Prevalence of HIV Sero-conversion and associated risk factors among antenatal clinic attendees in Enugu state university of science and technology teaching hospital, Enugu Nigeria

Abstract

Background: Human immunodeficiency virus (HIV) infection is a leading cause of morbidity and mortality among women of reproductive age and it is a major contributor to maternal, infant and child morbidity and mortality. Globally, in 2015, an estimated, 78 million people had become infected with HIV while 35 million people had died from Acquired Immune Deficiency Syndrome (AIDS)-related illness since the start of the epidemic. In Nigeria, a national HIV prevalence rate of 3.4% was reported in 2012 with 1.3% in Enugu State. HIV retesting is a WHO recommendation that was adopted by Nigerian her national guideline. The essence of antenatal HIV retesting includes the identification of pregnant women who were first tested during their window periods and subsequently sero-converted, and those who acquired new HIV infection after their initial screening test given the fact that a single HIV testing may not be enough to diagnose HIV with findings of high rates of incident HIV infection during pregnancy and at the post-partum periods. It has been shown that the rate of MTCT was higher from sero-converting women compared with women with already established HIV infection. Hence, this study which gave a clue to the rate of HIV sero-conversion among our antenatal women which may possibly popularize the concept of retesting especially among these women. Aim: To determine the prevalence of HIV sero-conversion and the associated risk factors among previously sero-negative antenatal clinic attendees in Enugu State University of Science and Technology Teaching Hospital, (ESUTTH). Methods: This was a prospective, cohort study involving 415 sero-negative HIV women recruited from antenatal clinic in ESUTH from January to April, 2019 and followed up for 12 weeks. Information on their socio-demographic characteristics, pregnancy history, sexual lifestyle, and clinical profile were obtained using an interviewer-administered questionnaire. HIV tests were done at booking and repeated after 12 weeks using the Rapid Diagnostic Test kits by the parallel algorithm format. Data was analyzed with the IBM SPSS version 23.0. Measures of associations were determined with the Chi-Square test and binary logistic regression. P-value < 0.05 was assessed as statistically significant. Results: The mean age of the participants was 29.44±4.91SD years with a range of 16-43 years. Majority of them were married (397; 95.7%) and had post-secondary education (321; 77.3%). The incidence of HIV sero-conversion was 1.0%. Less than 35 years of age, being single, tobacco use, multiple sexual partners in pregnancy and knowledge of partners’ HIV status were significantly associated with HIV sero-conversion (p < 0.05). However, none of these factors was a significant predictor following logistic regression. Conclusion: The rate of HIV sero-conversion in pregnancy is of public health importance in Enugu and obligatory repeat testing, especially among women with these identified associated risk factors is therefore advised to forestall the menace of HIV to the child and the society at large.