Human Immunodeficiency Virus Positive Mothers Research Articles

On characterizing gender and locational composition of adult PLHIV in Nigeria: Implications for HIV programming.

Human Immunodeficiency Virus (HIV) remains a global public health menace, and studies have suggested variations across demographic characteristics. This study attempted to characterize the gender and locational variations in the spread and control of HIV among adult Persons Living with HIV (PLHIV) to identify the clustering of PLHIV in Nigeria. We conducted an ecological analysis of data from the 2018 Nigeria HIV/AIDS Indicator and Impact Survey (NAIIS) report. To examine the statistical significance of differences between groups (by gender and location), chi-square and Fisher exact tests were conducted using the Real Statistics Resource Pack in Excel, and ArcGIS for visualization. Significance level was set at 5%. Overall, prevalence of HIV among adult PLHIV was 1.4%-the prevalence was slightly higher among women (1.8%) compared to men (1.0%). About 3/10 (29.3%) self-reported having received HIV test results. In the past 12 months before the survey, only 10.0% self-reported HIV testing among the population, with a significant difference (p<0.001) observed in the urban and rural area (12.4% in urban compared to 8.2% in rural). Another significant finding was the difference in the timing of HIV diagnosis between urban and rural areas (p<0.001). Adult PLHIV residing in rural areas had a higher rate of early detection (94.1%) compared to those in urban areas (70.3%). About 40.0% of HIV positive mothers reported awareness of their HIV status-approximately 58.0% of mothers living in the urban were aware of their HIV status compared to 29.8% in the rural area. The concentration of HIV was disproportionately higher in the rural populations compared to the urban. Findings from this study also show gender-disparities in HIV prevalence, diagnosis, and treatment. Interventions to bridge this gap should be promptly embraced in order to effectively combat the HIV epidemic in Nigeria and achieve an AIDS-free generation.

Nurse-patient relationship and its implications for retention in the PMTCT of HIV programme in Ghana: an appreciative inquiry

BackgroundRelationships established between nurses and midwives, and their patients have far-reaching implications; the most significant being their impact on the health-related outcomes of patients. These relationships are especially relevant in the Prevention of Mother-to-Child Transmission (PMTCT) of Human Immunodeficiency Virus (HIV) programme as women, diagnosed with HIV navigate the emotional and psychological effects of their diagnosis while carrying pregnancies. This study aimed to explore the relationships between nurses, midwives and mothers diagnosed with HIV and its impact on retention in the PMTCT Programme.MethodsAn Appreciative Inquiry approach that employed qualitative research methods was conducted among twenty-four participants made up of 12 HIV positive mothers, and eight midwives and four community health nurses engaged in the PMTCT programme. Individual generative interviews were conducted among the mothers while paired interviews were conducted among the health professionals. Thematic analysis guided by Colaizzi’s approach was conducted.ResultsThree main themes emerged each with its subthemes. Under Establishing Rapport, two sub-themes emerged; making the connection and building trusting relationships. The second theme, Journeying Together, describes how the nurse-patient relationship evolved as the participant engaged in the programme; sub-themes include developing mutual goals, impactful communication, and showing commitment and building self-worth. The third theme; Ending the professional relationship details two sub-themes; continuity of care across the cascade, and termination of care which proved unsuccessful in some relationships due to blurring professional boundaries.ConclusionsThe nurse-patient relationship in the PMTCT programme evolved as the relationship progressed along the PMTCT cascade. Strengthening of the nurse-patient relationships was underscored by building trust through the maintenance of confidentiality, setting mutual goals, shared emotional experiences and personal stories, and building clients’ self-worth. Therefore, there is a need to ensure that professional boundaries are set and maintained to reduce the occurrence of over-dependence of the clients and burnout of the nurses.

Characteristics of Babies Born to HIV Positive Mothers in Ulin General Hospital Banjarmasin January – December 2020

The high incidence rate of mothers with Human Immunodeficiency Virus (HIV) increases the potential of vertical transmission to the baby. HIV is a group of retroviruses that attacks the immune system. It can be transmitted through the exchange of various body fluids from the infected person, such as blood, breast milk, semen, and vaginal fluids. HIV can also be passed from a mother to her child during pregnancy and childbirth. Transmission of HIV from mother to baby is called a vertical transmission and may occur in 3 ways, including antenatal, perinatal, and postnatal (breast milk). This study aims to describe the characteristics of babies born to HIV positive mothers at Ulin General Hospital, Banjarmasin during January-December 2020. This is a descriptive observational study using secondary data from medical records of the babies born to HIV mothers at Ulin General Hospital, Banjarmasin. We include 13 cases of babies born to HIV-positive mothers. The characteristics of the babies were male (53.8%), born without asphyxia (92%), has normal birth weight (84.6%), full-term (92%), and 84.6% of babies were delivered through C-section. The results showed that it is necessary to work together with various fields to get early intervention for each baby.

Factors influencing exclusive breast feeding among children born to HIV positive mothers attending public health facilities in western Ethiopia: Cross-sectional study.

Only about 39% of infants in low- and middle-income countries are exclusively breast-fed for the first six months. In particular, human immunodeficiency virus (HIV) positive women report confusion about the best feeding methods. Exclusive Breastfeeding (EBF) practices in HIV positive mothers are sub-optimal in Ethiopia. This study aimed to identify the main factors influencing EBF among HIV positive breast-feeding mothers. A facility based cross-sectional study was carried out from September 2017 to June 30 2018 among HIV positive mothers with infants aged 6-23 months. Thirteen public health facilities (7 health centers and 6 hospitals) that provided anti-retroviral treatment (ART) and Prevention of mother-to-child transmission (PMTCT) services, found in three districts of West, East and Kellem Wollega Zones, were randomly selected. Respondents were recruited by systematic random sampling techniques from these facilities using client registers as a sampling frame. Data were collected using face to face interviews with a pre-tested questionnaire. Data were entered into EPI info Version 3.5.1 and analyzed using SPSS Version 20 for windows. Candidate variables for the final multi-variable model were selected considering P≤ 0.05 at bivariable analysis. Associations were declared at P≤ 0.05 by assuming Confidence Intervals did not cross '1'with corresponding 95%. A total of 218 HIV positive mothers were included in this study. Of these, only 122 (56.0%) practiced EBF in the first six months. The proportion of study participants who initiated EBF within the first hour of delivery was 134 (61.8%). Mean age of study participants was 28.6years with SD ± 4. Mothers' having received advice on EBF [AOR 3, 95% CI (1.2-6.7)], disclosure of HIV status to someone close to them including their husband [AOR 6, 95% CI (1.2-29.6)] and believing HIV can be transmitted during delivery [AOR 5.2, 95% CI (1.1-24.0)] were found to increase the likelihood of EBF practices among the study participants (P-value ≤ 0.05). In this study, only just over half of the mothers practiced EBF for the first six months. Care providers should continue to encourage mothers to practice EBF in the first six months and to disclosure of HIV status to someone close to them including their partner. Efforts should be in place to curb the risk of HIV/AIDS transmission during delivery. Continues advise for mothers to practice EBF in the first 6 months is still needed.

Congenital and Placenta Malaria and Newborn Birth Weight in Asymptomatic HIV Positive Pregnant Women at Term

Background: Human Immuno-deficiency Virus (HIV) and Malaria infection independently are major contributors to adverse perinatal outcomes in sub-Saharan Africa. A co-infection of both in pregnancy has been associated with more deleterious birth weight- related neonatal outcomes. We assessed for congenital malaria and evaluated the birth weights of babies born to HIV positive mothers with and without evidence of placenta malaria at term delivery. Methods: This was a comparative cross-sectional study in which 90 low-risk, HIV positive pregnant women on highly active retroviral therapy (HAART), asymptomatic for malaria, with uncomplicated delivery, at the Lagos State University Teaching Hospital, were consecutively recruited to have their maternal venous, placenta and newborn blood samples assessed following delivery for malaria. A placenta biopsy was also done to assess for features of placenta malaria. Data obtained were expressed in frequencies and percentages and variables were tested as appropriate using an independent t-test, chi-square and spearman’s correlation. The level of significance was set at p&lt;0.05. Findings: The prevalence of placenta malaria and congenital malaria in the study was 11.1% and 0.0% respectively. Only 3.3% of the asymptomatic HIV positive, pregnant women at delivery had positive malaria tests of their venous blood samples. The mean neonatal packed cell volume at birth for women with and without placenta malaria was 43.6% and 44.9% respectively (p=0.044). The mean birth weight of the babies born to HIV positive women with and without placenta malaria was 2.7±0.2kg and 3.0±0.4kg respectively (p=0.008). The correlation between birth weight and CD4 count was positive but insignificant (r=0.069, p=0.515). Conclusion: Although, irrespective of placenta malaria status, congenital malaria is a rarity in babies of HIV positive pregnant women, the birth weight and packed cell volume of babies born to HIV positive women is significantly lower in this group of women with features of placenta malaria than in women without placenta malaria.

Prevalence and Predictors of HIV Infection among Under FiveYear Children Born to HIV Positive Mothers in Muheza District, North-Eastern Tanzania

Background: Human Immunodeficiency Virus (HIV) pandemic has become a serious public health concern worldwide. The prevalence of paediatric HIV infection is largely unknown in many countries in Sub-Saharan Africa (SSA). We aimed to determine the prevalence and predictors of HIV infection among under-5 years children in Muheza District, Tanzania. Methods: A facility-based study among mothers/guardians with their under-5 years children exposed to HIV infection was conducted from June 2015 to June 2016. Information on HIV status, socio-demographic and other family characteristics was collected using a structured questionnaire. Data analysis was performed using STATA version 13.0. Results: A total of 576 HIV-exposed under-5 years children were recruited together with their respective mothers/guardians. The HIV prevalence among under-5 years children was 10.6% (95% CI: 8.1-13.1%). The burden of HIV infection was observed among older children aged 25 to 59 months (AOR= 8.0, 95% CI 2.5-26.0) than in the younger children. There was a four-fold (AOR=3.9, 95% CI 1.7-9.1) risk of HIV infection among children born to mothers of unknown HIV status at conception than among children born to mothers with known HIV status. The odds of HIV infection were higher among children who were delivered from home (AOR=2.6, 95% CI 1.0-6.5), received mixed feeding (AOR=2.4, 95% CI 1.2-4.9), and those living far from a health facility (AOR=3.0, 95% CI 1.4-6.5). Conclusion: The prevalence of HIV among under-5 years children in Muheza is higher among older children. The high prevalence is associated with being born to mothers with unknown HIV status at conception, received mixed feeding, home delivery, and living far from the health facility. Campaigns that provide health educational massages addressing risk factors of HIV need to be emphasised in order to promote the control and prevention of HIV among children.

Barriers to engaging fathers in supporting exclusive breastfeeding by HIV positive mothers in Temeke, Dar es Salaam, Tanzania

Background/Aims The low rate of exclusive breastfeeding among mothers living with human immunodeficiency virus (HIV) has been attributed to limited spousal support, and evidence shows that support from a male partner has a positive influence on HIV positive mothers' adherence to exclusive breastfeeding. There is a lack of research data on fathers' experiences of barriers to supporting their HIV-positive partners with exclusive breastfeeding for the first 6 months. This paper reports the results of a study that aimed to explore barriers to fathers' engagement in supporting exclusive breastfeeding by HIV-positive mothers in an urban setting in Tanzania. Methods A qualitative case study design was used in Temeke Municipal Council, at clinics for the prevention of mother to child transmission of HIV in four public health facilities. Purposive sampling was used to select 30 participants who took part in in-depth interviews. Data were digitally recorded, transcribed verbatim and translated from Kiswahili to English before being thematically analysed. Results Barriers to fathers' engagement in supporting exclusive breastfeeding included unstable income, inconvenient clinic hours, gender stereotypes, less emphasis on postpartum male involvement in prevention of mother-to-child transmission of HIV and stringent work regulations that provide very limited paternity leave. Conclusions This study has generated some insight into the main barriers to fathers' engagement in supporting exclusive breastfeeding among mothers with HIV. This knowledge can be applied to strengthen the role of fathers in prevention of mother-to-child transmission of HIV.

Dynamic analysis of mother-to-child transmission of HIV and antiretroviral treatment as optimal control

Human immunodeficiency virus (HIV) is still an extremely dangerous pandemic and without a prominent cure. And one of the most vulnerable population prone to acquiring the virus can be newborn babies from their HIV positive mothers. It can even turn fatal when an individual gets acquired immunodeficiency syndrome (AIDS) and the disease is left untreated and uncontrolled. One such treatment for suppressing the infections is antiretroviral therapy (ART) treatment. To gain insight of the Indian scenario of the mother to child transmission (MTCT) and the present work of the ARTs strategy in India we shall study a model for HIV infected newborns. Hence, we have formulated a model consisting of newborns born to HIV infected mothers, infected newborns and newborns acquiring AIDS. We have found the equilibrium points and established the local stability of the system. We then considered ARTS as optimal control for the HIV infected newborns and thus, extended our model with the class of newborns going for ARTS. With the help of Pontryagin’s Maximum Principle, we then obtain the optimal ART intensity as part of intervention to control infection among newborns for our optimal control problem. For the numerical simulations we took real time data of India for all parameters along with MTCT rate for the state of Maharashtra. One of our numerical results shows that ART’s as strategy among newborns born to HIV infected mothers decreases the number of HIV infected babies. Thus, the paper highlights the necessary and crucial role of ART programs for babies born to HIV positive mothers in order to suppress the infection for their brighter futures in the epidemic dynamics of India.

Infant feeding practices and its associated factors among HIV positive mothers attending public health institutions at Gondar Town, Northwest Ethiopia, 2019: An institutional based cross-sectional study

IntroductionFour out of ten infants born become infected with the human immunodeficiency virus during pregnancy, childbirth and breastfeeding in developing countries. Several factors are responsible for these, including practising mixed feeding that contributes to mother-to-child transmission and is unpreventable. Besides, it can cause diarrhoea, pneumonia and malnutrition, leading to morbidity and mortality. ObjectivesThis study aimed to assessinfant feeding practices and associated factors among human immunodeficiency virus-positive mothers attending public health institutions in Gondar Town. MethodsAn institutional-based cross-sectional study was conducted. A census method was employed. Data were collected by using a structured questionnaire. The data were entered by Epi Info version 7 and analyzed with SPSS version 20. The data were analyzed by using binary logistic regression. Those variables with a P-value of ≤ 0.05 were considered significantly associated with infant feeding practice. ResultThe overall infant feeding practice was 94 % [95CI (91.4–96.3)]. Being in the age category of 18–24 years [AOR = 2.34,95 % CI(1.26–10.56)], rural residence [AOR = 8.08, 95 %CI (2.45–21.62)], having social support [AOR = 1.82, 95 %CI (1.43–6.55)], disclosing HIV status [AOR = 4.67, 95 %CI (1.67–20.88)], having no pregnancy-related problem [AOR = 2.61, 95 %CI(1.23–7.96)] were significantly associated. Conclusion and recommendationIn the current study, recommended infant feedingpracticeswereoptimal. Age, place of residence, social support, disclosure of HIV status, and absence of pregnancy-related problems during pregnancy were significantly associated with outcome variables. Mothers should follow recommended infant feeding practices andpayspecialattentiontourbandwellers.

Effects of Human Immunodeficiency Virus-positive Mothers Receiving Antiretroviral Therapy to Prevent Mother-to-child Transmission on the Growth and Development of 18-month-old Children in Lingshan County of Guangxi

Objective To evaluate the effects of antiretroviral therapy(ART)for the prevention of mother-to-child transmission(PMTCT)of acquired immune deficiency syndrome(AIDS)on the growth and development of 18-month-old children born by human immunodeficiency virus(HIV)-positive pregnant women in Lingshan County,Guangxi Zhuang Autonomous Region,and provide scientific evidence for improving the ART medication plan for PMTCT.Methods Lingshan County,ranking the first in the HIV-epidemic counties of Guangxi,was selected as the research site.According to the design of retrospective case-control study,we assigned all the subjects into the case group and the control group:(1)The case group included the HIV-positive pregnant women who had received ART for PMTCT and their HIV-negative infants in Lingshan County from 2010 to 2017.The historical cards and PMTCT data of them were collected from the national PMTCT database.(2)The control group included the healthy pregnant women and their healthy babies born in the Lingshan Maternity and Infant Hospital in 2017,and the children's growth and development data were collected.The stunted growth in children was defined as at least one of the three main indicators of body height,body weight,and head circumference below the normal range.Results The number of HIV-positive mothers and their infants in the case group was 391 and 368,respectively,and 87.21%(341/391)and 95.38%(351/368)of mothers and infants respectively received ART medication.The HIV positive rate,mortality rate,and mother-to-child transmission rate of 18-month-old children were 1.36%(5/368),4.35%(16/368),and 2.01%(5/249),respectively.The incidence of stunted growth of 18-month-old children in the case group and the control group was 42.12%(155/368)and 23.06%(101/438),respectively,with significant difference(χ2=33.520,P<0.001).Conclusion After HIV-positive mothers in Lingshan County of Guangxi received ART for PMTCT,the incidence of growth stunting in 18-month-old children increased.

Assessment of the impact of HIV infection and anti-retroviral treatment on the cardiometabolic health of pregnant mothers and their offspring (ARTMOMSBABES)

BackgroundThe risk of cardiovascular diseases (CVDs) is becoming more prevalent in pregnant women though not much data is available for pregnant women with human immunodeficiency virus (HIV). Foetoplacental vascular endothelial dysfunction is thought to be at the origin of chronic diseases such as diabetes and obesity later on in life. Because HIV and anti-retroviral treatment (ARTs) are associated with endothelial dysfunction, children exposed in utero to these conditions may be at greater risk of developing CVDs. Despite the high prevalence of HIV in pregnant South African women, little is known about the effects of ART on the cardiovascular health of the mother and offspring. Hence, the proposed study intends to investigate how HIV/ARTs may affect the cardiovascular health of the mother and offspring at different time points during the pregnancy and up to 2 years after birth.MethodsA longitudinal case–control study in HIV positive pregnant women on ART and HIV negative pregnant women will be conducted. All pregnant women will be assessed for cardio-metabolic risk factors and markers (lipids, anthropometric and glycaemic indies, oxidative stress), hemodynamic status (blood pressure parameters) and vascular function (arterial compliance, retinal microvasculature, uterine artery mean pulsatility index). Child health will be monitored in utero and postnatally via routine foetal health screening, placental integrity, anthropometry, blood pressure parameters, markers of oxidative stress and endothelial function in cord blood and cardiovascular epigenetic markers in urine.DiscussionThere is a paucity of studies in South Africa and sub-Sahara Africa as a whole that utilised a longitudinal study model to assess the effects of ARTs on vascular endothelial changes in pregnant women living with HIV and the cardiometabolic health of their offspring. This study will therefore help to monitor changes in cardiometabolic risk during pregnancy and in children exposed in utero to HIV-infection and ART use. Findings from this study will provide useful information for developing guidelines on the use of ARTs in pregnancy and management of cardiometabolic health of the offspring of HIV positive mothers.

Hypoglycemia and Anemia Associated with Malaria among Pregnant Mothers living with HIV attending Aminu Kano Teaching Hospital, Kano State-Nigeria

Human Immunodeficiency Virus (HIV) and Malaria each interact with the host immune system, resulting in complex activation of immune cells. Human Immunodeficiency Virus (HIV) positive patients are predisposed to severe malaria with marked reduction of CD4 cells count and increase in plasma viral load. An assessment was carried out to examine the relationship between hypoglycemia, HIV infection and malaria prevalence in pregnant mothers as well as parasitemia in relation to severity of infection. A hospital based case-control study was carried out. Screening was done at the antenatal and ART clinics, Aminu Kano Teaching Hospital through routine voluntary and confidential HIV testing. After obtaining ethical approval, a total of 200 HIV positive and equivalent numbers of HIV negative pregnant mothers were selected from whom socio-demographic and biomedical data was collected using structured Questionnaire. Blood samples were aseptically collected in an EDTA container. Blood smears (Thick and thin) for malaria screening, Packed Cell Volume (PCV) and Blood Glucose Level were systematically performed using standard procedure. The results were analyzed using Microsoft excel and OpenEpi statistical software version 2.3 and p-value of ≤ 0.05 was considered significant. Malaria prevalence was 141(70.5%) in HIV positive and 110(55.0%) in HIV negative clients. The severity of infection was 41(29.1%) and 5(4.5%) in HIV positive and HIV negative respectively with significant difference (p &lt;0.05).Cases of hypoglycemia ( Blood glucose level ≤ 2.2mmol/L) were observed to be higher among the malaria positive in both the HIV positive and HIV negative clients (100%). There was no significant difference with the severity of infection (p&gt;0.05).The higher prevalence of severe malaria infection among HIV positive clients obtained in this study reveals that HIV positive pregnant mothers had clear evidence of greater exposure to severe malaria in this study area. Therefore strategies to reduce the severity of malaria during pregnancy should be reinforced especially in area of high HIV prevalence by both governmental and non-governmental agencies.&#x0D;

The Influence of Individual Determinants on Adherence to Feeding Guidelines for Infants Born to HIV Positive Mothers in Rakai District

Introduction: In Uganda, Human Immunodeficiency Virus (HIV) was first reported at Kasensero landing site in Rakai district, in the South Western region in 1982. The district has continued to experience high HIV rates at 12% compared to the national average of 7.3% with relatively higher vertical transmission rates. Objective: The purpose of this study was to determine the individual determinants of adherence to feeding guidelines for infants born to HIV positive mothers in Rakai District, Uganda. Methodology: A descriptive cross-sectional study design was used with a sample size of 138 respondents and employing quantitative method of enquiry. A non-probability sampling strategy called consecutive sampling was used to sample the mothers with HIV. Data were analyzed using SPSS to generate descriptive and bivariate analysis data. Results: Individual determinants found to have a statistically significant influence to feeding guidelines for infants born to mothers living with HIV were: Age (X2 = 45.967, P-value = 0.000), Number of children (X2 = 93.069, P-value = 0.000), Number of children given birth to since diagnosis (X2 = 18.604, P-value = 0.000), income per month (X2 = 50.477, P-value = 0.000), ever had breast complication (X2 = 15.039, P-value = 0.000), disclosure of HIV status (X2 = 10.740, P-value = 0.001), quantity of breast milk produced (X2 = 10.637, P-value = 0.0005) and whether mothers attended antenatal care services (X2 = 38.613, P-value = 0.000). Conclusion: Age, Number of Children, Number of Children given birth to since diagnosis, breast complications, disclosure of HIV status, quantity of breast milk produced and utilization of antenatal care services were found to have an association with the adherence to feeding guidelines among HIV positive mother and this was statistically significant. Recommendation: General improvement of socio-economic status of the mothers should be done and be given priority so that in turn it will enable the women to adequately focus on maintaining optimum and the health of their children.

The Correlation between HIV/AIDS Positive Pregnant Mother with Infant APGAR Score in RSD dr. Soebandi Jember

Human Immunodeficiency Virus (HIV) is a virus that decreased immunity and a set symptoms of diseases called Acquired Immune Deficiency Syndrome (AIDS). One of the major risk factors for HIV transmission is perinatal transmission about 2.8% during pregnancy, delivery, and postpartum. HIV positive mothers have a potential to give birth infants with low APGAR. APGAR Score was used as a reference to determine asphyxia in the first and fifth minutes of life. The purpose of this research were to determine the correlation between HIV/AIDS positive pregnant mother with infant APGAR Score and to determine the other factors that affect the infant APGAR Score in RSD dr. Soebandi Jember. This research used observational analytic survey method with cross sectional design using medical record of HIV positive and negative pregnant women from August 2014-July 2017 in RSD dr. Soebandi Jember as a subject that qualify the inclusion and exclusion criteria. This research used case group sampling technique by total sampling and control group by simple random sampling each 52 samples. Test result of the correlation between HIV/AIDS positive pregnant mother with infant APGAR Score using Chi-Square test obtained p value=1.000 (OR=1.13) that means there was no significant correlation. Test result of the correlation between the other factors that affect infant APGAR Score concluded that there were no significant correlation.&#x0D; Keywords: pregnant mother, HIV/AIDS, APGAR Score, infant

Determinants of HIV infection among children born to mothers on prevention of mother to child transmission program of HIV in Addis Ababa, Ethiopia: a case control study

BackgroundDespite wide spread use of Antiretroviral Therapy (ART) by pregnant women living with Human Immunodeficiency Virus (HIV), the transmission rate is still higher by 18% after breastfeeding ends. The aim of this study was to identify factors affecting mother-to-child HIV transmission.MethodsUnmatched case–control study was conducted in Addis Ababa, from April to May, 2017. A case was HIV positive mother who had been on PMTCT program with her child confirmed HIV positive at or before 24 months and control was HIV positive mother who had been on PMTCT program with her child tested definitive HIV negative at 24 months. Accordingly, 44 cases were identified and for each case four controls with the nearest date of birth to the cases were selected from same health facilities. Primary data collected from the mothers were supplemented by record reviews and entered to Epidata version 3.1 and analyzed using SPSS version 22. Multivariate logistic regression was fitted to identify factors independently associated with mother-to-child HIV transmission.ResultsLack of participation in mother-to-mother support program (AOR: 5.1; 95% CI: 1.4, 18.1), low partner involvement (AOR: 6.9; 95% CI: 1.4, 13.4), poor ART adherence (AOR:3.1; 95% CI: 1.3, 7.5), positive syphilis test results (AOR: 3.2; 95% CI: 1.2, 8.6), maternal malnutrition (AOR: 3.1; 95% CI: 1.4, 6.8), unplanned pregnancy (AOR: 10.3; 95% CI: 3.9, 27.2), home delivery (AOR: 5.3; 95% CI: 1.4, 19.4) and mixed feeding of the child during first six months of life (AOR: 12.5; 95% CI: 2.9, 52.7) were significantly associated with MTCT of HIV.ConclusionsMother-to-mother support, male partner involvement in PMTCT of HIV, strengthening antenatal care, counseling mothers on appropriate infant feeding options are important to reduce mother –to- child transmission of HIV.

Status of New HIV Infections among Infants Born of HIV Positive Mothers on Prevention of Mother to Child Transmission at Kisii Teaching and Referral Hospital, Kenya

Introduction: The goal of Prevention of Mother to child Transmission (PMTCT) is to minimize new HIV infection with PMTCT interventions which can reduce to as low as 2%. Gusii region is number 5 among counties that contribute to 65% of new HIV (Human Immunodeficiency Virus) in infections in Kenya. The study was to determine the prevalence of new HIV infections among infants (3 - 18 months) born of HIV positive mothers on PMTCT follow up at Kisii Teaching and Referral Hospital (KTRH). Method: This was a descriptive cross sectional study involving 96 infants born of HIV positive mothers on PMTCT programme at Kisii Teaching and Referral Hospital (KTRH) was conducted. The infants were between 3 to 18 months of age. The infants were investigated for their HIV status and factors associated with prevalence. The data collection was done during postnatal checkups, antiretroviral treatment follow up and immunization schedule. Data was analyzed using Statistical Package for Social Sciences (SPSS) version 20. Results: 13.5% (95% C.I = 10.1% to 16.9%) were found to be positive despite their mothers being on PMTCT program. There was no significant difference between gender and status of the infant (χ2 = 0.758, df = 1, p-value = 0.0384). Conclusion: The study confirms that there are still new HIV infections despite being followed up in the PMTCT program. The new HIV infections were associated with mixed feeding. Recommendation: Counseling on Infant feeding, use of ant-retroviral treatment and support from partners should be strengthen in the PMTCT program to ensure reduction of new HIV infections.

Multidrug Regimen for Prevention of Mother-to-child Transmission in Human Immunodeficiency Virus-positive Mothers in India—From Prevention toward Elimination

Multidrug Regimen for Prevention of Mother-to-child Transmission in Human Immunodeficiency Virus-positive Mothers in India—From Prevention toward Elimination

Knowledge and Awareness of MTCT and PMTCT Post-Natal Follow-up Services Among HIV Infected Mothers in the Mankweng Region, South Africa.

Background:The pandemic of Human Immunodeficiency Virus (HIV) is the most severe health challenge affecting children across the world. It is estimated that more than 90% of all HIV infections in children result from Mother-to-Child Transmission (MTCT). Poor knowledge and awareness of MTCT and Prevention of Mother-to-Child Transmission (PMTCT) among HIV positive mothers and their babies is a major setback to the success of the PMTCT programmes.Methods:A qualitative approach and a cross-sectional design were applied in this study. The sample size of the study was 26 participants. Purposive sampling was used to select HIV infected mothers enrolled for PMTCT follow-up services and health care providers responsible for the implementation of the PMTCT programmes. In-depth interviews were conducted with fifteen HIV infected mothers at two health facilities. Two Focus Group Discussions (FGDs) were conducted with eleven health workers at the two health facilities. Focus groups comprised of six participants from Mankweng Clinic and five participants from Mankweng Gateway Clinic.Results:The findings from the study reveal that the majority of the respondents were aware of MTCT, but lacked knowledge and understanding about how a mother can transmit HIV to her child during pregnancy, labour and breastfeeding. The majority of the participants did not understand the risk of MTCT after birth and failed to mention breastfeeding as a mode of transmission. However, most of the participants were aware that MTCT can be prevented. The respondents were aware of the importance of treatment adherence as a prevention measure to avoid MTCT.Conclusion:Based on these findings, a number of recommendations were made. The first is that educational and awareness programmes need to be developed or strengthened on health risks. Mass campaign media should provide information on the importance of PMTCT activities through the use of community radio stations, Television, newsletters, bill boards etc. People need to know more about PMTCT activities, health personnel need continuous training to provide clear information on PMTCT activities.

Socio - demographic characteristics of HIV patients diagnosed at immunization centres in Calabar, South – south, Calabar, Nigeria

Introduction: The World Health Organization (WHO) estimated that 3.2 million children were living with Human Immunodeficiency Virus (HIV) at the end of 2013, mostly in sub- Saharan Africa. Socio- economic and demographic factors do not only affect viral transmission but also the success of preventive strategies and treatment.Objective: To determine the socio -demographic characteristics of mothers, and the relationship between maternal and HIV status of their infants attending immunization clinics in Calabar.Methods: Using multistage sampling method, 330 subjects were enrolled and screened from 63 immunization centres. The sociodemographic characteristic ofeach infant’s mother was documented. The results of Rapid test for mothers and Dried Blood Spots (DBS) results for infants were compared.Results: Of the 330 subjects recruited, 173 (52.4%) were males while 157(47.6%) were females. Mean age of the infants was 9.20 ± 3.1 weeks. Twenty four mothers and infants tested positive for HIV antibodies. After confirmatory tests using HIV Deoxyribosenucleic acid (DNA PCR), 14(58.3%) out of 24 antibody seropositive infants were infected. The transmission rate after confirmation was 58.3%.Conclusion: Parental education, social class and low maternal Antiretroviral drug (ARV) use were responsible for transmission. It is therefore recommended that health education on ARV use during antenatal period and HIV status of mother baby pair be done at immunization centres. HIV positive mothers and babies should be promptly referred for therapy.Keywords: Immunization, HIV, Infants, DNA PCR, PMTCT, ARV

Outcome of children born to human immunodeficiency virus positive mothers - A retrospective study

Background: Mother-to-child transmission of human immunodeficiency virus (HIV) is a major route of new infections in children. The use of anti-retroviral therapy and nevirapine to mother-baby pairs has shown to be quite effective in preventing the transmission of virus from mother-to-child. Objectives: To analyze the incidence of HIV transmission in children born to HIV-infected pregnant women and to analyze the outcome of these children. Methods: This retrospective study was conducted in a tertiary care referral hospital of central India for a period of 3 years. Data analysis of the mothers with HIV-positive serology up to their delivery andfollow-up of their babies for 18 months was performed. Perinatal mortality rate (PMR) and neonatal mortality rates (NMRs), mother-to-child transmission rate, and the outcome of their children on the basis of various factors - such as maternal CD4 count, treatment taken, and feeding practices - were analyzed. Results: 161 HIV-positive mothers gave birth to 164 babies (including 1 triplet and 1 twin) during the study period. An incidence of mother-to-child transmission was 8.06% and it was influenced by maternal CD4 count, maternal comorbidities, mode of delivery, and feeding practices. In our study, PMR was 48.78/1000 live births; NMR was 54.87/1000 live births as compared to 25/1000 live births in children born to seronegative mothers. Conclusion: The risk of vertical transmission of HIV from mother-to-baby was 8%. Maternal HIV transmission is the primary means by which infants become infected. Hence, the prevention of maternal HIV transmission is of paramount importance.