mental health questions. Data pertinent to women’s health that are already being collected in SMARTT are summarized in Appendix 1. Since 2010, PHACS researchers have published 10 peer-reviewed investigations focused on the health and/or care of women living with HIV in SMARTT. In addition, new initiatives, including the July 2015 expansion of the maternal data elements and planned changes ushered in under version 5.0 of the SMARTT protocol, options for co-enrollment between SMARTT and the AMP-UP cohort, and active engagement of women living with HIV on the PHACS Community Advisory Boards present a synergistic opportunity to explore pressing women’s health research questions and to conduct clinically relevant research with a unique young cohort of women living with HIV who are of childbearing age. Strategically, with the appropriate research roadmap and funding, longer-term longitudinal follow-up of this cohort would position the PHACS team to answer broader women’s health questions for women living with HIV across their lifespan, with the potential to inform clinical guidelines, public health policy, and catalyze the development of interventions.