Prevention Of Mother-to-child Transmission Research Articles

Are prevention of mother-to-child HIV transmission service providers acquainted with national guideline recommendations? A cross-sectional study of primary health care centers in Lagos, Nigeria

BackgroundImplementation of interventions for the prevention of mother-to-child transmission (PMTCT) of HIV in low- and middle-income countries, faces several barriers including health systems challenges such as health providers’ knowledge and use of recommended guidelines. This study assessed PMTCT providers’ knowledge of national PMTCT guideline recommendations in Lagos, Nigeria.MethodsThis was a cross-sectional survey of a purposive sample of twenty-three primary health care (PHC) centers in the five districts of Lagos, Nigeria. Participants completed a self-administered 16-item knowledge assessment tool created from the 2016 Nigeria PMTCT guidelines. Research Electronic Data Capture (REDCap) was used for data entry and R statistical software used for data analysis. The Chi square test with a threshold of P < 0.05 considered as significant was used to test the hypothesis that at least 20% of service providers will have good knowledge of the PMTCT guidelines.ResultsOne hundred and thirteen (113) respondents participated in the survey. Most respondents knew that HIV screening at the first prenatal clinic was an entry point to PMTCT services (97%) and that posttest counselling of HIV-negative women was necessary (82%). Similarly, most respondents (89%) knew that early infant diagnosis (EID) of HIV should occur at 6–8 weeks of life (89%). However, only four (3.5%) respondents knew the group counselling and opt-out screening recommendation of the guidelines; 63% did not know that haematocrit check should be at every antenatal clinic visit. Forty-eight (42.5%) service providers had good knowledge scores, making the hypothesis accepted. Knowledge score was not influenced by health worker cadre (p = 0.436), training(P = 0.537) and professional qualification of ≤5 years (P = 0.43).ConclusionService providers’ knowledge of the PMTCT guidelines recommendations varied. The knowledge of group counselling and opt-out screening recommendations was poor despite the good knowledge of infant nevirapine prophylaxis. The findings highlight the need for training of service providers.

Challenges of implementing the prevention of mother to child transmission (PMTCT) program

Background: HIV/AIDS is still a global health problem that needs to be addressed including prevention of hiv/AIDS transmission from mother to baby. Prevention of transmission is carried out by implementing the Prevention of Mother to Child Transmission program or PMTCT program. The PMTCT program is considered successful in reducing the risk of transmission from mother to baby, but it has not been implemented properly and thoroughly, various challenges occur in the implementation of the PMTCT program. The purpose of this literature review is to analyze the results of previous research on the challenges of implementing the Prevention of Mother to Child Transmission (PMTCT) Program. Method: The method used is literaturee review. In the first stage begins by doing article alignment using pubmed search engines and Google scholar. The keywords used in article searches are "PMTCT, HIV. Results: Challenges in the implementation of the PMTCT program include lack of information about ARV treatment, lack of family support, the severity of the workload experienced by health workers and the limited hiv testing equipment and drug stocks.

Client Experiences in a Mobile-Phone Counseling Intervention for Enhancing Access to Prevention of Mother To-Child Transmission (PMTCT) Services in Kenya.

BackgroundThe prevention of mother-to-child transmission (PMTCT) is considered one of the most successful HIV prevention strategies in detecting and reducing HIV acquisition in utero or at birth. It is anticipated that with the increasing growth of digital technologies mobile phones can be utilized to enhance PMTCT services by improving provider-client interactions, expanding access to counseling services, and assisting in counteracting social and structural barriers to uptake of PMTCT services. Understanding the subjective experiences of women accessing PMTCT services in different settings has the potential to inform the development and promotion of such methods. This paper explores the perspectives of HIV-positive pregnant women attending maternal and neonatal clinic services in Kisumu, Kenya.MethodsData are reported from in-depth interviews with women, following a longitudinal study investigating the impact of a structured, counselor-delivered, mobile phone counseling intervention to promote retention in care and adherence to ARV prophylaxis/treatment, for HIV-positive pregnant women. Thematic content analysis was conducted.ResultsDiscussions indicated that mobile-phone counseling provided useful health-related information, enhanced agency, and assisted mothers access critical PMTCT services across the cascade of care. Similarly, mobile-phone counseling offered personalized one-to-one contact with trained health providers including facilitating discussion of personal issues that likely affect access to services. Findings also identified barriers to the uptake of services, including a lack of partner support, poor health, poverty, facility-related factors, and provider attitudes.DiscussionOverall, findings show that mobile-phone counseling is feasible, acceptable, and can enhance access to PMTCT services by overcoming some of the individual and facility-level barriers. Although mobile-phone counseling has not been routinized in most health facilities, future work is needed to assess whether mobile-phone counseling can be scaled-up to aid in the effective use of HIV and PMTCT services, as well as improving other related outcomes for mother and child dyad.

Awareness, attitude and practice on prevention of mother to child transmission of human-immunodeficiency virus among pregnant women in Taungoo Township, Myanmar

Background: Globally, about 1.3 million human-immunodeficiency virus (HIV)-positive women get pregnant once a year, and about 160,000 children are born with the HIV. This study was conducted to investigate pregnant women's awareness, attitude, and practice regarding the prevention of mother to child HIV transmission (PMTCT).Methods: This cross-sectional study collected qualitative data from 152 pregnant women registered in the health facilities in Taungoo township. Simple random sampling was applied to cull three out of total rural health centres and systematic random sampling was exercised to recruit the required pregnant women from all registered pregnancies. The semi-structured questionnaire and statistical package for the social sciences (SPSS) version 23 were used for data collection and analysis accordingly.Results: In overall, the pregnant women studied had good awareness (56.6%), favourable attitude (60.5%), and good practice (55.3%) on PMTCT services. 78.3% were aware of the PMTCT project and knew that a baby can be prevented from HIV transmission by an HIV mother, 57.8% agreed that counselling and testing for HIV during pregnancy are important and 85.5% were tested for HIV. The awareness was associated with the family type (p=0.049), the attitude was associated with age (p=0.048), residence (p=0.024), and frequency of antenatal visits during current pregnancy (p=0.021), and practice was associated with antenatal care delivery sites (p=0.038), husband's support for antenatal care (p=0.004) and taking antenatal services during a previous pregnancy (p=0.033).Conclusions: Many unsatisfactory findings regarding PMTCT services were noted. So, strategic interventions and effective approaches for getting the full coverage of PMTCT programs should be strengthened.

Clients’ satisfaction with prevention of mother-to-child transmission of HIV services received at health facilities in the Volta Region of Ghana

ABSTRACT The risk of mother-to-child transmission (MTCT) of HIV can be reduced through the provision of prevention of MTCT (PMTCT) of HIV services. This study assessed clients’ satisfaction with PMTCT of HIV services received at health facilities in the Volta Region, Ghana. A cross-sectional design was employed to collect data from a sample of 405 pregnant women receiving antenatal care (ANC) services and 80 mothers attending postnatal care clinics (PNCs). Logistic regression was performed at the 0.05 significance level. About 77.1% were satisfied with PMTCT of HIV services. Respondents with no formal education (Adjusted Odds Ratio [AOR] = 0.05; CI: 0.01 to 0.52; p = 0.012), Farmers (AOR = 0.18; CI: 0.07 to 0.43; p < 0.001), the Guans (AOR = 0.04; CI: 0.04 to 0.35; p = 0.003) and the Konkombas (AOR = 0.05; CI: 0.01 to 0.50; p = 0.011) were less likely to be satisfied with the PMTCT services. Clients in the rural areas (AOR = 15.00; CI: 4.45 to 56.74; p < 0.001), those in semi-urban areas (AOR = 2.13; CI: 1.12 to 1.47; p = 0.021), mothers with one child (AOR = 3.39; C.I: 1.07 to 10.66; p = 0.037) and two children (AOR = 8.70; CI: 2.36 to 31.66; p < 0.001) were more likely to be satisfied with the PMTCT services. Clients who received information from health workers (AOR = 7.03; CI: 1.81 to 27.36; p = 0.005), those who received HIV testing (AOR = 8.83; CI: 2.18 to 35.86; p = 0.002) and infant feeding (AOR = 3.15; CI: 1.05 to 9.43; p = 0.041) services were more likely to be satisfied with the PMTCT services. Health promotion interventions should target those without any formal education, farmers, those residing in urban settings and those without children.

Infant feeding knowledge and practice among HIV positive mothers attending HIV treatment centres in Lagos

Background: Twenty five to forty percent of children will be infected with HIV in the absence of any form of intervention which is Prevention of Mother to Child Transmission (PMTCT).Objectives: This study determined the infant feeding knowledge and practices among HIV positive mothers attending HIV treatment centers in Lagos.Methods: A descriptive crosssectional design was used for the study. A multistage sampling technique was used to select / recruit 290 HIV positive mothers with babies between the ages of 2weeks to 18months, attending PMTCT services into the study Pre-tested interviewer administered structured questionnaire was used to collect data and analysis was done using Epi-info software. Chi-square and Fischer exact tests were used to determine association between the dependent and independent variables. The pvalue was set at 0.05.Results: Majority of the respondents (58.9%) were within the age range of 31 – 40 years and about half had a secondary school level of education. Exclusive formula feeding (40.3%) and exclusive breast feeding (42.4%) were feeding options known by the majority of the respondents. More than half (55.5%) of the mothers had a good knowledge of infant feeding options. Exclusive breastfeeding (EBF) was practiced by majority (55.5%) of the respondents, 21.4% practiced exclusive formula feeding (EFF) while only 6% practiced mixed feeding (MF). Knowledge of infant feeding options and the attitude towards exclusive breast feeding being enough in the first 6 months of life were associated with infant feeding options practiced; those with good knowledge of infant feeding options did not practice MF (9.7%) (p = 0.013).Conclusion: knowledge of infant feeding options was good and poor knowledge was associated with exclusive formula feeding. Majority practiced EBF. Educational programmes targeted at improving the knowledge of HIV and infant feeding options as well as strengthening of counseling sessions at PMTCT clinic would help reduce the risk of HIV transmission to the child.

Mother-to-Child Transmission of HIV Through Breastfeeding Improving Awareness and Education: A Short Narrative Review.

Despite critical progress registered in the reduction of mother to child transmission (MTCT) of HIV worldwide, transmission through breastfeeding still contributes to almost 50% of pediatric HIV infections recorded every year. In this short narrative review, after development of an extensive background on HIV and breastfeeding, some directions are suggested to address the key bottlenecks. Specifically, reinforcing the prevention of MTCT through breastfeeding (BF) in order to move towards elimination of MTCT prior to 2030 may require, among others strategies: tracking all women of child bearing age through HIV testing, improving testing and retesting of women during pregnancy and breastfeeding, strengthening adherence on antiretroviral therapy (ART) among pregnant and lactating women, ensuring continuum and retention in care of mother and baby-pairs up to 24 months, switching ART in non-viral suppressed mothers after improvement of adherence counseling. In addition, due to the burden of seroconversion during pregnancy or thereafter through BF, pre-exposure prophylaxis (PreP) for most at risk women should be implemented urgently. The opportunity to extend the infant prophylaxis to the whole lactating period should be assessed to address residual transmission amongst viral suppressed mothers.

Timely Attendance of the First Antenatal Care among Pregnant Women Aged 15–49 Living with HIV in Juba, South Sudan

Timely attendance of the first antenatal care (ANC) is the period in which pregnant women visit ANC less than four months of pregnancy. There is a paucity of data on timely first ANC attendance and its associated factors among pregnant women living with human immunodeficiency virus (HIV) in Juba. The aim of this study was to investigate timely attendance of the first ANC visit among pregnant women living with HIV. Institutional cross-sectional study was conducted in three public health facilities in Juba by convenience sampling from January 2019 to December 2019. Pearson’s chi-squared test was conducted for bivariate analysis and variables with probability values ( p values) less than 5% were considered as statistically significant for multivariable analyses using Fisher’s exact test. At the multivariate level, binary logistic regression analysis was conducted. Out of the 192 participants studied, 27 (14.1%) had timely first ANC attendance as recommended and 165 (85.9%) attended first ANC at four months and above. Distances (adjusted risk ratio [aOR], 7.14; 95% confidence interval [CI], 1.40–36.68), ANC card (aOR, 3.48; 95% CI, 1.17–10.40), waiting time ([aOR], 0.04; 95% CI, 0.01–0.75), and prevention of mother-to-child transmission (PMTCT) services (aOR, 0.12; 95% CI, 0.03–0.56) were the factors associated with timely first ANC attendance. Health education interventions targeting pregnant women attending ANC at health facilities should focus on increasing knowledge and awareness of the importance of timely first ANC attendance.

Women\u2019s decision-making power and knowledge of prevention of mother to child transmission of HIV in sub-Saharan Africa

BackgroundSub-Saharan Africa (SSA) bears the highest burden of Human Immunodeficiency Virus (HIV) in the world. Even though the prevention of mother to child transmission (PMTCT) programmme is one of the strategies to control the HIV pandemic, the uptake in SSA countries is low. Women’s decision-making power has a positive influence on health seeking behavior and uptake of several maternal health services. However, its relationship with knowledge of PMTCT services is understudied in SSA. Therefore, this study aimed to examine the association between women’s decision-making power and knowledge of PMTCT in 24 countries in SSA.MethodsAnalysis of this study included data on 158,812 married women from the Demographic and Health Surveys of 24 sub-Saharan African countries conducted between 2010 and 2020. Using Stata version-14 software, bivariate and multivariable logistic regression analyses were conducted. The results were presented using adjusted odd ratios (aOR) with the corresponding 95% confidence intervals (CI).ResultsIn the pooled results, 69.5% (95% CI; 66.7–72.1%) of married women in the studied countries had knowledge of PMTCT, ranging from 13.9% (95% CI; 11.9–16.2%) in Comoros to 75.4% (95% CI; 73.7–76.9%) in Zimbabwe. Higher odds of PMTCT knowledge were seen among married women who had decision-making power compared to married women who had no decision-making power. Moreover, we found higher odds of PMTCT knowledge among married women with manual occupation, those in the richest households and those with 1–2 children compared to married women who were not working, from the poorest households, and those with no children, respectively.ConclusionWomen’s decision-making power had positive influence on PMTCT knowledge. To increase the coverage of PMTCT knowledge, policy makers and other stakeholders need to target ways to empower women through increasing women’s decision-making power. Moreover, creating employment opportunities and economic empowerment for women need to be considered, especially in countries with very low coverage of PMTCT knowledge.

The role of tenofovir disoproxil fumarate for preventing vertical transmission of hepatitis B.

Since immunoprophylaxis failure can occur if maternal serum hepatitis B virus (HBV) DNA levels are >200,000IU/ml, tenofovir disoproxil fumarate (TDF) therapy has been investigated for preventing mother to child transmission (PMTCT). A literature search for maternal TDF therapy for PMTCT between 1/1/2015 and 7/1/21 on PUBMED, EMBASE, Cochrane, CNKI, and Wanfang databases was performed. Data from RCTs in English or Chinese were extracted and reviewed. The outcomes of interest included the efficacy and safety of TDF versus placebo for PMTCT. Among 11 RCTs identified from the databases, the risk-of-bias was low. All studies demonstrated that maternal TDF therapy initiated from the second or third trimester for highly viremic chronic hepatitis B mothers is highly effective and safe in the PMTCT of HBV, except one RCT performed in Thailand which showed no therapeutic advantage on TDF treatment versus placebo for PMTCT (0% vs 3% transmission). Recent emerging data suggest that maternal TDF therapy initiated at the 2nd or early 3rd trimester in mothers with HBV DNA >200,000IU/ml achieved viremic control before delivery. In the 4-year long follow-up study for maternal TDF therapy, there were no impacts on infants' physical growth, psychological or mental development, and bone mineral density after fetal exposure to TDF. In the light of updated efficacy and safety data from RCTs, an algorithm was proposed. The approaches in resource-limit areas were discussed. TDF is safe for both mothers and infants as the preferred therapy for PMTCT in highly viremic mothers. TDF should be initiated at the second or early third trimester in the combination of the appropriate infants' immunoprophylaxis.

Awareness and Perception Towards Prevention of Mother-to-child Transmission of HIV Guidelines Among Health Providers at the Saudi Maternity Hospital, Sudan

Abstract&#x0D; Background: The prevention of mother-to-child transmission (PMTCT) is a basic approach to control the HIV epidemic. The goal of this research is to learn more about healthcare practitioners' knowledge, attitudes, and practices to PMTCT.&#x0D; Methods: A descriptive cross-sectional institutional study was conducted amongst nurses, working at the Saudi maternity Hospital in Sudan. The data is collected by using a questionnaire designed for the study to collect the necessary data addressing knowledge, attitude, and factors associated with PMTCT services. Data analysis achieved by a statistical package for social science (SPSS) V 20, presented in figures and tables.&#x0D; Result: From the respondent's answers find the mode of transmissions more than half of the nurse's selected needle stick (51.2%), encouraging women for HIV test during the pregnancy (97.5%), more than two-thirds (67.5%) felt worried when they are caring pregnant women with HIV. On the other hand, (91.2%) of the respondents indicate a willingness to assist with the delivery of a baby born to a mother with HIV/AIDS.&#x0D; Conclusion: Without extensive training and an increase in staffing levels of knowledge, the quality of and access to PMTCT services will likely impact negatively.

Group antenatal care for improving retention of adolescent and young pregnant women living with HIV in Kenya

BackgroundPregnant and breastfeeding adolescents and young women living with HIV (AYWLH) have lower retention in prevention of mother-to-child transmission (PMTCT) services compared to older women.MethodsWe evaluated a differentiated service model for pregnant and postnatal AYWLH at seven health facilities in western Kenya aimed at improving retention in antiretroviral treatment (ART) services. All pregnant AYWLH < 25 years presenting for antenatal care (ANC) were invited to participate in group ANC visits including self-care and peer-led support sessions conducted by health facility nurses per national guidelines. ART register data were used to assess loss to follow-up (LTFU) among newly-enrolled pregnant adolescent (< 20 years) and young women (20–24 years) living with HIV starting ART in the pre-period (January-December 2016) and post-period (during implementation; December 2017-January 2019). Poisson regression models compared LTFU incidence rate ratios (IRR) in the first six months after PMTCT enrollment and risk ratios compared uptake of six week testing for HIV-exposed infants (HEI) between the pre- and post-periods.ResultsIn the pre-period, 223 (63.2%) of 353 pregnant AYWLH newly enrolled in ANC had ART data, while 320 (71.1%) of 450 in the post-period had ART data (p = 0.02). A higher proportion of women in the post-period (62.8%) had known HIV-positive status at first ANC visit compared to 49.3% in the pre-period (p < 0.001). Among pregnant AYWLH < 20 years, the incidence rate of LTFU in the first six months after enrollment in ANC services declined from 2.36 per 100 person months (95%CI 1.06–5.25) in the pre-period to 1.41 per 100 person months (95%CI 0.53–3.77) in the post-period. In both univariable and multivariable analysis, AYWLH < 20 years in the post-period were almost 40% less likely to be LTFU compared to the pre-period, although this finding did not meet the threshold for statistical significance (adjusted incidence rate ratio 0.62, 95%CI 0.38–1.01, p = 0.057). Testing for HEI was 10% higher overall in the post-period (adjusted risk ratio 1.10, 95%CI 1.01–1.21, p = 0.04).ConclusionsInterventions are urgently needed to improve outcomes among pregnant and postnatal AYWLH. We observed a trend towards increased retention among pregnant adolescents during our intervention and a statistically significant increase in uptake of six week HEI testing.

Effect of peer-mother interactive programme on prevention of mother-to-child HIV transmission outcomes among pregnant women on anti-retroviral treatment in routine healthcare in Dar es Salaam, Tanzania.

Peer support services are increasingly being integrated in programmes for the prevention of mother-to-child HIV transmission (PMTCT). We aimed to evaluate the effect of a peer-mother interactive programme on PMTCT outcomes among pregnant women on anti-retroviral treatment (ART) in routine healthcare in Dar es Salaam, Tanzania. Twenty-three health facilities were cluster-randomized to a peer-mother intervention and 24 to a control arm. We trained 92 ART experienced women with HIV to offer peer education, adherence and psychosocial support to women enrolling in PMTCT care at the intervention facilities. All pregnant women who enrolled in PMTCT care at the 47 facilities from 1st January 2018 to 31st December 2019 were identified and followed up to 31st July 2021. The primary outcome was time to ART attrition (no show >90 days since the scheduled appointment, excluding transfers) and any difference in one-year retention in PMTCT and ART care between intervention and control facilities. Secondary outcomes were maternal viral suppression (<400 viral copies/mL) and mother-to-child HIV transmission (MTCT) by ≥12 months post-partum. Analyses were done using Kaplan Meier and Cox regression (ART retention/attrition), generalized estimating equations (viral suppression) and random effects logistic regression (MTCT); reporting rates, proportions and 95% confidence intervals (CI). There were 1957 women in the peer-mother and 1384 in the control facilities who enrolled in routine PMTCT care during 2018-2019 and were followed for a median [interquartile range (IQR)] of 23 [10, 31] months. Women in both groups had similar median age of 30 [IQR 25, 35] years, but differed slightly with regard to proportions in the third pregnancy trimester (14% versus 19%); advanced HIV (22% versus 27%); and ART naïve (55% versus 47%). Peer-mother facilities had a significantly lower attrition rate per 1000 person months (95%CI) of 14 (13, 16) versus 18 (16, 19) and significantly higher one-year ART retention (95%CI) of 78% (76, 80) versus 74% (71, 76) in un-adjusted analyses, however in adjusted analyses the effect size was not statistically significant [adjusted hazard ratio of attrition (95%CI) = 0.85 (0.67, 1.08)]. Viral suppression (95%CI) was similar in both groups [92% (91, 93) versus 91% (90, 92)], but significantly higher among ART naïve women in peer-mother [91% (89, 92)] versus control [88% (86, 90)] facilities. MTCT (95%CI) was similar in both groups [2.2% (1.4, 3.4) versus 1.5% (0.7, 2.8)]. In conclusion, we learned that integration of peer-mother services in routine PMTCT care improved ART retention among all women and viral suppression among ART naïve women but had no significant influence on MTCT.

Maternal and health care workers\u2019 perspectives on exclusive breastfeeding in the context of maternal HIV infection, in Busia county, western Kenya: a mixed methods cross-sectional survey

BackgroundWorld Health Organization recommends exclusive breastfeeding (EBF) for 6 months with maternal active antiretroviral therapy (ART) to prevent mother-to-child transmission (PMTCT) of HIV. However, EBF in low resource settings remains low. We explored perspectives of EBF by HIV-infected mothers and health care workers in Busia County with a high prevalence of HIV to understand factors influencing the practice.MethodsA mixed methods cross-sectional survey using concurrent quantitative and qualitative data collection methods was conducted at PMTCT clinics. Data on socio-demography, young infant feeding practices, maternal and infant health was collected between February 2013 and August 2015 from 371 purposively sampled HIV-infected mother-infant dyads using a semi-structured questionnaire. Focus group discussions with mothers, in-depth interviews and passive observation of health care workers during interaction with mothers were conducted. Significance of difference between mothers practicing EBF or not was tested by Chi-square and Fisher’s exact tests setting significance level at 5%. Qualitative data was coded and content analyzed to generate themes.ResultsThree hundred and forty-nine (94%) mothers practiced EBF. Maternal comprehension of EBF to PMTCT of HIV influenced choice and practice of EBF (P value = 0.019 and < 0.001 respectively). Health care workers emphasized adherence to ART and offered nutritional supplementation during EBF. Health care workers’ nutritional counseling in the context of maternal HIV was poor. Mentor mothers shared their experiences with mothers and offered live case demonstrations of their successfully EBF, healthy and HIV-uninfected children. The main threats to EBF were teenage motherhood, low maternal education and working during EBF.ConclusionsEBF among HIV-infected mothers in Busia County, Kenya was high. Health education and counselling by health care workers, maternal comprehension of ART adherence to PMTCT of HIV, nutritional supplementation and mentor mothers’ peer counseling using live case demonstrations of HIV-uninfected EBF children promoted and sustained practice of EBF for 6 months. Teenage motherhood, low maternal education and having to work threatened EBF,

Successful Implementation of Prevention of HIV Mother-to-child Transmission (PMTCT) in Tlemcen, Algeria

Successful Implementation of Prevention of HIV Mother-to-child Transmission (PMTCT) in Tlemcen, Algeria

A Retrospective Study of Incidence and Predictors on Mother-to-Child Transmission of HIV among HIV-Exposed Infants in West Guji Zone, Southern Ethiopia.

Background The transmission of HIV from mother to child among HIV-positive infants is estimated to be higher than 20%, despite the fact that antiretroviral treatment is available for antenatal mothers with HIV. In Ethiopia, the prevalence of HIV transmission from mother to child among infants aged one and a half years is estimated to be approximately 15.7 percent. Methods A retrospective cohort analysis using a simple random sampling technique was incorporated among 422 HIV-exposed babies and their mothers who were randomly chosen and screened using OPD (outpatient card) from March 2019 to March 2021 in the general hospitals of West Guji zone, Oromia, Ethiopia. The data were coded and entered into EpiData version 4.6.1 and exported to SPSS version 23 for cleaning and analysis. Result The study revealed that at the end of follow-up, 3.8% of the HIV-exposed infants were found to be HIV positive. Poor adherence of infant for CPT (AOR: 5.6; 95% CI: 1.010–27.24), father not enrolled to ART (AOR: 4.4; 95% CI: 1.187–15.724), age of infants at enrollment >6 weeks (AOR: 4.5; 95% CI: 1.102–16.1), mother's enrollment to PMTCT during labor and delivery or after (AOR: 6.84; 95% CI: 1.316–42.743), and mothers on the WHO clinical stage mild or advanced (AOR: 3.6; 95% CI: 1.146–16.842) was found to be the most important significant predictors of mother-to-child transmission of HIV. Conclusion Several factors included in the study were the main predictors of mother-to-child transmission of HIV. The study concluded that there are some lacunae in the prevention of MTCT of HIV but that the incidence of MTCT of HIV was significantly lower in this part of the world.

Estimated blood pressure trajectories and hypertension patterns among pregnant women living with HIV, Haiti, 2007-2017.

Hypertension in pregnancy is a key driver of mortality and morbidity among Haitian women. HIV infection and treatment may worsen hypertension and increase cardiovascular disease risk. The authors examined blood pressure and hypertension patterns among 1965 women (2306 pregnancies ending in live births) in a prevention of maternal‐to‐child transmission (PMTCT) program in Port‐au‐Prince, Haiti, between 2007 and 2017. Hypertension was defined as blood pressure ≥140/90 mm Hg on two consecutive visits. Latent class analysis assessed trajectories of mean arterial pressure (MAP) and multinomial ordinal logistic regression examined factors associated with higher trajectories. Between 2007–2009 and 2013–2016, hypertension at PMTCT entry increased from 1.3% to 3.8% (p = .005), while incidence at any time during PMTCT follow‐up increased from 5.0 to 16.1 per 100 person‐years (p < .001). Hypertension detected ≤20 weeks and > 20 weeks of gestation (possible gestational hypertension) increased from 1.1% to 3.5% (p = .003) and from 2.3% to 6.9% (p < .001), respectively. Five MAP trajectories ranged from low‐stable to high‐increasing. In multivariable analysis controlling for history of antiretroviral therapy, age, parity, and weight, program entry in more recent years was associated with greater odds of higher MAP trajectory (adjusted odds ratio for 2013–2016 vs. 2007–2009 = 3.1, 95% confidence interval: 1.7–5.6). The increasing prevalence and incidence of hypertension highlight a need for screening and management prior to PMTCT entry and during follow‐up. In a population with limited access to chronic disease care, and where many deliveries occur outside of a clinical setting, the period of PMTCT follow‐up represents an opportunity to diagnose and initiate management of preexisting and pregnancy‐related hypertension.

A systematic review of the effects of intimate partner violence on HIV-positive pregnant women in sub-Saharan Africa

BackgroundIntimate partner violence (IPV) affects more than one in three women in sub-Saharan Africa (SSA). It is associated with both pregnancy and HIV, adversely affecting women in this region. This is the first systematic examination of the effects of IPV on HIV-positive (HIV+) pregnant women in SSA.MethodsA systematic review of the literature on HIV+ pregnant women experiencing IPV in SSA was carried out. Searches were carried out in PubMed, Web of Science and African Journals Online databases. Articles published between January 2010 and June 2020, in English, were included. Data extraction included details on study locations, study design, study participants and the study outcome variables (depression, IPV, medication adherence, postpartum unsafe sex, and HIV disclosure).ResultsFourteen studies (ten cross-sectional studies, four cohort studies) were included. Results indicate a high prevalence of IPV amongst pregnant women with HIV in SSA (18.0 to 63.1%). The results suggest an association between HIV-positive status and consequences of IPV during pregnancy, particularly mental health effects, such as depression symptoms and suicidal ideation. HIV-related stigma has a key role within the relationship between HIV and IPV during pregnancy. One study described that the presence of IPV reduces adherence to Prevention of Mother-To-Child Transmission (PMTCT) medication. Three studies reported no association between HIV positive status or HIV status disclosure and IPV during pregnancy.Discussion/conclusionsThe systematic review confirms interconnections between IPV and HIV seropositivity amongst pregnant women in SSA. Importantly, stigma, social isolation and poor mental health hinder help-seeking, disclosure, and treatment adherence among HIV+ pregnant women exposed to IPV in SSA. As a result, the potential of community interventions to tackle issues associated with IPV in HIV-positive pregnant women in this area should be explored in research, policy, and practice.

Determinants of HIV infection among children born from mothers on prevention of mother to child transmission programme of HIV in southern Ethiopia: a case–control study

ObjectiveThis study was aimed to identify determinants of HIV infection among children born from mothers on the prevention of mother to child transmission (PMTCT) programme in Southern Ethiopia. It was...

Retroviral seroprevalence and sociodemographic parameters of the ante-natal pregnant women in a pre-tertiary health facility

Background: Foetus can be infected by HIV-positive pregnant women. A research to assess the seroprevalence and socio-demographic parameters of antenatal pregnant women in a pre-tertiary health facility, Uyo was carried out Methods: Standard serological and statistical methods were employed. Results: As we previously presented in a conference: “A total of 184 pregnant women were screened and thirty-seven (20.1%) of them were HIV-positive. The ages of all the women ranged from 17-44 years, out of which the age group 35-39 years had the highest prevalence (41.2%) of HIV-positive women, followed by 25-29years (24.4%) while &lt;20 years and ≥40years had none. Married pregnant women had the highest overall prevalence of 14.1% while individual who registered in the hospital as divorcees had highest prevalence (70%) within group. Working pregnant women were more affected (21.9%) than unemployed counterparts (17.8%), just as the educated were more affected (23.9%) than the uneducated (17.9%). None of the pregnant women was undergoing prevention of mother to child transmission (PMTCT) programs. Unmarried youth, underage and those who registered as divorcee were more than the pregnant women”. Conclusions: There is need to further emphasize HIV screening among pregnant women in developing countries to commence PMTCT promptly. As we also concluded in a conference presentation, “the urgent need for PMTCT programme in this study area becomes obvious due adverse maternal and foetal outcome associated with HIV positive participants.”