Early Diagnosis of HIV among Infants Born to HIV-Positive Mothers on Option-B Plus in Kampala, Uganda

Abstract

Introduction Globally, there is delay in accessing early HIV diagnosis (EID) among HIV exposed infants (HEIs). With paucity of data on EID use at Kisenyi Health Center, this study assessed factors associated with EID use among HEIs (HIV exposed infants). Method This was a cross-sectional study of 246 HIV-positive mother-baby pairs. Data was collected by structured questionnaire, double-entered in EpiData, and analyzed with STATA using multinomial logistic regression at 5% significance level. Results 132 (53.7%) HEIs were not tested, 60 (24.4%) tested outside EID guideline, and 54 (21.9%) tested per the guideline. Testing per guideline was associated with maternal age above 30 years (AOR = 2.75; 95% CI: 1.20–6.34; P = 0.017); testing outside the guideline was associated with maternal HIV serostatus disclosure (AOR = 2.70; 95% CI: 1.10–6.63; P = 0.003) and four or more antenatal care (ANC) visits (AOR = 3.25; 95% CI: 1.23–8.59; P = 0.017). However, maternal knowledge of HIV transmission was associated with testing outside the guideline (AOR = 2.90; 95% CI: 1.10–7.65; P = 0.032) and per the guideline (AOR = 3.70; 95% CI: 1.39–9.88; P = 0.009). Conclusion Timely EID testing was low. Improving maternal knowledge of EID during ANC visits and positive living empowerment is critical.

High Baseline CD4 Count and Exclusive Breastfeeding Are Associated with Lower Rates of Mother to Child HIV Transmission in Northwestern Uganda: A Two-Year Retrospective Cohort Study

“…Elsewhere [4], the implementation of Option B plus in Uganda was described. Briefly, under Option B plus, the diagnosis of HIV in infants born to HIV-positive mothers is through the collection of Dry Blood Spot (DBS) samples at 6-8 weeks and at 6 weeks after cessation of breastfeeding for HIV testing using Polymerase Chain Reaction (DNA-PCR), and at 18 months using fresh whole blood with HIV antibody test [5].…”

Cessation of breastfeeding and associated factors in the era of elimination of mother to child transmission of HIV at Ndejje Health Center, Uganda: a retrospective cohort study

“…The health facility implements the Uganda National Option B Plus policy [7][8][9], which we have fully described elsewhere [12,13]. Under this policy, all pregnant mothers living with HIV are started on ART for life regardless of their immunological and clinical status and infants receive Nevirapine syrup as prophylaxis from birth until six weeks, adjusted according to weight and age bands.…”

Breastfeeding cessation in the era of Elimination of Mother to Child Transmission of HIV in Uganda: a retrospective cohort study

“…Ndejje Health Center (HC) IV implements the Uganda national and World Health Organization's Option B Plus(7), a policy we have fully described elsewhere. (8,9) Under this policy, all HIV infected pregnant mothers are started on Anti-retroviral Therapy (ART for life irrespective of their immunological and clinical status while an HEI receive Nevirapine syrup as prophylaxis from birth until six weeks adjusted according to weight and age bands. Once Nevirapine syrup is stopped at six weeks, Cotrimoxazole prophylaxis is introduced, a dry blood spot is obtained for HIV test using Deoxyribonucleic Acid-Polymerase Chain Reaction (DNA-PCR).…”