Impact of a Maternal Prevention of Mother-to-child Transmission of HIV (PMTCT) Intervention on HIV-exposed Infants in Uganda
DOI:
https://doi.org/10.21106/ijma.380Keywords:
- Prevention of maternal to child transmission of HIV,
- HIV,
- Nevirapine,
- Antiretroviral therapy prophylaxis,
- Early infant diagnosis,
- HIV-exposed infants
Abstract
Background: Uganda has successfully reduced pediatric HIV infections through prevention of mother-to-child transmission of HIV (PMTCT) programs, yet little is known about adherence to infant-specific components of interventions. We hypothesized that infants born to mothers receiving the WiseMama (WM) electronic drug monitoring (EDM)-based adherence intervention would have increased uptake of six-week post-natal nevirapine (NVP) infant prophylaxis and better adherence to six-week early infant diagnosis (EID) HIV testing.
Methods: At two sites in Uganda, the Wise Infant Study (WIN) prospectively followed an infant cohort. Infants were born to women enrolled in an RCT testing the effect of real-time reminders delivered via EDM on maternal adherence to antiretroviral therapy. We assessed intrapartum and discharge receipt of NVP prophylaxis using pharmacy and infant HIV DNA testing laboratory data.
Results: Of 121 women eligible for WIN, 97 (80%) consented and enrolled; 46 had been randomized to control and 51 to intervention. There were no differences in receipt of a six-week NVP supply (control 87%, intervention 82%, p = 0.53). Receipt of any NVP prophylaxis did not vary by delivery location (p = 0.35), and although 12% of infants were delivered at non-study health facilities, they were not less likely to receive NVP at discharge (p = 0.37). Among infants with a completed HIV test, there was no difference in mean time to first test (control 52 days (SD 18), intervention 51 days (SD 15), p = 0.86). Only one infant, in the control group, tested positive for HIV.
Conclusion and Global Health Implications: We found no significant differences in adherence to infant PMTCT practices between intervention and control infants with relatively high rates of NVP receipt albeit with suboptimal adherence to six-week EID testing. Further work is needed to ensure improved access, uptake, and follow-up of HIV-exposed infants in the Option B+ era.
Downloads
Similar Articles
- Elizabeth Armstrong-Mensah, Damilola Dada, Amber Bowers, Aruba Muhammad, Chisom Nnoli, Geographic, Health Care Access, Racial Discrimination, and Socioeconomic Determinants of Maternal Mortality in Georgia, United States , Vol. 10 No. 2 (2021): International Journal of Maternal and Child Health and AIDS
- Elangovan Arumugam, Joseph K. David, Santhakumar Aridoss, Nagaraj Jaganathasamy, Malathi Mathiyazhakan, Ganesh Balasubramanian, Manikandan Natesan, VM, Padmapriya, BK Kirubakaran, Sanjay Patel, Pradeep Kumar, Shobini Rajan, An Analysis of Levels and Trends in HIV Prevalence Among Pregnant Women Attending Antenatal Clinics in Karnataka, South India, 2003-2019 , Vol. 10 No. 2 (2021): International Journal of Maternal and Child Health and AIDS
- Andrew Walubo, Refuoe Baleni, Hillary Mukudu, Henry Kambafwile, Mukesh Dheda, Thanduxolo Thengwa, Tshepang Jiane, Clinical Characteristics of Children with HIV Initiated on Antiretroviral Treatment at HIV Clinics in Bloemfontein, South Africa , Vol. 10 No. 1 (2021): International Journal of Maternal and Child Health and AIDS
- Gopal K. Singh, Trends and Social Inequalities in Maternal Mortality in the United States, 1969-2018 , Vol. 10 No. 1 (2021): International Journal of Maternal and Child Health and AIDS
- Elizabeth Armstrong-Mensah, Ato Kwamena Tetteh, Seung Choi, Utilization of Rapid Diagnostic Testing in sub-Saharan Africa: Challenges and Effects on HIV Prevention , Vol. 10 No. 1 (2021): International Journal of Maternal and Child Health and AIDS
- George Chidi Anwuri, Michael S. Dunn, Frederick Schulze, Determinants of Voluntary HIV/AIDS Counseling and Testing among Community College Students in the United States , Vol. 6 No. 2 (2017): International Journal of Maternal and Child Health and AIDS
- Margaret Omowaleola Akinwaare, Funmilayo A. Okanlawon, Monisola A. Popoola, Omotayo O. Adetunji, Birth Preparedness Plans and Status Disclosure Among Pregnant Women Living with HIV Who are Receiving Antiretroviral Therapy in Ibadan, Southwest, Nigeria , Vol. 12 No. 1 (2023): International Journal of Maternal and Child Health and AIDS
- Wah Myint, Aishatu Yusuf, Angela Nguyen, Elfreda Samman, HIV Testing, Household and Reproductive Health Decision-Making: The Role of Women Autonomy in a Nationally Representative Study in Cambodia , Vol. 14 No. Continuous (2025): International Journal of Maternal and Child Health and AIDS
- Godwin Omokhagbo Emmanuel, Olaniyi Felix Sanni, Abang Roger, Paul Umoh, Ochonye Bartholomew Boniface, Amechi Paul, Ismaeel Mohammed Yahaya, Agie Muhmmad Auwal, Improving HIV Prevention for Key Populations in Nigeria: Insights on Access, Barriers, Stigma, and Service Utilization , Vol. 14 No. Continuous (2025): International Journal of Maternal and Child Health and AIDS
- Esum Mathias Eyong, Nwana Yvette Ngwe, Claude Ngwayu Nfuksai, Loveline Lum Niba, Akoachere Jane-Francis, Prevalence of Occupational Exposure to HIV and Factors Associated with Compliance with Post-Exposure Prophylaxis Among Health Workers of the Biyem-Assi, Buea, and Limbe Health Districts of Cameroon Maternal and Child Health and AIDS , Vol. 11 No. 1 (2022): International Journal of Maternal and Child Health and AIDS
<< < 1 2 3 4 5 6 7 8 9 10 > >>
You may also start an advanced similarity search for this article.
Published
How to Cite
Issue
Section
License
Copyright © 2020 Anays Murillo, Mary Bachman DeSilva, Lora L. Sabin, Nafisa Halim, Harriet Chemusto, Philip Aroda, Julia Gasuza, Davidson H. Hamer, Anna Larson Williams, Barbara Mukasa, Lisa J. Messersmith, Rachael Bonawitz. Published by Global Health and Education Projects, Inc., USA.
This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License , which permits others to remix, transform, and build upon the work non-commercially, provided the original author is credited and the new creations are licensed under the same terms.