Effectiveness and associated factors of prevention for mother-to-child human immunodeficiency virus transmission in 536 human immunodeficiency virus-positive pregnant women in Hubei Province

Abstract

Objective To evaluate the effectiveness and associated factors of prevention of mother-to-child human immunodeficiency virus (HIV) transmission in Hubei Province, and to provide a reference for prevention of mother-to-child transmission of HIV. Methods In this prospective cohort study, HIV-positive pregnant women who were in some counties and cities of Hubei Province from January 2004 to December 2016 were enrolled. Prevention of mother-to-child transmission of HIV was conducted for these HIV-positive pregnant women and their infants, and their clinical data were collected. Descriptive analysis and χ2 test were used to analyze the general characteristics of HIV-positive pregnant women and their infants. Logistic regression analysis was adopted to explore the associated factors of mother-to-child HIV transmission. Results In total, 536 HIV-positive pregnant women (628 pregnancies) were found, among which, 334 pregnant women and 345 infants were enrolled in this study. Twenty-four infants were HIV-positive, which was 6.96% in all infants (95%CI: 4.27%-9.64%). The rates of mother-to-child HIV transmission without prevention, formula feeding only, infant medication plus formula feeding, mother and infant medication plus formula feeding were 35.71% (95%CI: 21.61%-51.93%), 8.82% (95%CI: 2.08%-15.57%), 7.41% (95%CI: 0.92%-24.22%), and 0.48% (95%CI: 0.01%-2.64%), respectively. No antiretroviral medications during delivery (OR=14.484, 95%CI: 1.740-120.577, P=0.013), breastfeeding (OR=6.542, 95%CI: 2.416-17.713, P=0.000), and CD4+ T lymphocyte count<200 cells/μL during delivery (OR=3.060, 95%CI: 1.076-8.703, P=0.036) were independent risk factors of mother-to-child HIV transmission. Conclusions The rate of mother-to-child HIV transmission without prevention is high in Hubei Province, which can be significantly reduced by comprehensive interventions (mother and infant medication plus formula feeding). Thus, we should diagnose HIV-positive pregnant women as early as possible, and should give pregnant woman antiretroviral therapy plus infant medication and formula feeding to further reduce the rate of mother-to-child HIV transmission. Key words: HIV; Pregnant women; Prevention of mother to child transmission; Associated factors