Factors associated with HIV positive sero-status among exposed infants attending care at health facilities: a cross sectional study in rural Uganda

• Published in: BMC public health Vol. 18; no. 1; p. 139
• Main Authors: Kahungu, Methuselah Muhindo, Kiwanuka, Julius, Kaharuza, Frank, Wanyenze, Rhoda K
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 16.01.2018; BioMed Central; BMC
• Subjects: Acquired immune deficiency syndrome; Adolescent; Adult; AIDS; Analysis; Antiretroviral drugs; Care and treatment; Commodities; Content analysis; Cross-Sectional Studies; Data analysis; Data processing; Disease transmission; Distribution; Exposure; Female; Health aspects; Health care facilities; Health facilities; HIV; HIV (Viruses); HIV Infections - epidemiology; HIV Infections - therapy; HIV Infections - transmission; HIV seropositivity; HIV Seropositivity - epidemiology; Human immunodeficiency virus; Humans; Infant; Infant, Newborn; Infants; Infectious Disease Transmission, Vertical - prevention & control; Infectious Disease Transmission, Vertical - statistics & numerical data; Male; Maternal-Child Health Centers; Medical personnel; Middle Aged; Mother and child; Pregnancy; Pregnancy Complications, Infectious - therapy; Prophylaxis; Qualitative analysis; Regression analysis; Risk Factors; Rural Population - statistics & numerical data; Syrup; Syrups; Uganda - epidemiology; Womens health; Workers; Young Adult; Uganda; Sub-Saharan Africa; South Africa; Nigeria; United States > US; Kampala Uganda; Ethiopia
• ISSN: 1471-2458; 1471-2458
• DOI: 10.1186/s12889-018-5024-6

East and South Africa contributes 59% of all pediatric HIV infections globally. In Uganda, HIV prevalence among HIV exposed infants was estimated at 5.3% in 2014. Understanding the remaining bottlenecks to elimination of mother-to-child transmission (eMTCT) is critical to accelerating efforts towards eMTCT. This study determined factors associated with HIV positive sero-status among exposed infants attending mother-baby care clinics in rural Kasese so as to inform enhancement of interventions to further reduce MTCT. This was a cross-sectional mixed methods study. Quantitative data was derived from routine service data from the mother's HIV care card and exposed infant clinical chart. Key informant interviews were conducted with health workers and in-depth interviews with HIV infected mothers. Quantitative data was analyzed using Stata version 12. Logistic regression was used to determine factors associated with HIV sero-status. Latent content analysis was used to analyse qualitative data. Overall, 32 of the 493 exposed infants (6.5%) were HIV infected. Infants who did not receive ART prophylaxis at birth (AOR = 4.9, 95% CI: 1.901-13.051, p=0.001) and those delivered outside of a health facility (AOR = 5.1, 95% CI: 1.038 - 24.742, p = 0.045) were five times more likely to be HIV infected than those who received prophylaxis and those delivered in health facilities, respectively. Based on the qualitative findings, health system factors affecting eMTCT were long waiting time, understaffing, weak community follow up system, stock outs of Neverapine syrup and lack of HIV testing kits. Increasing facility based deliveries and addressing underlying health system challenges related to staffing and availability of the required commodities may further accelerate eMTCT.