Factors Associated with Mother-to-child Transmission of HIV in Eswatini

Abstract

ABSTRACT Background: Mother-to-child-transmission of the human immunodeficiency virus (HIV) continues to cause increased child morbidity and mortality despite the constantly improved prevention of mother to child transmission (PMTCT) programme interventions. The programme interventions continue to be surrounded by barriers hindering eradication of HIV in newborns. Objective: To identify factors associated with HIV seropositivity in infants aged 6–8 weeks in Eswatini. Method: A secondary analysis of 1415 HIV infected mothers and their HIV exposed infants who attended child immunisation clinics between 2011 and 2012 was performed. Factors associated with HIV seropositivity were analysed through univariate and multivariable logistic regression methods. Results: Of the 1415 HIV exposed infants, 31 were HIV positive reflecting a mother-to-child-transmission rate of 2.2%. Maternal age, number of antenatal clinic (ANC) visits, maternal antiretroviral regimen, place of delivery and birth-weight were associated with HIV seropositivity on univariate analysis. On multivariate analysis, the only factor which remained significantly protective (OR = 0.83; P value = 0.004) for HIV transmission to infants were the number of ANC visits. Those infants whose mothers had more than 4 visits were less likely to be HIV positive when compared with fewer visits. Conclusion: Increased number of antenatal care visits attended by pregnant women is beneficial as it increases access to PMTCT services thereby decreasing the prospect of mother-to-child HIV transmission.