Factors associated with mother to child transmission of HIV despite overall low transmission rates in HIV-exposed infants in rural Kenya

Int J STD AIDS. 2017 Oct;28(12):1215-1223. doi: 10.1177/0956462417693735. Epub 2017 Feb 9.

Abstract

Despite the availability of efficacious prevention of mother-to-child transmission (PMTCT) interventions and improved access to preventive services in many developing countries, vertical HIV transmission persists. A matched case-control study of HIV-exposed infants between January and June 2012 was conducted at 20 clinics in Kenya. Cases were HIV-infected infants and controls were exposed, uninfected infants. Conditional logistic regression analysis was conducted to determine characteristics associated with HIV infection. Forty-five cases and 45 controls were compared. Characteristics associated with HIV-infection included poor PMTCT service uptake such as late infant enrollment (odds ratio [OR]: 7.1, 95% confidence interval [CI]: 2.6-16.7) and poor adherence to infant prophylaxis (OR: 8.3, 95%CI: 3.2-21.4). Maternal characteristics associated with MTCT included lack of awareness of HIV status (OR: 5.6, 95%CI: 2.2-14.5), failure to access antiretroviral prophylaxis (OR: 22.2, 95%CI: 5.8-84.6), and poor adherence (OR: 8.1, 95%CI: 3.7-17.8). Lack of clinic-based HIV education (OR: 7.7, 95%CI: 2.0-25.0) and counseling (OR: 8.3, 95%CI: 2.2-33.3) were reported by mothers of cases. Poor uptake of PMTCT services and a reported absence of HIV education and counseling at the clinic were associated with MTCT. More emphasis on high-quality, comprehensive PMTCT service provision are urgently needed to minimize HIV transmission to children.

Keywords: Africa; HIV; PMTCT; prevention; prevention of mother-to-child transmission; women.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Anti-HIV Agents / therapeutic use*
  • Case-Control Studies
  • Child
  • Female
  • HIV Infections / drug therapy*
  • HIV Infections / psychology
  • HIV Infections / transmission*
  • Health Knowledge, Attitudes, Practice
  • Humans
  • Infant
  • Infectious Disease Transmission, Vertical / prevention & control*
  • Kenya
  • Mothers / psychology*
  • Pregnancy
  • Pregnancy Complications, Infectious / drug therapy*
  • Prenatal Care
  • Risk Factors
  • Rural Population
  • Social Stigma
  • Treatment Outcome

Substances

  • Anti-HIV Agents

Grant support