Timing and Duration of Prediabetic Metabolic Dysfunction Differentially Impact Cerebral Perfusion, Vascular Structure, and Behavior.

Despite major progress in human immunodeficiency virus (HIV) prevention and treatment, HIV remains a global public health challenge. In 2023, an estimated 39.9 million people were living with HIV, with 1.3 million new infections and 63 000 acquired immunodeficiency syndrome (AIDS)-related deaths, highlighting persistent gaps in prevention, treatment and continuity of care, including in maternal and child health. Option B+, introduced in 2011–2012, recommends immediate and lifelong antiretroviral therapy (ART) for all pregnant and breastfeeding women living with HIV, regardless of cluster of differentiation 4 (CD4) count or clinical stage. It aims to reduce mother-to-child transmission, improve maternal health and simplify the prevention of mother-to-child transmission (PMTCT) of HIV service delivery. In African settings, retention in HIV care during pregnancy and postpartum remains challenging in the Option B+ era; a systematic review estimated 12-month retention at 76.4%, with particular vulnerability after delivery. Quality improvement initiatives such as process mapping and quality improvement (PROMAQI) may support monitoring of engagement and follow-up in Option B+ programmes. Current World Health Organization (WHO) guidance no longer uses the designation ‘Option B+’ but reinforces its core principle by recommending ART for all people living with HIV, including pregnant and breastfeeding women, and differentiated service delivery to support retention and adherence. World Health Organization and United Nations Children’s Fund (UNICEF) also recommend breastfeeding for at least 12 months, and up to 24 months or longer, when effective ART and adherence support are sustained, although women living with HIV in sub-Saharan Africa tend to breastfeed for shorter durations than HIV-negative women. Antiretroviral therapy initiation, adherence and retention among pregnant and postpartum women living with HIV are shaped by individual and contextual factors, including knowledge of HIV and PMTCT, treatment demands, disclosure and partner involvement. Qualitative evidence from Ethiopia also shows that stigma, adverse marital dynamics, economic barriers, religious beliefs and confidentiality concerns contribute to loss to follow-up, whereas peer support, partner involvement and active tracing may promote re-engagement in care. These dimensions make comparisons by age (< 25 vs ≥ 25 years) and by partner partner support and involvement (present vs absent) relevant, given that younger women are at greater risk of loss to follow-up and partner support and involvement is associated with greater adherence and retention in PMTCT programmes. In Angola, HIV remains a relevant public health challenge, with UNAIDS reporting an estimated national prevalence of 1.5%, approximately 310 000 people living with HIV and 15 000 new infections in 2022. Pregnant women remain a vulnerable group, with sentinel surveillance reporting HIV prevalence of 2.2% among women aged 15–49 years. Despite progress, ART coverage in 2022 remained below global targets, estimated at 49% among adults and 22% among children living with HIV. The National HIV/AIDS Strategic Plan 2023–2026 seeks to expand HIV prevention, testing and treatment, including efforts to strengthen PMTCT services, follow-up of HIV-exposed children and use of vertical transmission data. Previous Angola-based studies have highlighted persistent challenges in PMTCT service use and programme effectiveness, reinforcing the need to strengthen access, continuity of maternal–child HIV care and follow-up of HIV-exposed children. Incomplete knowledge of HIV and AIDS among Angolans aged 15–49 years further supports the need for context-sensitive counselling and communication. However, qualitative evidence on women’s postpartum experiences remains limited, despite this being a critical period for ART adherence, early infant diagnosis (EID), infant feeding decisions and prevention of loss to follow-up along the PMTCT continuum. This qualitative study, with an experiential orientation informed by phenomenological sensitivity, explored the lived experiences of HIV-positive postpartum women at Lucrécia Paim Maternity Hospital, Luanda, Angola and identified opportunities to strengthen postpartum PMTCT services. Comparisons by age and partner status examined variations in psychosocial needs and care experiences across groups. This was not designed as an interpretative phenomenological study. Rather, it was a qualitative study situated within an interpretivist and contextualist paradigm, with an experiential orientation informed by phenomenological sensitivity. The study sought to understand participants’ lived postpartum experiences without conducting a formal phenomenological analysis. Reflexive thematic analysis, following Braun and Clarke, was used to identify patterns of meaning grounded in participants’ accounts, rather than to apply interpretative phenomenological analysis or Giorgi’s descriptive ph