Mother-To-Child Transmission of HIV in Adolescents and Young Women: Findings From a National Prospective Cohort Survey, Zimbabwe, 2013–2014

Details

• Alternative Title:
  J Adolesc Health
• Personal Author:
  Burrage, Amanda B. ; Mushavi, Angela ; Shiraishi, Ray W. ; Barr, Beth Tippett ; Shambira, Geral ; Nyakura, Justice ; Balachandra, Shirish ; Kilmarx, Peter H. ; Dinh, Thu-Ha
• Description:
  Purpose: ; We assessed 18-month cumulative mother-to-child HIV transmission (MTCT) risk and risk factors for no antiretroviral medication use during pregnancy among adolescent, young women, and adult mothers in Zimbabwe. ; Methods: ; We analyzed data from a prospective survey of 1,171 mother–infant pairs with HIV-exposed infants aged 4–12 weeks who were recruited from 151 immunization clinics from February to August 2013. HIV-exposed infants were followed until diagnosed with HIV, death, or age 18 months. Findings were weighted and adjusted for complex survey design and nonresponse. ; Results: ; The 18-month cumulative MTCT risk was highest among adolescent aged ≤19 years (12%) followed by young women aged 20–24 years (7.5%) and adult women aged ≥25 years (6.9%). Across these groups, more than 94% had ≥1 antenatal care visit by 21 weeks of gestation, more than 95% had ≥1 HIV test, and more than 98% knew their HIV status. Of known HIV-positive mothers, maternal antiretroviral medication coverage during pregnancy was 76.8% (95% confidence interval: 65.1–85.5), 83.8% (78.6–87.9), and 87.8% (84.6–90.4) among adolescent, young women, and adult mothers, respectively. Among HIV-positive mothers diagnosed prenatally, the adjusted odds ratio of no ARV use during pregnancy was increased among those who had no antenatal care attendance (adjusted odds ratio: 7.7 3.7–16.0), no HIV testing (7.3 2.3–23.5), no prepartum CD4 count testing (2.1 1.3–3.4), and maternal HIV identification during pregnancy (2.9 1.8–4.8). Age was not a risk factor. ; Conclusions: ; With similar coverage of prevention of MTCT services, the 18-month cumulative MTCT risk was higher among adolescents and young women, compared with adults. Additional research should examine the causes to develop targeted interventions.
• Subjects:
  • Adolescent
  • Adult
  • Age Distribution
  • Child
  • Child, Preschool
  • Female
  • HIV Infections
  • Humans
  • Infant
  • Infectious Disease Transmission, Vertical
  More +
• Source:
  J Adolesc Health. 66(4):455-463
• Pubmed ID:
  31964611
• Pubmed Central ID:
  PMC8740363
• Document Type:
  Journal Article
• Funding:
  U2G GH000315/GH/CGH CDC HHSUnited States/ ; PEPFAR/PEPFARUnited States/
• Place as Subject:
  Zimbabwe
• Volume:
  66
• Issue:
  4
• Download URL:
  https://stacks.cdc.gov/view/cdc/113161/cdc_113161_DS1.pdf
• File Type:
  [PDF - 853.68 KB]
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:1ed8ff8c7e78b1fb45e30643d4e8ce7e4df9e41d7956248d1448b83a389a241e