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, Sarah; Clark, Kristine F.; Khamadi, Samoel; Gautney, Brad J.; Okoth, Vincent; Goggin, Kathy; and HITSystem Study Team, "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." (2016). Manuscripts, Articles, Book Chapters and Other Papers. 1024.