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

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.

journal_name

Int J STD AIDS

journal_title

International journal of STD & AIDS

authors

Okoko NA,Owuor KO,Kulzer JL,Owino GO,Ogolla IA,Wandera RW,Bukusi EA,Cohen CR,Abuogi LL

doi

10.1177/0956462417693735

subject

Has Abstract

pub_date

2017-10-01 00:00:00

pages

1215-1223

issue

12

eissn

0956-4624

issn

1758-1052

journal_volume

28

pub_type

杂志文章

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