Optimizing PMTCT efforts by repeat HIV testing during antenatal and perinatal care in resource-limited settings: A longitudinal assessment of HIV seroconversion

Mushamiri, Ivy; Adudans, Maureen; Apat, Donald; Amor, Yanis Ben

doi:10.1371/journal.pone.0233396

Cited by 11 publications

(10 citation statements)

References 22 publications

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“…HIV testing is also the main strategy for reducing HIV-related illnesses and deaths, and new infection transmission. In addition, the success of the prevention of mother-to-child transmission (PMTCT) programme has been highlighting the role of the HIV testing service uptake in reducing HIV infection rates among children 5 6. Finally, a well-functioning HIV testing service ensures that people who are HIV negative are linked to effective prevention services 7…”

Section: Introductionmentioning

confidence: 99%

HIV testing uptake and determinants among adolescents and young people in Burundi: a cross-sectional analysis of the Demographic and Health Survey 2016–2017

et al. 2022

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ObjectivesTo assess HIV testing uptake and its determinants among adolescents and young adults.DesignCross-sectional design involving analysis of 2016 Demographic and Health Survey data.SettingNationally representative survey of Burundi.ParticipantsA total of 7218 young women and 2860 young men were included.Primary and secondary outcomeWe estimated the proportion of adolescent (15–19 years) and young adult (20–24 years) women and men who had tested for HIV and received results in the 12 months preceding the survey. Multivariable logistic models for determining predictors of HIV testing uptake were fitted among respondents aged 15–24 regardless of sexual activity in the 12 months before the survey and separately among a subset that reporting having had sex in the 12 months preceding the survey.ResultsAn estimated 27.1% (95% CI 25.8% to 28.4%) women and 16.6% (95% CI 15.1% to 18.1%) men had tested for HIV and received results in the 12 months preceding the survey. The proportion was more than twice as high among those aged 20–24 years compared with 15–19 years, among both sexes. In multivariable analysis, older age (20–24 years) was associated with HIV testing (adjusted OR (aOR): 1.62, 95% CI 1.38 to 1.91) among women; (aOR: 1.78, 95% CI 1.32 to 2.40) among men. Higher educational level (aOR: 1.40, 95% CI 1.11 to 1.76) was significantly associated with HIV testing uptake among women. Male circumcision status, condom use, number of sex partners, history of STIs were not associated with HIV testing among the subset that reported having had sex in the 12 months preceding the survey.ConclusionDespite the interventions implemented to reach the 90-90-90 UNAIDS goals, HIV testing among youth in Burundi was low. Youth-friendly health centres should be part of strategies to stimulate young people to increase uptake of HIV preventive services in Burundi.

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Section: Introductionmentioning

confidence: 99%

HIV testing uptake and determinants among adolescents and young people in Burundi: a cross-sectional analysis of the Demographic and Health Survey 2016–2017

et al. 2022

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“…Research has emphasized the importance of conducting provider-initiated counselling and testing (PICT) not only during the initial antenatal care (ANC) visit but also at term/delivery. This is because some pregnant women may seroconvert to HIV later in their pregnancy, underscoring the necessity of repeat tests [ 41 ]. HIV incidence proportions among pregnant women who initially tested negative but later seroconverted were observed at 0.41% in Kenya [ 41 ], 0.12% in India [ 42 ], 0.5% in Zambia [ 43 ].…”

Section: Discussionmentioning

confidence: 99%

Impact of training and case manager support for traditional birth attendants in the linkage of care among HIV-positive pregnant women in Southwest Nigeria: a 3-arm cluster randomized control trial

Ogunyemi,

Odeyemi,

Okusanya

et al. 2024

BMC Pregnancy Childbirth

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Background Mother-to-child transmission (MTCT) accounts for 90% of all new paediatric HIV infections in Nigeria and for approximately 30% of the global burden. This study aimed to determine the effectiveness of a training model that incorporated case managers working closely with traditional birth attendants (TBAs) to ensure linkage to care for HIV-positive pregnant women. Methods This study was a 3-arm parallel design cluster randomized controlled trial in Ifo and Ado-Odo Ota, Ogun State, Nigeria. The study employed a random sampling technique to allocate three distinct TBA associations as clusters. Cluster 1 received training exclusively; Cluster 2 underwent training in addition to the utilization of case managers, and Cluster 3 served as a control group. In total, 240 TBAs were enrolled in the study, with 80 participants in each of the intervention and control groups. and were followed up for a duration of 6 months. We employed a one-way analysis of variance (ANOVA) statistical test to evaluate the differences between baseline and endline HIV knowledge scores and PMTCT practices. Additionally, bivariate analysis using the chi-square test was used to investigate linkage to care. Furthermore, logistic regression analysis was utilized to identify TBA characteristics associated with various PMTCT interventions, including the receipt of HIV test results and repeat testing at term for HIV-negative pregnant women. The data analysis was performed using Stata version 16.1.877, and we considered results statistically significant when p values were less than 0.05. Results At the end of this study, there were improvements in the TBAs’ HIV and PMTCT-related knowledge within the intervention groups, however, it did not reach statistical significance (p > 0.05). The referral of pregnant clients for HIV testing was highest (93.5%) within cluster 2 TBAs, who received both PMTCT training and case manager support (p ≤ 0.001). The likelihood of HIV-negative pregnant women at term repeating an HIV test was approximately 4.1 times higher when referred by TBAs in cluster 1 (AOR = 4.14; 95% CI [2.82–5.99]) compared to those in the control group and 1.9 times in cluster 2 (AOR = 1.93; 95% CI [1.3–2.89]) compared to the control group. Additionally, older TBAs (OR = 1.62; 95% CI [1.26–2.1]) and TBAs with more years of experience in their practice (OR = 1.45; 95% CI [1.09–1.93]) were more likely to encourage retesting among HIV-negative women at term. Conclusions The combination of case managers and PMTCT training was more effective than training alone for TBAs in facilitating the linkage to care of HIV-positive pregnant women, although this effect did not reach statistical significance. Larger-scale studies to further investigate the benefits of case manager support in facilitating the linkage to care for PMTCT of HIV are recommended. Trial registration The study was retrospectively registered in the Pan African Clinical Trial Registry, and it was assigned the unique identification number PACTR202206622552114.

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“…In Kenya they found a seroconversion incidence of 0.41% with no speci c pattern in time during or after pregnancy when this happens. They recommended repeat testing based on risk pro le of the mother [23]. A modelling study found that a 50% reduction in transmission could be achieved with performing an HIV test at 34 weeks and 8 weeks postpartum during the rst immunization follow-up of the child [24].…”

Section: Discussionmentioning

confidence: 99%

Analysis of the HIV Elimination of Mother-to-Child transmission policy Cascade in Suriname

Stijnberg

Holband

Ulenaers

et al. 2022

Preprint

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Background The calculation of the cascade for the Elimination Mother-to-Child-Transmission of HIV (EMTCT) enables the systematic evaluation of different steps in the health care system towards not transmitting HIV to the exposed infant. This study aims to calculate the EMTCT cascade and identify influencing sociodemographic and clinical factors for Suriname. Methods Descriptive analytical study using data regarding prenatal care for women 15–49 year collected in the Multi Indicator Cluster Survey (MICS) 2018. Furthermore, national data from infants and their HIV infected mothers born 2016 to 2018 were used. Multiple regression looking into sociodemographic and clinical factors effecting the transmission of HIV from mother-to-child was executed. Results In 89% (95%CI 85–92%) of the cases there was no transmission of HIV from mother-to-child. Earlier cascade steps show 38% unmet family planning needs and evaluating pregnant women 15% with no prenatal visit, 8% deliveries outside a health facility and 72% HIV test coverage during prenatal care. Of the 0.9% (95%CI 0.8-1.0) of pregnant women with HIV, the ART coverage was 84% (95%CI 80–88%). Their infants received HIV prophylactic treatment in 96% (95%CI 93–98%) and a PCR test after birth in 94% (95%CI 90–96%) of the cases. Increased odd of having a negative PCR result was linked with HIV treatment for mother (aOR 26.8, 95% CI 4.1–173.7) and child (aOR 33.9, 95% CI 2.7–419.7). This while living in the interior compared to urban living decreased the odds (aOR 0.8, 95% CI 0.6-1.0). Conclusions HIV medication for both HIV infected mothers and their infants remain key in the prevention of HIV mother-to-child-transmission. Prenatal care for pregnant women in general shows gaps reaching those important steps. Interventions with a particular focus on mothers living in the interior, guaranteeing the continuity of care are needed.

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Optimizing PMTCT efforts by repeat HIV testing during antenatal and perinatal care in resource-limited settings: A longitudinal assessment of HIV seroconversion

Cited by 11 publications

References 22 publications

HIV testing uptake and determinants among adolescents and young people in Burundi: a cross-sectional analysis of the Demographic and Health Survey 2016–2017

HIV testing uptake and determinants among adolescents and young people in Burundi: a cross-sectional analysis of the Demographic and Health Survey 2016–2017

Impact of training and case manager support for traditional birth attendants in the linkage of care among HIV-positive pregnant women in Southwest Nigeria: a 3-arm cluster randomized control trial

Analysis of the HIV Elimination of Mother-to-Child transmission policy Cascade in Suriname

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