ART Readiness in HIV-infected Pregnant Women

This is qualitative and quantitative research exploring the issues of patient readiness to initiate lifelong ART among HIV-infected pregnant women, as well as ART adherence and retention in HIV care and treatment during pregnancy and after delivery. The objectives of Phase 1 of the study are as follows: * To identify common themes about patient readiness for ART initiation in the days and weeks following ART eligibility in the context of pregnancy * To learn about strategies that HIV-infected women and partners of reproductive-age women believe will assist with daily adherence to triple-drug ART and retention in care during pregnancy and after delivery The objectives of Phase 2 of the study are as follows: * To develop a screening instrument for assessing readiness of ART initiation during pregnancy * To pilot the ART readiness assessment tool and evaluate its acceptability and feasibility through qualitative research * To design a combination intervention that systematically addresses barriers to patient readiness and in so doing, may shorten time from HIV diagnosis to ART initiation and increase rates of ART adherence and retention in care in the short term The objectives of Phase 3 of the study are as follows: * To evaluate an enhanced adherence package for improving timely ART initiation and retention in care, defined by attending follow-up ART visit(s), at 30 days after ART eligibility and by maternal HIV viral levels at time of delivery * To determine the accuracy of the screening instrument in predicting ART readiness by looking at early ART adherence and retention * To obtain early data about virologic response in pregnancy and postnatal period among HIV-infected women on Option B+ * To obtain data about 6-week and 6-month MTCT rates of HIV among HIV-infected women on Option B+ * To obtain data about renal function in pregnancy and postnatal period among HIV-infected women on Option B+, given that tenofovir is first-line in Zambia