Abstract
Mother-to-child transmission of HIV infection is a significant problem in Mozambique. This study aims to determine the risk factors associated with mother-to-child transmission of HIV in rural Mozambique. Retrospective case-control study in a rural area of Bilene District, on the coast of southern Mozambique, performed from January 2017 to June 2018. The analysis considered the clinical data of HIV exposed children with definitive HIV positive results and their respective infected mothers (cases), and the data of HIV exposed children with definitive HIV negative results and their respective infected mothers (controls) registered in At Risk Child Clinics from 1st January 2017 to 30th June 2018 at the Macia and Praia de Bilene health facilities in Bilene district, Gaza province-Mozambique. Ninety pregnant women with HIV were involved in the study, including 30 who had transmitted the infection to their children and 60 who had not. Statistical analysis, adjusted for maternal age and gestational age at first antenatal care visit, showed that independent risk factors for transmission were gestational age at first visit (adjusted odds ratio [aOR] 1.19, 95% confidence interval [CI] 1.05-1.36), non-adherence to combination antiretroviral therapy (56.7% vs. 5%; aOR 14.12, 95% CI 3.15-63.41); a viral load of 1000 copies/mL or more (90% vs. 5%; aOR: 156, 95% CI 22.91-1,062) and female sex of the neonate (80% vs. 51.7%; aOR: 4.43, 95% CI 1.33-15.87). A high viral load and non-adherence to antiretroviral therapy are important predictors of mother-to-child HIV transmission.
Highlights
HIV infection remains a major public health problem in the world and in developing countries
This study aims to determine the risk factors associated with mother-to-child transmission of HIV in rural Mozambique
Statistical analysis, adjusted for maternal age and gestational age at first antenatal care visit, showed that independent risk factors for transmission were gestational age at first visit, non-adherence to combination antiretroviral therapy (56.7% vs. 5%; adjusted odds ratios (aOR) 14.12, 95% confidence intervals (CIs) 3.15–63.41); a viral load of 1000 copies/mL or more (90% vs. 5%; aOR: 156, 95% CI 22.91–1,062) and female sex of the neonate (80% vs. 51.7%; aOR: 4.43, 95% CI 1.33–15.87)
Summary
HIV infection remains a major public health problem in the world and in developing countries. The prevalence of human immunodeficiency virus or acquired immunodeficiency syndrome (HIV/AIDS) has increased rapidly since the 1980s in developing countries. As a result, this has led to several demographic, economic and social consequences. More than 2 million children are living with HIV/AIDS worldwide, with more than 80% of them living in sub-Saharan African countries. Mozambique is one of the southern African countries with a high HIV burden. Mother-to-child transmission of HIV infection is a significant problem in Mozambique.
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