Mother-To-Child Transmission of HIV in Adolescents and Young Women: Findings From a National Prospective Cohort Survey, Zimbabwe, 2013-2014
| Autor: | Beth A. Tippett Barr, Justice Nyakura, Amanda Burrage, Angela Mushavi, Thu-Ha Dinh, Shirish Balachandra, Peter H. Kilmarx, Geral Shambira, Ray W. Shiraishi |
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| Rok vydání: | 2019 |
| Předmět: |
Adult
Zimbabwe medicine.medical_specialty Adolescent Human immunodeficiency virus (HIV) HIV Infections medicine.disease_cause Article 03 medical and health sciences Young Adult 0302 clinical medicine Age Distribution Pregnancy 030225 pediatrics medicine Humans 030212 general & internal medicine Prospective Studies Risk factor Pregnancy Complications Infectious Prospective cohort study Child Obstetrics business.industry Public Health Environmental and Occupational Health Attendance Infant Odds ratio medicine.disease Confidence interval Infectious Disease Transmission Vertical Psychiatry and Mental health Socioeconomic Factors Child Preschool Pediatrics Perinatology and Child Health Gestation Female business Maternal Age |
| Zdroj: | J Adolesc Health |
| ISSN: | 1879-1972 |
| Popis: | Purpose We assessed 18-month cumulative mother-to-child HIV transmission (MTCT) risk and risk factors for no antiretroviral medication use during pregnancy among adolescent, young women, and adult mothers in Zimbabwe. Methods We analyzed data from a prospective survey of 1,171 mother–infant pairs with HIV-exposed infants aged 4–12 weeks who were recruited from 151 immunization clinics from February to August 2013. HIV-exposed infants were followed until diagnosed with HIV, death, or age 18 months. Findings were weighted and adjusted for complex survey design and nonresponse. Results The 18-month cumulative MTCT risk was highest among adolescent aged ≤19 years (12%) followed by young women aged 20–24 years (7.5%) and adult women aged ≥25 years (6.9%). Across these groups, more than 94% had ≥1 antenatal care visit by 21 weeks of gestation, more than 95% had ≥1 HIV test, and more than 98% knew their HIV status. Of known HIV-positive mothers, maternal antiretroviral medication coverage during pregnancy was 76.8% (95% confidence interval: 65.1–85.5), 83.8% (78.6–87.9), and 87.8% (84.6–90.4) among adolescent, young women, and adult mothers, respectively. Among HIV-positive mothers diagnosed prenatally, the adjusted odds ratio of no ARV use during pregnancy was increased among those who had no antenatal care attendance (adjusted odds ratio: 7.7 [3.7–16.0]), no HIV testing (7.3 [2.3–23.5]), no prepartum CD4 count testing (2.1 [1.3–3.4]), and maternal HIV identification during pregnancy (2.9 [1.8–4.8]). Age was not a risk factor. Conclusions With similar coverage of prevention of MTCT services, the 18-month cumulative MTCT risk was higher among adolescents and young women, compared with adults. Additional research should examine the causes to develop targeted interventions. |
| Databáze: | OpenAIRE |
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