The Contribution of Family Planning towards the Prevention of Vertical HIV Transmission in Uganda

Details

• Alternative Title:
  PLoS One
• Personal Author:
  Hladik, Wolfgang ; Stover, John ; Esiru, Godfrey ; Harper, Malayah ; Tappero, Jordan
• Description:
  Background
  
  Uganda has one of the highest total fertility rates (TFR) worldwide. We compared the effects of antiretroviral (ARV) prophylaxis for the prevention of mother-to-child HIV transmission (PMTCT) to that of existing family planning (FP) use and estimated the burden of pediatric HIV disease due to unwanted fertility.
  
  Methodology/Principal Findings
  
  Using the demographic software Spectrum, a baseline mathematical projection to estimate the current pediatric HIV burden in Uganda was compared to three hypothetical projections: 1) without ARV-PMTCT (to estimate the effect of ARV-PMTCT), 2) without contraception (effect of existing FP use), 3) without unwanted fertility (effect of unmet FP needs). Key input parameters included HIV prevalence, ARV-PMTCT uptake, MTCT probabilities, and TFR. We estimate that in 2007, an estimated 25,000 vertical infections and 17,000 pediatric AIDS deaths occurred (baseline projection). Existing ARV-PMTCT likely averted 8.1% of infections and 8.5% of deaths. FP use likely averted 19.7% of infections and 13.1% of deaths. Unwanted fertility accounted for 21.3% of infections and 13.4% of deaths. During 2008–2012, an estimated 131,000 vertical infections and 71,000 pediatric AIDS deaths will occur. The projected scale up of ARV-PMTCT (from 39%–57%) may avert 18.1% of infections and 24.5% of deaths. Projected FP use may avert 21.6% of infections and 18.5% of deaths. Unwanted fertility will account for 24.5% of infections and 19.8% of deaths.
  
  Conclusions
  
  Existing FP use contributes as much or more than ARV-PMTCT in mitigating pediatric HIV in Uganda. Expanding FP services can substantially contribute towards PMTCT.
  
  
• Subjects:
  Acquired Immunodeficiency Syndrome Adolescent Adult Anti-Retroviral Agents Female HIV Infections Humans Infant, Newborn Infectious Disease Transmission, Vertical Male Middle Aged Pregnancy Pregnancy Complications, Infectious Prevalence Software

  More +
• Source:
  PLoS One. 4(11).
• Pubmed ID:
  19888347
• Pubmed Central ID:
  PMC2766039
• Document Type:
  Journal Article
• Place as Subject:
  Uganda
• Volume:
  4
• Issue:
  11
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha-512:3a25d7d0a6997858f5a2042697f76967a4b5bb715b72adf0ae05625d23e6487b0bdf1dcae94f0fc190a4a31a2e7ceac633fee661965a3cf26f16f9ed6ffbbe06
• Download URL:
  https://stacks.cdc.gov/view/cdc/4275/cdc_4275_DS1.pdf
• File Type:
  [PDF - 121.68 KB ]