Prevalence, trend and associated risk factors of Mother-to-Child Transmission of HIV among HIV-exposed infants

Abstract

Background: The Human Immunodeficiency Virus (HIV) Mother-To-Child-Transmission (MTCT) can primarily occur during pregnancy, birth and breastfeeding. However, there is limited recent evidence from large-scale study on MTCT of HIV in Ethiopia. Thus, this study was aimed to determine the prevalence, trend and associated risk factors of MTCT among HIV-exposed infants. Methodology: A cross-sectional study was conducted on 5,679 infants whose specimen referred to Ethiopian Public Health Institute HIV referral laboratory from January 01, 2016 to December 31, 2020. Required information was obtained from Early Infant Diagnosis (EID) database. Frequencies and percent were used to describe the distribution of the infants. Logistic regression analysis was used to identify factors associated with HIV infection. The level of significance was set at 5%. Results: The mean age of the infants was 12.64 (±14.62) weeks with 4 to 72 weeks range. Half of the infants (51.4%) were female. Prevalence of HIV infection over the course of five years among HIV-exposed infants (HEI) was 2.6%. The prevalence of MTCT decreased from 2.9% in 2016 to 0.9% in 2020. After adjusting for covariates; infant testing after six weeks (Adjusted odds ratio (AOR) = 2.7; 95% confidence interval (CI): (1.8–4.0, )) p-value <0.001, absence of Prevention of Mother-To-Child-Transmission (PMTCT) service (AOR = 4.6; 95% CI: (2.9–7.4)) p-values =0.001, mother being on daily prophylaxis at birth (AOR = 2.0; 95% CI: (1.3–3.2)) p-value <0.001, and mother HIV status before date of delivery (AOR =11; 95% CI: (5.5–22.1)) p-value <0.001 were significantly associated with MTCT of HIV. Conclusion: The prevalence of MTCT of HIV is considerable. However, the prevalence was declining during the study period. Tested after six weeks for EID, unavailability of PMTCT service were the factors associated with HIV infection among HEI. Strengthen PMTCT service and early HIV screening of pregnant women are critical to reduce HIV infection among HEI.