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20Background: Human Immunodeficiency Virus infection (HIV) remains a public health concern in 21 Cameroon that requires regular surveillance for informed policy-making to guide programmatic 22interventions. Using data from the 2016 HIV national sentinel survey in Cameroon, we ascertained HIV 23 prevalence and factors associated with risk of infection among pregnant women 42 43 Background 44 According to the Joint United Nations program on HIV/AIDS (UNAIDS), 36.9 million people 45 were living with HIV in 2017 and 1.8 million were newly infected across the globe. Sub-Saharan 46 Africa bears the greatest burden of the epidemic with 25.7 million people infected in this region[1]. 47 Cameroon is a lower middle-income country with a generalized HIV epidemic. The country has 48 the second largest epidemic after Nigeria in the West and Central African sub-region. The 49 Cameroon Population-based HIV Impact Assessment (CAMPHIA) conducted in 2017 reported an 50 HIV prevalence of 3.7% in the population aged 15-64 years[2]. This prevalence has significant 51 disparities according to specific groups of the population and geographical areas of the country. 52For example, females have an HIV prevalence which is twice as high as that of males (5% and 53 2.3% respectively) [2] while women who are pregnant, are even more disproportionately infected 54 by the virus. 55 In 2012, the national sentinel surveillance survey of HIV and syphilis (SSS) among pregnant 56 women attending first antenatal clinic consultation (ANC1) found that 7.2% of the attendees were 57 infected with HIV [3]. Since mother-to-child transmission (MTCT) of HIV is the leading cause of 58 infection among children, this high prevalence among pregnant women translates to a higher risk 59 of infection to children. Indeed, the HIV prevalence amongst HIV-exposed infants was 8.4% 60 nationwide in that same year. In order to address this high MTCT rate of HIV, the country 61 developed a national plan to eliminate MTCT(eMTCT plan) of the virus, through four priority 62 approaches, amongst which are prevention of HIV infection among women of childbearing age, 63 prevention of unwanted pregnancies among HIV infected women, provision of a comprehensive 64 package of prevention of MTCT of HIV (PMTCT) services, and treatment, care and support to 127 all women tested positive were placed on ART according to national guidelines. Confidentiality 128 and privacy of the study subjects was ensured by permanently delinking personal identifiers with 129 subject information. 130 Results 131 Sociodemographic characteristics 132 A total of 6 859 pregnant women were enrolled in the study. The number of participants varied 133 from 619 in the littoral region to 712 in the North and South-West regions. The mean age was 134 26.2±6.2 years and young women less than 25 represented 42.7% (2 929/6 859) of the sample with 135 up to 15.1% (1033/6 859) below 20 years of age. Over four fifths (86.2%) attended at least the 136 primary school and 13.5% (949/6859) had university level of education. Ab...