Pregnant with HIV before age 25: data from a large national study in Italy, 2001–2016

Floridia, Marco; Masuelli, Giulia; Tamburrini, Enrica; Cetin, Irene; Liuzzi, Giuseppina; Martinelli, Pasquale; Guaraldi, Giovanni; Spinillo, Arsenio; Vimercati, Antonella; Maso, Gianpaolo; Pinnetti, Carmela; Frisina,; Dalzero, Serena; Ravizza, Marina

doi:10.1017/s0950268817001340

Cited by 2 publications

(2 citation statements)

References 21 publications

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“…Unplanned pregnancy is higher amongst adolescents compared to adults and pregnant young women have an increased risk of MTCT and poorer maternal and infant health outcomes than older women [25,26]. Findings by Floridia et al show that younger women had a lower rate of planned pregnancy (OR 0.50, CI: 0.36-0.69) and were more frequently diagnosed with HIV in pregnancy (OR 3.29, CI: 2.54-4.25) [27].…”

Section: Discussionmentioning

confidence: 99%

A risk measurement tool for targeted HIV prevention measures amongst young pregnant and lactating women in South Africa

et al. 2022

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Background We aimed to develop and validate a tool to identify which pregnant/lactating young South African women (≤ 24 years) are at risk of HIV infection. Methods Data from three national South African Prevention of Mother-to-Child Transmission (PMTCT) evaluations were used to internally validate three HIV acquisition risk models for young postpartum women. We used univariate and multivariable logistic regression analysis to determine which risk factors were significant. Model coefficients were rounded and stratified into risk groups and the area under the receiver operating curve (AUROC) was computed. Models were developed to determine which risk factors provided the most predictive accuracy whilst remining clinically meaningful. Results Data from 9 456 adult and 4 658 young pregnant and lactating women were included in the development and validation data sets, respectively. The optimal model included the following risk factors: age (20–24 years old), informal house structure, two or more pregnancies, mothers who had knowledge of when they received their last HIV test result, no knowledge of the infant’s father’s HIV status, no knowledge of breastfeeding as a mode of MTCT and knowledge of PMTCT programme. The mean AUROC was 0.71 and 0.72 in the development and validation datasets respectively. The optimum cut off score was ≥ 27, having 84% sensitivity, 44% specificity, and identifying 44% of high-risk women eligible for PrEP. Conclusion The optimal model to be used as a possible risk scoring tool to allow for early identification of those pregnant/lactating women most at-risk of HIV acquisition included both statistically as well as clinically meaningful risk factors. A field-based study is needed to test and validate the effectiveness of this targeted approach.

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Section: Discussionmentioning

confidence: 99%

A risk measurement tool for targeted HIV prevention measures amongst young pregnant and lactating women in South Africa

et al. 2022

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“…In The National AIDS Plan, in the section on ways to improve control of the HIV epidemic in Italy, there is a chapter dedicated to MTCT. The provision of mandatory screening at the beginning of pregnancy and the implementation of multidisciplinary management protocols are measures that should be implemented immediately .…”

Section: Discussionmentioning

confidence: 99%

Missed opportunities to prevent mother‐to‐child transmission of HIV in Italy

et al. 2019

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ObjectivesVertical transmission of HIV can be effectively controlled through antenatal screening, antiretroviral treatment and the services provided during and after childbirth for mother and newborn. In Italy, the National Health Service guarantees universal access to prenatal care for all women, including women with HIV infection. Despite this, children are diagnosed with HIV infection every year. The aim of the study was to identify missed opportunities for prevention of mother-to-child transmission of HIV. MethodsThe Italian Register for HIV Infection in Children, which was started in 1985 and involves 106 hospitals throughout the country, collects data on all new cases of HIV infection in children. For this analysis, we reviewed the database for the period 2005 to 2015. ResultsWe found 79 HIV-1-infected children newly diagnosed after birth in Italy. Thirty-two of the mothers were Italian. During the pregnancy, only 15 of 19 women with a known HIV diagnosis were treated with antiretroviral treatment, while, of 34 women who had received an HIV diagnosis before labour began, only 23 delivered by caesarean section and 17 received intrapartum prophylaxis. In 25 mothers, HIV infection was diagnosed during pregnancy or in the peripartum period. Thirty-one newborns received antiretroviral prophylaxis and 39 received infant formula. ConclusionsWe found an unacceptable number of missed opportunities to prevent mother-to-child transmission (MCTC). Eliminating HIV MTCT is a universal World Health Organization goal. Elucidating organization failures in Italy over the past decade should help to improve early diagnosis and to reach the zero transmission target in newborns.

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Pregnant with HIV before age 25: data from a large national study in Italy, 2001–2016

Cited by 2 publications

References 21 publications

A risk measurement tool for targeted HIV prevention measures amongst young pregnant and lactating women in South Africa

A risk measurement tool for targeted HIV prevention measures amongst young pregnant and lactating women in South Africa

Missed opportunities to prevent mother‐to‐child transmission of HIV in Italy

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