Progress Toward Eliminating Mother to Child Transmission of HIV in Kenya: Review of Treatment Guideline Uptake and Pediatric Transmission at Four Government Hospitals Between 2010 and 2012.
PMCID: PMC4618783 DOI: 10.1007/s10461-015-1071-5
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.
AIDS and behavior
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
Adherence; Eliminating pediatric infection; Gestational week of initiation; HIV; Option B+; Preventing mother to child transmission (PMTCT); Retention in care; WHO guidelines
Finocchario-Kessler S, Clark KF, Khamadi S, et al. Progress Toward Eliminating Mother to Child Transmission of HIV in Kenya: Review of Treatment Guideline Uptake and Pediatric Transmission at Four Government Hospitals Between 2010 and 2012. AIDS Behav. 2016;20(11):2602-2611. doi:10.1007/s10461-015-1071-5
Health Services Research Commons, International Public Health Commons, Maternal and Child Health Commons, Virus Diseases Commons
This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
Publisher's Link: https://link.springer.com/article/10.1007/s10461-015-1071-5