Abstract
AbstractThe human immunodeficiency virus (HIV) remains a leading cause of maternal morbidity and mortality in Sub-Saharan Africa. Prevention of mother-to-child transmission (PMTCT) has proven an effective strategy to end paediatric infections and ensure HIV-infected mothers access treatment. Based on cross-sectional data collected from June 2008 to May 2013, we assessed changes in HIV prevalence, risk factors for HIV, provision of PMTCT antiretroviral treatment (ART), and the association between HIV infection, birth outcomes and maternal characteristics at the Simão Mendes National Hospital, Guinea-Bissau’s largest maternity ward. Among 24,107 women, the HIV prevalence was 3.3% for HIV-1, 0.8% for HIV-2 and 0.9% for HIV-1/2. A significant decline in HIV-1, HIV-2, and HIV-1/2 prevalence was observed over time. HIV infection was associated with age and ethnicity. A total of 85% of HIV-infected women received ART as part of PMTCT, yet overall treatment coverage during labour and delivery declined significantly for both mothers and infants. Twenty-two percent of infants did not receive treatment, and 67% of HIV-2-infected mothers and 77% of their infants received ineffective non-nucleoside reverse transcriptase inhibitors for PMTCT. Maternal HIV was associated with low birth weight but not stillbirth. Inadequate continuity of care and ART coverage present challenges to optimal PMTCT in Guinea-Bissau.
Funder
Department of Infectious Diseases, Odense University Hospital, and the Department of Public Health, Research Unit for General Practice, University of Southern Denmark
Research grant from the Albert McKern Bequest, Edinburgh, UK
Publisher
Springer Science and Business Media LLC
Reference55 articles.
1. UNAIDS. Miles to go—Closing Gaps, Breaking Barriers, Righting Injustices. (Geneva, Switzerland 2018).
2. Zaba, B. et al. Effect of HIV infection on pregnancy-related mortality in sub-Saharan Africa: secondary analyses of pooled community-based data from the network for Analysing Longitudinal Population-based HIV/AIDS data on Africa (ALPHA). The Lancet 381, 1763–1771 (2013).
3. UNICEF. Women: At the Heart of the HIV Response for Children (United Nations Children’s Fund (UNICEF), New York, 2018).
4. Bailey, H., Zash, R., Rasi, V. & Thorne, C. HIV treatment in pregnancy. Lancet HIV 5, e457–e467. https://doi.org/10.1016/S2352-3018(18)30059-6 (2018).
5. De Cock, K. M. et al. Prevention of mother-to-child HIV transmission in resource-poor countries: translating research into policy and practice. JAMA 283, 1175–1182 (2000).
Cited by
15 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献