Community-Based Evaluation of PMTCT Uptake in Nyanza Province, Kenya

Details

• Alternative Title:
  PLoS One
• Personal Author:
  Kohler, Pamela K. ; Okanda, John ; Kinuthia, John ; Mills, Lisa A. ; Olilo, George ; Odhiambo, Frank ; Laserson, Kayla F. ; Zierler, Brenda ; Voss, Joachim ; John-Stewart, Grace
• Description:
  Introduction
  
  Facility-based assessments of prevention of mother-to-child HIV transmission (PMTCT) programs may overestimate population coverage. There are few community-based studies that evaluate PMTCT coverage and uptake.
  
  Methods
  
  During 2011, a cross-sectional community survey among women who gave birth in the prior year was performed using the KEMRI-CDC Health and Demographic Surveillance System in Western Kenya. A random sample (n = 405) and a sample of women known to be HIV-positive through previous home-based testing (n = 247) were enrolled. Rates and correlates of uptake of antenatal care (ANC), HIV-testing, and antiretrovirals (ARVs) were determined.
  
  Results
  
  Among 405 women in the random sample, 379 (94%) reported accessing ANC, most of whom (87%) were HIV tested. Uptake of HIV testing was associated with employment, higher socioeconomic status, and partner HIV testing. Among 247 known HIV-positive women, 173 (70%) self-disclosed their HIV status. Among 216 self-reported HIV-positive women (including 43 from the random sample), 82% took PMTCT ARVs, with 54% completing the full antenatal, peripartum, and postpartum course. Maternal ARV use was associated with more ANC visits and having an HIV tested partner. ARV use during delivery was lowest (62%) and associated with facility delivery. Eighty percent of HIV infected women reported having their infant HIV tested, 11% of whom reported their child was HIV infected, 76% uninfected, 6% declined to say, 7% did not recall; 79% of infected children were reportedly receiving HIV care and treatment.
  
  Conclusions
  
  Community-based assessments provide data that complements clinic-based PMTCT evaluations. In this survey, antenatal HIV test uptake was high; most HIV infected women received ARVs, though many women did not self-disclose HIV status to field team. Community-driven strategies that encourage early ANC, partner involvement, and skilled delivery, and provide PMTCT education, may facilitate further reductions in vertical transmission.
  
  
• Subjects:
  Adolescent Adult Anti-HIV Agents Data Collection Female HIV Infections Humans Infectious Disease Transmission, Vertical Patient Acceptance Of Health Care Pregnancy Pregnancy Complications, Infectious Prenatal Diagnosis Residence Characteristics Young Adult

  More +
• Source:
  PLoS One. 2014; 9(10).
• Document Type:
  Journal Article
• Place as Subject:
  Kenya
• Volume:
  9
• Issue:
  10
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:dc40f7c7f8bbd134f59e703e5fe328f5f2fe51e8a665fdeeedbaaf1de1fbcc32
• Download URL:
  https://stacks.cdc.gov/view/cdc/25983/cdc_25983_DS1.pdf
• File Type:
  [PDF - 329.31 KB ]