Malawi pioneered Option B+ (B+), a novel application of test-and-treat that provided life-long ART for HIV+ pregnant and ... VITAL Start was designed to help optimize retention and adherence to ART among pregnant and breastfeeding women in Malawi. ... Women who are HIV positive by two antibody rapid tests approved by the Malawi Ministry of Health ... in Malawi with the primary composite outcome of retention and adherence (viral suppression) 12 months after starting ...