Child Transmission Of HIV Research Articles

The Analysis of Factors Influencing Behavior of Pregnant Mother in Performing Prevention Mother to Child HIV Transmission (PMTCT) in PHC Pesantren I Kediri

Background: Mother to child transmission of HIV can be prevented, but the incident of HIV in children from year to year continues to increase. Purpose: The research objective is to analyze the factors influencing behavior of pregnant mothers in performing Prevention Mother to Child HIV Transmission (PMTCT). Method: The research design was analytic observational with cross sectional approach. The population was all of pregnant mothers in working area of PHC Pesantren I Kediri. The samples were 63 respondents using simple random sampling. Data were collected using questionnaires given to pregnant mothers at the time of antenatal care in PHC Pesantren I Kediri and then analyzed using logistic regression. Results: The results showed that variable X1 (role of officer) with p = 0.104; OR = 4.609, Variable X2 (knowledge) with p = 0.004; OR = 31.057, Variable X3 (attitude) with p = 0.030; OR = 8.993, Variable X4 (husband support) with p = 0.015; OR = 4.789, Variable X5 (house distance) with p = 0.720; OR = 1.232 and Variable X6 (interest) with p = 0.014; OR = 2.863. In conclusion, the factors influencing Y (behavior of pregnant mothers in performing PMTCT examination) were knowledge and attitude, with the most dominant factor was knowledge with the influence of 31.057. Conclusion: Shows that,The low level of mother’s knowledge about PMTCT, uncooperative mother’s attitude, lack of husband support and lack of mother’s interest caused the low coverage of PMTCT examination in PHC Pesantren I Kediri. The health promotion efforts need more intensive so that the success of PMTCT program can be achieved.

The global burden of HIV/AIDS in Russia in terms of public health. Part 1

Objective. Evaluation of the global HIV burden in Russia, identification of progress made and outstanding problems for 1987–2021.Materials and methods. The analysis of national and foreign publications, data obtained from Rosstat, from forms of federal statistical observation and the FNM of the AIDS Center of Rospotrebnadzor was carried out. The study used information-analytical, epidemiological and statistical methods. Mathematical calculations were performed using the SPSS-26 program.Results and discussion. In Russia, the target indicators of the state program of HIV/AIDS response strategy is being provided in different directions: the greatest success has been achieved in conducting chemoprevention of mother to child HIV transmission, somewhat less in the coverage of the population with HIV testing, which amounted to 26.1% versus the target indicator of 30.0% in 2021, the number of newly detected cases of HIV infection is decreasing (from 73.7 to 71.0 thousand people in 2020–2021, versus the target indicators of 76.1 and 72.3 thousand people, respectively), there is decreasing the HIV incidence (40.4 per 100 thousand. in 2021 versus 68.5 in 2015). Antiretroviral therapy (ART) coverage of patients registered in AIDS Centers went up from 12.4% to 78.9% in 2007–2021. Meanwhile, the determining factor in the HIV/AIDS epidemic progress in Russia is a heterosexual route (F=75.1, p<0.0001) leading to the penetration of infection into all population segments. In addition, despite the increase in the coverage of ART for people living with HIV (PLWH), the HIV mortality rate is remaining high (11.6 per 100 thousand population in 2021, versus 7.9 in 2007).Conclusion. In recent years, there has been a positive trend in the coverage of three-stage HIV chemoprophylaxis in pregnant women, women in labor and newborns. The number of HIV population based screening tests is increasing annually. There is an increase in the ART coverage of patients and a decrease in the number of newly diagnosed cases of the disease. However, along with the observed increase in the HIV spread through heterosexual contacts, it is necessary to strengthen information and preventive measures, especially among the reproductive age group. The high HIV mortality rate is continuing to remain, despite the increase in ART coverage of PLWH. The identified problems need to be solved comprehensively based on the results of large-scale sociological research conducted in various regions of Russia.

Pengalaman Tenaga Kesehatan dalam Melakukan Tes HIV pada Ibu Hamil di Puskesmas

The number of new HIV cases in DKI Jakarta is increasing every year. The East Jakarta has the highest incidence of HIV cases. The increasing number of HIV cases is not followed by awareness of HIV test, especially pregnant women. The purpose of this study was to obtain an overview of the experience of health care providers in performing HIV tests on pregnant women. The research method was descriptive narrative with participants from health workers who did HIV tests on pregnant women. The research was conducted at two Community Health Center in East Jakarta. Interviews used structured questions, conducted for 30 – 55 minutes, and recorded using a digital voice recorder with 13 participants. The data were analyzed using content analysis techniques. The four themes emerged including HIV test was mandatory for pregnant women at the first visit (K1); emphasizing on explaining the benefits of HIV test for prevention of HIV transmission in children; coordinating in the implementation HIV test for pregnant women and handling of those who are HIV positive; and challenges in implementing HIV test. in pregnant women. Health education about the importance of HIV test for pregnant women should be done from an early age. Additional of reagents HIV test for mothers from other regions is needed. The results of this study are expected to be input in improving the quality of HIV test for pregnant women.

Achieving HIV Epidemic Control and Improving Maternal Healthcare Services with Community-Based HIV Service Delivery in Zambia: Mixed-Methods Assessment of the SMACHT Project.

Novel community-based approaches are needed to achieve and sustain HIV epidemic control in Zambia. Under the Stop Mother and Child HIV Transmission (SMACHT) project, the Community HIV Epidemic Control (CHEC) differentiated service delivery model used community health workers to support HIV testing, ART linkage, viral suppression, and prevention of mother-to-child transmission (MTCT). A multi-methods assessment included programmatic data analysis from April 2015 to September 2020, and qualitative interviews from February to March 2020. CHEC provided HIV testing services to 1,379,387 clients; 46,138 were newly identified as HIV-positive (3.3% yield), with 41,366 (90%) linked to ART. By 2020, 91% (60,694/66,841) of clients on ART were virally suppressed. Qualitatively, healthcare workers and clients benefitted from CHEC, with provision of confidential services, health facility decongestion, and increased HIV care uptake and retention. Community-based models can increase uptake of HIV testing and linkage to care, and help achieve epidemic control and elimination of MTCT.

Influence of Some Demographic Variables On Adherence to Counselling Services On Mother-To-Child HIV Transmission Among HIV Positive Pregnant Women in Ekiti State, Nigeria

The study accessed the HIV counselling services that are available at the Ekiti state antenatal clinics and adherence of the HIV positive pregnant women to the counselling services received. It particularly looked into the influence of demographic variables on the adherence to counselling services on mother to child HIV transmission among positive pregnant women in Ekiti State, Nigeria. Descriptive survey design was used for the study. The population for the study comprises of all HIV positive pregnant women in Ekiti State with sample of 110 of HIV positive pregnant women selected from a tertiary hospital using multistage sampling techniques. A self-designed questionnaire and an adopted instrument were used to elicit information from both the clients and the social workers at the clinic. The instruments were subjected to face and content validity. A pilot study was conducted to determine the reliability of the instruments. This was determined using test-retest method and reliability co-efficient of 0.85, found significant at 0.05 level of significance. Data were analysed descriptively using frequency count, percentage, mean, standard deviation, correlation matrix, and multiple regression. The findings show that there are enough counselling services in Ekiti State Antenatal Clinics and the counsellors are discharging their duties but more still need to be done in other to create more awareness of the preventive measure to HIV and awareness of the counselling services that are available. Also, the adherence to counselling services received by HIV positive pregnant women in Ekiti State is influenced by the education level of the pregnant women, occupation, marital status, and religion affinities. It is recommended that government should not relent in their effort to eradicate HIV and also counselling intervention should be more intensified in the hospitals. It is concluded that that there is HIV counselling in Ekiti State ante-natal clinic and the HIV positive pregnant women have moderate adherence level to the counselling services which is influenced by their level of education, occupation, marital status, and religion affinities.

Twenty years of Prevention of Mother to Child HIV Transmission: research to implementation at a national referral hospital in Uganda.

Over 90% of new paediatric HIV infections are acquired through mother to child transmission. Prevention of mother to child HIV transmission (PMTCT) research in sub-Saharan Africa informed WHO guidelines which enabled implementation of PMTCT programs globally. To describe Makerere University-Johns Hopkins University (MU-JHU) perinatal HIV prevention research and implementation of the Mulago National Referral Hospital (MNRH) PMTCT program. Perinatal HIV prevention studies conducted at MU-JHU between 1997-2016 were summarized. Program aggregated data was extracted and analyzed using STATA 15. In 1999, the HIVNET 012 study demonstrated that single-dose nevirapine (sdNVP) to the mother at onset of labor and to her newborn, reduced MTCT by nearly 50%. In 2016, the PROMISE study documented the safety and efficacy of ART during pregnancy and breastfeeding period. Program implementation at MNRH started in 2000. Uptake of HIV testing increased from 70% to 99% from 2006 onwards. sd NVP was the initial ARV regimen but by 2012, MOH recommended Option B+(triple therapy). MTCT rates reduced from 16.9% in 2001 to 2.3% in 2020. Perinatal HIV prevention clinical trials conducted at MU-JHU provided evidence to inform WHO PMTCT guidelines. MNRH program evaluation demonstrated the significant decline in MTCT rates over the last two decades.

Intimate partner violence and HIV testing during antenatal care: A latent class analysis to identify risk factors for HIV infection in mothers and their children in the United Republic of Tanzania.

Intimate partner violence has adverse effects on mother's overall health and prevention of mother to child HIV transmission. To identify and examine subgroups of mothers experiencing intimate partner violence and the likelihood of HIV testing during antenatal care, we conducted a latent class analysis using data from the Tanzania Demographic and Health Survey 2010 (N = 2,809). Intimate partner violence included mother's experiences with partners' controlling behaviors, as well as emotional, physical, and sexual violence. The outcome was mother's accepting HIV testing offered during their antenatal care visit. Covariates included mother's level of education, rural/urban residence, and prevention of mother to child HIV transmission talk during antenatal care visit. The latent class analysis indicated a three-class solution was the best model and identified the following profiles: mothers with no experience of intimate partner violence (61% of sample) with a 90.5% likelihood of HIV testing; mothers with moderate levels of intimate partner violence (26%) with an 84.7% likelihood of testing; and mothers with extreme levels of intimate partner violence (13%) with an 82% likelihood of testing. An auxiliary multinomial logistic regression with selected covariates was conducted to further differentiate IPV profiles, where mothers with extreme levels of intimate partner violence had 57% increased odds [95%CI:1.06-2.33, p = .023] of living in rural areas compared to mothers with no experience of intimate partner violence. Our person-centered methodological approach provided a novel model to understand the impact of multiple intimate partner violence risk factors on antenatal care HIV testing to identify mothers in need of interventions and their children at highest for parent to child HIV transmission. Our model allows person-centered interventional designs tailored for the most at-risk subgroups within a population.

Health Promotion Effort through Individual and Group Counseling on Knowledges of Pregnant Mothers on Prevention Mother to Child HIV Transmission (PMTCT) for Pregnant Mothers in Tamanan Kediri 2022

Cases of pregnant women who are HIV-AIDS positive have increased from 2017-2020. In 2017 there were 3,873 pregnant women with HIV positive. In 2018, there was an increase of 5,074 pregnant women who were HIV positive. An increase in cases also occurred in 2019 as many as 6,439 cases. In 2020 for the January-September period there were 5,828 cases of HIV positive pregnant women. Efforts toOne way to prevent mother-to-child transmission is with Prevention Mother To Child Transmission counseling (PMTCT). This study aims to determine the effect of health promotion through individual and group counseling on knowledge of pregnant women about PMTCT in Tamanan Village, Kediri City Tahun 2022. This research method uses pre-experiments through a two group pre-test-post-test approach with the number of samples is 32 pregnant women. The analysis used is the Wilcoxon test with research instruments in the form of a questionnaire that has been tested for validity. Results the research shows that there is an effect of health promotion through individual and group counseling on the knowledge of pregnant women about PMTCT with p value = 0.00. It is hoped that the results of this research can used as a reference for implementing the program counseling regarding PMTCT.

Factors Associated with Compliance with Prevention of Mother – To – Child Transmission of HIV Among Mothers Attending Antenatal Clinics in University College Hospital, Ibadan

Factors Associated with Compliance with Prevention of Mother – To – Child Transmission of HIV Among Mothers Attending Antenatal Clinics in University College Hospital, Ibadan

Epidemiological drivers of mother to child HIV transmission in West Bengal, India: A retrospective cohort study.

HIV transmission through vertical route can be reduced to a large extent with combination of medical interventions. Apart from maternal HIV status several other epidemiological attributes determine this transmission dynamics.Objective: The objective of this study was to identify various associated factors that determine and modify the risk of HIV transmission from a mother living with HIV to her child.Materials and method: A retrospective cohort-study was conducted with 518 HIV-positive pregnant women with delivering live babies between April 2016 - September 2018. The HIV status of the children was ascertained with polymerase chain reaction. A number of socio-demographic and medical attributes were compared between HIV-positive (41) and HIV-negative babies (477) using bivariate and multivariate methods to identify disease modifying factors. Maternal HIV detection during the postnatal period (AOR = 11.2; 5.2 - 23.8), low birth weight (AOR = 2.7; 1.2 - 5.9), and vaginal delivery (AOR = 2.8; 1.01 - 7.7) were significantly associated with vertical transmission of HIV. Lower duration of maternal antiretroviral treatment and higher maternal age (>25years) were also associated in bivariate analysis. The battery of PPTCT (Prevention of Parent to Child Transmission) interventions should be tailored in such a way to address all the epidemiological attributes influencing vertical transmission.

Eliminating Mother to Child Transmission of HIV in Arua District Through Mother–Baby–Pair Points

Introduction: Mother-to-child transmission is the leading cause of HIV infection in children. Without treatment, half of these HIV infected children die before their second birthday.Purpose: To establish the contribution of mother-baby-pair points approach to eMTCT outcomes in Arua District Uganda.Material and Methods: A descriptive and analytical cross sectional study design which employed mixed methods approach was used. 196 HIV positive breast feeding mothers from three government hospitals (Arua Regional Referral Hospital, Adumi Health Center IV and Oli Health Center IV) were interviewed. Data was collected using structured questionnaires, focus group discussions and interviews guides.Results: Majority 168 (85.7%) of the respondents and their babies were enrolled to eMTCT care immediately after delivery and up to 17(8.7%) were enrolled beyond two weeks after delivery. Reasons for enrolment into care included; counseling before, during and after pregnancy on the importance of adherence to ART, early enrolment into care and delivery in a health facility. Most of the babies enrolled in mother-baby-points were HIV sero-negative (75.5%) with only 6.6% of them being sero-positive, thus signifying the contribution of mother-baby-points towards eliminating mother-child-transmission of HIV. Age of mothers was associated with retention on eMTCT care (χ2(5) =11.19, p=0.048). Again, having had any form of education on eMTCT was associated with retention on eMTCT care (p=0.001).Conclusion: The degree of enrollment in to eMTCT care was high but some mothers who still enrolled late. This affects early infant diagnosis, uptake of eMTCT services and retention of mothers and their infants.

Knowledge and determinants of women\u2019s knowledge on vertical transmission of HIV and AIDS in South Africa

BackgroundHIV/AIDS is still one of the major public health concerns globally. It is one of the major contributory causes of deaths among women in the reproductive age (15–49 years) and has resulted in about 14 million orphaned children globally. Knowledge of Mother-to Child transmission is one of the strategies to fight against HIV. This study, therefore, sought to assess the knowledge and determinants of women’s knowledge on vertical transmission of HIV and AIDS in their reproductive age in South Africa.MethodsData were obtained from the South Africa Demographic and Health Survey (SADHS) 2016. Both descriptive (frequencies and percentages) and inferential analysis (multilevel mixed-effects complementary log–log regression model) were conducted and the statistical significance was set at p < 0.05.ResultsThe prevalence of knowledge of mother to child transmission of HIV and AIDS during pregnancy, delivery, breastfeeding and at least knowledge of one source are 87.0%, 81.1%, 80.3% and 91.4% respectively. At the individual level, those with secondary [AOR = 1.28, CI = 1.04,1.57] and higher [AOR = 1.55, CI = 1.21,1.99], those who read newspaper less than once a week [AOR = 1.16, CI = [1.05,1.28], at least once a week [AOR = 1.14, CI = 1.04,1.25], and those who listen to the radio less than once a week [AOR = 1.22, CI = 1.03,1.43] had higher odds of knowledge on MTCT of HIV and AIDS. However, those with parity 0 [AOR = 0.73, CI = [0.63,0.85] had lower odds of knowledge of MTCT of HIV and AIDS compared with those with parity 4 or more. At the contextual level, those in the poorest wealth quintile [AOR = 0.82,CI = 0.69,0.97] had lower odds of having knowledge of MTCT of HIV and AIDS. Those in the urban areas [AOR = 1.17, CI = [1.04,1.31], those in Limpopo [AOR = 1.35, CI = [1.12,1.64], Gauteng [AOR = 1.35, CI = [1.12,1.62] and North west[AOR = 1.49, CI = [1.22,1.81] had higher odds of knowledge of mother to child transmission of HIV and AIDS.ConclusionThe study has demonstrated that there is relatively high knowledge of mother to child transmission of HIV and AIDS in South Africa. The factors associated with the knowledge are educational level, exposure to mass media, parity, wealth status, place of residence and the region of residence. To further increase the knowledge, it is imperative to adopt various messages and target respondents in different part of SSA through the mass media channels. This should be done taking cognizant of the rural–urban variations and socio-economic status.

Efficacy of Mobile phone use on adherence to Nevirapine prophylaxis and retention in care among the HIV-exposed infants in prevention of mother to child transmission of HIV: a randomized controlled trial

BackgroundHIV is a major contributor to infant mortality. A significant gap remains between the uptake of infant and maternal antiretroviral regimens and only a minority of HIV-exposed infants receives prophylaxis and safe infant feeding. Losses to follow-up of HIV-exposed infants are associated with shortcomings of facility-based PMTCT models with weak community support of linkages. Use of mobile phones offers an opportunity for improving care and promoting retention assessed by timely attendance of scheduled appointments for the mother-baby pairs and achievement of an HIV-free generation. The objective of this study was to compare self-reported adherence to infant Nevirapine (NVP) prophylaxis and retention in care assessed by timely attendance of scheduled appointments over 10 weeks in HIV exposed infants randomized to 2-weekly mobile phone calls (intervention) versus no phone calls (control).MethodsIn this open label randomized controlled study, one hundred and fifty HIV infected women drawn from 3 health facilities in Western Kenya and their infants were randomly assigned to receive either phone-based reminders on PMTCT messages or standard health care messages (no calls) within 24 h of delivery. Women in the intervention arm continued to receive fortnightly phone calls. At 6- and 10-weeks following randomization we collected data on infant adherence to Nevirapine, mode of infant feeding, early HIV testing and retention in care in both study arms. All analyses were intention to treat.ResultsAt 6 weeks follow-up, 90.7% (n = 68) of participants receiving phone calls reported adherence to infant NVP prophylaxis, compared with 72% (n = 54) of participants in the control group (p = 0.005). Participants in the intervention arm were also significantly more likely to remain in care than participants in the control group [78.7% (n = 59) vs. 58.7% (n = 44), p = 0.009 at 6 weeks and 69.3% (n = 52) vs. 37.3% (n = 28), p < 0.001 at 10 weeks].ConclusionsThese results suggest that phone calls are potentially an important tool to improve adherence to infant NVP prophylaxis and retention in care for HIV-exposed infants.Trial registrationPACTR202007654729602. Registered 6 June 2018 - Retrospectively registered, https://pactr.samrc.ac.za/TrialDisplay.aspx?TrialID=3449

Maternal Transmission of Human Immunodeficiency Virus to Infants in A Tertiary Care Hospital in Pakistan

Objective: To determine frequency of transmission of HIV from mother to child at Aziz Bhatti Shaheed Teaching Hospital Gujrat.Methodology: Cross-sectional study conducted at Aziz Bhatti Shaheed Teaching Hospital Gujrat in Department of Gynecology and Obstetric Unit II from January 2012 to March 2019 using non-probability consecutive sampling. Patients who tested positive for HIV and reached full term were included. Mothers were started ART at time of diagnosis. Infant prophylaxis was done according to WHO guidelines. Counseling regarding breastfeeding was done. HIV status of infants was noted at 12 weeks after birth. A total of 51 patients were included. SPSS 20.0 was used for data analysis.Results: Fifty-one patients included having mean age 29.45+3.15 years. All patients were diagnosed during pregnancy. ART was initiated in 17(33.3%) in first trimester, 10(19.6%) in second trimester, 20(39.2%) in third trimester and in 4(7.8%) post-partum. At 6 weeks follow up of mothers, 46(90.2%) were stable, 3(5.9%) lost to follow up and 2(3.9%) mothers died post-partum at home. At 12 weeks follow up of infants 39(76.5%) tested negative for HIV, 2(3.9%) were tested positive, 7(13.7%) lost to follow up and 3(5.9%) infants died during this period. In alive and tested infants 2 out of 41 were tested positive, making HIV transmission to children from mothers to be 4.9%. Conclusion: HIV transmission to children form mothers is high in our population and there is need for active screening of all pregnant mothers. Key Words: Mother to Child HIV Transmission, HIV, HIV in Infants, Pregnancy, AIDS

#33: A Tale of Two Pneumos: the Impact of HIV Exposure or Infection Status on Pediatric Carriage of Streptococcus pneumoniae and Pneumocystis jirovecii, a Nested Case–control Analysis from the Pneumonia Etiology Research in Child Health (PERCH) study in Zambia

Abstract Background Most pediatric HIV cases in Africa reflect maternal to child transmission (MTCT). The persistently high seroprevalence of HIV in pregnant women (16.6%) and the low rates of mother to child HIV transmission (~2%) have resulted in a high number of children who are HIV exposed but uninfected (HEU). HIV exposed but uninfected (HEU) children have increased rates of morbidity and mortality vs. HIV unexposed and uninfected (HUU). Methods To explore the mechanisms behind this phenomenon, each case and control was sampled using a nasopharyngeal NP swab and an oropharyngeal (OP). A multiplex real-time polymerase chain reaction (PCR) assay was used to determine the presence of Streptococcus pneumoniae and Pneumocystis jirovecii in the NP/OP specimens. We compared nasopharyngeal carriage rates of S. pneumoniae and P. jirovecii between HIV-infected, HEU, or HUU case (pneumonia) and control (without pneumonia) children. In bivariate analyses, using carriage as a dichotomous outcome, proportions we compared using chi-square or odds ratios with 95% confidence intervals. In multivariate models, we created logistic and linear regression models adjusting for nutritional status as possible mediators of carriage status. Results SP carriage rates were similar between cases and controls. However, density was increased among HIV-infected children vs. HEU or HUU children (15.8 vs. 4.7 vs. 3.6 × 105 copies/mL, respectively). Among cases, PJ carriage among HIV positive, HEU and HUU children was 31%, 15% and 10%,, respectively, (P &amp;lt; 0.05) and carriage density was 63.9, 20.9, and 4.8 × 103 copies/mL, respectively (P &amp;lt; 0.05). In adjusted logistic regression models, HIV-infected cases were slightly more likely to be an S. pneumoniae carrier compared with HUU cases (aOR = 1.1; 95% CI: 0.57–2.14). In contrast, all other case/exposure combinations were less likely to be S. pneumoniae carriers with the lowest adjusted odds among HIV-infected controls children (aOR = 0.34; 95% CI: 0.17–0.71). The odds of being a PJ carrier was almost 6 times higher in HIV-infected cases than in HIV unexposed cases (aOR = 6.63; 95% CI: 3.24–13.54). Conclusions We demonstrate that HIV infection and HIV exposure without infection each have an impact on carriage rates and density for S. pneumoniae and P. jirovecii, though the magnitude and nature of these effects differs substantially between the two pathogens. This may be explained in part by differences in immune responses to these two different pathogens. Our analysis provides further evidence of fundamental differences in immune function among HIV exposed but uninfected infants compared with HIV unexposed, uninfected infants.

Detectable viral load among HIV -1 positive pregnant women on ART (Option B +) in northern Tanzania: Baseline results from the HIVDR study

Introduction: In Tanzania, the Ministry of Health, Community Development, Gender, Elderly and Children (MoHCDEC) has implemented the Option B+ as one of the strategies to facilitate achievement of elimination of mother to child transmission of HIV. To prevent emergence of drug resistance mutations early identification of option B+ failure is critical. The emergence of drug resistance mutation and subsequent treatment failure poses a major concern for HIV program in low- and middle-income resource settings where treatment options are limited.&#x0D; Methodology: We recruited treatment naïve, treatment experienced HIV-1 positive pregnant women and those who had prophylaxis in their previous pregnancy in Kilimanjaro, northern Tanzania August 2016 to February 2017. Whole blood (2ml) for biochemistry, viral load and drug resistance testing were taken at baseline. ARV drug resistance testing was done on women with VL ≥ 1000 copies/ml. We used descriptive statistic and logistic regression to determine the strength of association between virologic outcome (virologic failure) and independent predictors.&#x0D; Results: One hundred and forty eight (148) pregnant HIV-positive women were enrolled in the study with mean age of 29.82 years (SD=6.17) from August, 2016 to February, 2017. Virologic failure was demonstrated in 34 (23%) with viral load ≥ 1,000 copies/ml. Genotyping results were available from 26 women, mutations associated with ARV resistance were detected in 23.1% (n = 6/26). Among the six women with ARV resistance mutation 4(66.7%) had high level resistance and 2(33.3%) had low level resistance. Among the 26 samples genotyped 15(58%) viruses were subtype A, while eight were subtype C (31%) and three subtypes D (11%). The most dominant drug resistance mutations against the reverse transcriptase inhibitors for the women with high level resistance were K103N, Y188L, D67N, K70R, M184V, T215F, K219EQ, and the low-level resistance was E138A. The older age was associated with virological failure compared to those who were &lt; 20 year of age.&#x0D; Conclusion: Viral load testing should be done on women who were already on antiretroviral treatment on their first antenatal visit to ensure early detection of virological failure and enable clinicians to take an appropriate course of action on their management.&#x0D; Educational intervention on adherence should be targeted at an early stage to women with virological failure during pregnancy to reduce the emergence of HIV-1 drug resistance mutations.

Design mHealth prototyping to Eliminate Mother to Child HIV Transmission (EMTCT) in Indonesia

Mobile health (mHealth) is the proposed solution from digital health intervention to improve the service quality to eliminating mother to child HIV transmission (EMTCT) in Indonesia. The purpose of this study is to develop a mHealth prototype for EMTCT. This study used prototyping Rapid Application Development (RAD). The external entities of the mHealth prototype consist; pregnant women as the main data sources midwives as program implementers who also work as information producers, contact person for EMTCT at the primary health center and health office, as the program manager for dashboard users. Nine data on longitudinal EMTCT services are antenatal visits, pre-test counseling, HIV testing, the results of HIV status, post-test counseling, antiretroviral therapy (ART), adherence for ARV therapy, viral load, and HIV status in children.

Unintended Pregnancy and Associated Factors Among HIV Positive Women in Ilu Aba Bora zone, South Western Ethiopia: A Facility-Based Cross-Sectional Study.

BackgroundUnintended pregnancy reflects the existence of unprotected sex. Understanding factors associated with unintended pregnancy among HIV-positive women is very important to design strategies for the prevention of further transmission and infection with the virus. However, there is scarce information in this regard. Given the degree of HIV prevalence among women and the current antiretroviral therapy scale up in Ethiopia, it is important to understand factors associated with un-intended pregnancy in order to prevent mother to child HIV transmission (MTCT).MethodsAn institution-based cross-sectional study design was employed. The sample size was 353; all HIV/AIDS sero-positive reproductive age group (15–49) women having any pregnancy history after their diagnosis and having started HAART were included and simple random sampling was used to select study participants. Data collection period was from March 9 to April 13, 2019.ResultsThe prevalence of unintended pregnancy among the participants was 40.9%. In the multivariate logistic regression, unemployment (AOR, 3.36; 95% CI: 1.55–7.26), not being knowledgeable on MTCT and prevention of MTCT (PMTCT) (AOR, 3.18; 95% CI: 1.92–5.24), and having had no discussion on reproductive health issues (AOR, 1.83; 95% CI: 1.09–3.07) are factors significantly associated with unintended pregnancy occurrence among HIV-positive women on antiretroviral therapy.Conclusion and RecommendationThe prevalence of unintended pregnancy among the women in the study is high. To avoid unintended pregnancies, HIV-infected women need access to effective family planning services and risk reduction discussions during routine care visits.

An Assessment of Prevention of Mother to Child Transmission (PMTCT) of HIV Services in Gombe State, Nigeria

Transmission of HIV from mother to child continues to be the major source of HIV infection among children under the age of fifteen. Therefore, targeting pregnant women attending antenatal clinics provides a unique opportunity for the implementation of prevention of mother-to-child transmission (PMTCT) intervention program against HIV infection of new-born babies. This study was aimed at assessing the Mother to Child Transmission of HIV intervention and the follow up of exposed infant HIV testing in nine selected health facilities in Gombe state between January 2016 and December 2016. The methodology used was a non-experimental descriptive study that combined hospital record review and structured questionnaire to collect relevant data. A cross-sectional retrospective evaluation of women enrolled in Prevention of Mother to Child Transmission of HIV programme at facilities supported by an indigenous partner (Centre for Integrated Health Program - CIHP), was carried out. In addition, structured questionnaires were served on 498 ANC attendees and service providers, selected by consecutive sampling method. Data entry and analysis were done using SPSS version 21. The study showed that there was adequate coverage with PMTCT services in the study area as all the respondents affirmed to accessing all expected services in all the facilities. Pregnancy was found to be an automatic indicator (469, 94.2%) for HIV test and therefore ANC served as a critical window for the provision of PMTCT services. Mother-to-child transmission remained a major route of HIV transmission in children with 12 (2.4%) cases of HIV in infants at 6weeks DNA PCR test and 5 (1.0%) cases of HIV-positive in children after the Rapid test at 18 months. Hence, it is recommended that there should be a scale-up of the programme, pre-natal sensitization of women, baby positioning and attachment for safe and effective breastfeeding, ensuring prompt (within 28 days) availability of DNA/PCR test results and adopting consensus method for the assessment of PMTCT.

Knowledge of Mother to Child Transmission of HIV (MTCT) and Associated Factors among Women Living with HIV/AIDS Attending Antiretroviral Therapy Clinic in West Wollega, Ethiopia

Knowledge of Mother to Child Transmission of HIV (MTCT) and Associated Factors among Women Living with HIV/AIDS Attending Antiretroviral Therapy Clinic in West Wollega, Ethiopia