Introduction
HIV PNP
Since 2012, lifelong antiretroviral therapy (ART) is internationally recommended for pregnant and breastfeeding mothers living with HIV (Post-natal prophylaxis (PNP) is internationally recommended by WHO for 6 to 12 weeks (The PROMISE-EPI randomized controlled trial was implemented in Zambia and Burkina Faso between December 2019 and October 2022. The trial tested a single-drug PNP with lamivudine which was initiated for all infants at high risk of acquisition of HIV, until the end of the breastfeeding period or the end of the study at 12 months, whichever came first. Infants were classified as high risk if maternal viral load was ≥1000cp/mL measured at the second visit of immunization (EPI-2), when the baby is 6 weeks old, or at month 6. The comparative group followed the national standard of care, described above.There is no reliable and easy-to-implement technique to assess adherence to infant HIV PNP in resource-limited countries. Long-term PNP adherence was studied through quantitative data from survey interviews with mothers (Several qualitative studies, implemented in low and middle income countries, assessed barriers to pediatric ARV adherence in children living with HIV (The present research is part of a larger implementation sub-study of PROMISE-EPI trial with the aim to explore the factors (1) influencing Prevention of MTCT (PMTCT) program (2) associated with the acceptability and feasibility of the standard of care compared to the PROMISE-EPI intervention. Focusing on the relationship to drugs, this analysis aimed to characterize (1) the comparison of the barriers and facilitators of the three drug prophylaxis provided by the Zambian national program versus lamivudine prophylaxis provided in PROMISE-EPI; (2) the barriers and facilitators of long term use of lamivudine.