Document Type

Article

Publication Date

11-1-2016

Identifier

PMCID: PMC4618783 DOI: 10.1007/s10461-015-1071-5

Abstract

We analyzed prevention of mother-to-child transmission (PMTCT) data from a retrospective cohort of n = 1365 HIV+ mothers who enrolled their HIV-exposed infants in early infant diagnosis services in four Kenyan government hospitals from 2010 to 2012. Less than 15 and 20 % of mother-infant pairs were provided with regimens that met WHO Option A and B/B+ guidelines, respectively. Annually, the gestational age at treatment initiation decreased, while uptake of Option B/B+ increased (all p's < 0.001). Pediatric HIV infection was halved (8.6-4.3 %), yet varied significantly by hospital. In multivariable analyses, HIV-exposed infants who received no PMTCT (AOR 4.6 [2.49, 8.62], p < 0.001), mixed foods (AOR 5.0 [2.77, 9.02], p < 0.001), and care at one of the four hospitals (AOR 3.0 [1.51, 5.92], p = 0.002) were more likely to be HIV-infected. While the administration and uptake of WHO PMTCT guidelines is improving, an expanded focus on retention and medication adherence will further reduce pediatric HIV transmission.

Journal Title

AIDS and behavior

Volume

20

Issue

11

First Page

2602

Last Page

2611

MeSH Keywords

Adult; Anti-HIV Agents; Child; Cohort Studies; Developing Countries; Dose-Response Relationship, Drug; Drug Administration Schedule; Drug Therapy, Combination; Early Diagnosis; Female; Gestational Age; Government; Guideline Adherence; HIV Infections; Hospitals, Public; Humans; Infant; Infant, Newborn; Infectious Disease Transmission, Vertical; Kenya; Lamivudine; Medication Adherence; Pregnancy; Pregnancy Complications, Infectious; Retrospective Studies; Zidovudine

Keywords

Adherence; Eliminating pediatric infection; Gestational week of initiation; HIV; Option B+; Preventing mother to child transmission (PMTCT); Retention in care; WHO guidelines

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