# Evaluating the HITSystem to Improve PMTCT Retention and Maternal Viral Suppression in Kenya

> **NIH NIH R01** · UNIVERSITY OF KANSAS MEDICAL CENTER · 2024 · $149,420

## Abstract

Abstract
Despite progress in providing comprehensive prevention of mother-to-child transmission of HIV
(PMTCT) services, significant gaps in the timely uptake and provision of guideline-adherent
services and maternal retention in care remain. Such gaps create missed opportunities for
preventing mother-to-child transmission and result in nearly 6,100 infants becoming infected
with HIV each year in Kenya. Effective interventions that routinize the delivery of evidence-
based PMTCT services and foster consistent patient engagement are essential to close the
remaining gaps and eliminate mother-to-child transmission of HIV. Building off of a successful
R34 grant to develop and pilot test the HITSystem 2.0, an eHealth intervention targeting PMTCT
services, the overall goal of this proposal is to use a cluster randomized control design at 12
Kenyan government hospitals to evaluate a modified HITSystem 2.1 intervention. HITSystem
2.1 reflects the 2018 Kenyan PMTCT guidelines, including routine viral load monitoring and
interventions to suppress maternal viral load. We aim to evaluate the impact of HITSystem 2.1
to optimize the provision of guideline-adherent services and viral suppression through the
antenatal, delivery, and early postpartum periods. Aim 1 of the proposed study will assess the
efficacy of the HITSystem 2.1 to increase the proportion of mothers who receive complete
PMTCT services (including appointment attendance, medication adherence support, viral load
testing, hospital-based delivery, and infant testing per Kenyan National Guidelines) through 6
months postpartum. We hypothesize that mothers receiving the HITSystem 2.1 intervention will
have a significantly higher completion rate for guideline-adherence PMTCT services compared
to mothers receiving standard of care PMTCT services. In Aim 1b, we will evaluate HITSystem
2.1 implementation using the RE-AIM model to inform sustainable scale up. Aim 2 will assess
the efficacy of HITSystem 2.1 to increase viral suppression (<1,000 copies/mL) among pregnant
and postpartum women, including those who disengage from care. We hypothesize that
mothers at HITSystem 2.1 sites will have higher rates of viral suppression at delivery and 6
months postpartum. Aim 3 will evaluate the cost-effectiveness of the HITSystem 2.1. Driven by
differences in PMTCT retention, viral suppression, and modeled estimates of pediatric HIV
infections averted, we hypothesize that the HITSystem 2.1 will be cost-effective, based on
World Health Organization criteria. This proposal is aimed at improving the quality of PMTCT
services in the health facility setting. If efficacious and cost-effective, HITSystem 2.1 holds
strong promise for national dissemination.

## Key facts

- **NIH application ID:** 10980806
- **Project number:** 3R01MH121245-05S1
- **Recipient organization:** UNIVERSITY OF KANSAS MEDICAL CENTER
- **Principal Investigator:** SARAH Finocchario KESSLER
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $149,420
- **Award type:** 3
- **Project period:** 2019-12-18 → 2025-05-15

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10980806

## Citation

> US National Institutes of Health, RePORTER application 10980806, Evaluating the HITSystem to Improve PMTCT Retention and Maternal Viral Suppression in Kenya (3R01MH121245-05S1). Retrieved via AI Analytics 2026-06-14 from https://api.ai-analytics.org/grant/nih/10980806. Licensed CC0.

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