Volume 3, Issue 5, October 2017, Page: 54-62
Risk Factors Associated with HIV Infection Among Infants Below 24 Months Born to HIV Positive Mothers
Gloria Kirungi Kasozi, Department of Public Health, Faculty of Health Sciences, Uganda Christian University, Mukono, Uganda
Afayoa Robert, Department of Public Health, International Health Sciences University, Kampala, Uganda
Received: Oct. 13, 2017;       Accepted: Oct. 31, 2017;       Published: Nov. 30, 2017
DOI: 10.11648/j.ijhpebs.20170305.12      View  1434      Downloads  135
In order to eliminate infant HIV infection from mother to child, evidence based implementation strategies are needed to address the risk factors that are associated with this infection using limited resources and applicable to all stakeholders especially the parents of the infants. This study assessed the infant, maternal and paternal risk factors associated with HIV infection among infants below 24 months born to HIV positive mothers in care. An unmatched nested case control study was conducted at the HIV/ART clinic, Mildmay Uganda in 2012. 370 HIV positive mothers with their biological infants below 24 months who had had a DNA-PCR test done in the last 6 months were enrolled in the study (cases: DNA-PCR positive infants, controls: DNA-PCR negative infants). Data was collected using a structured questionnaire. Descriptive, bivariate and multivariate analyses were done. The risk factors that showed a significant relationship with HIV infection of infants below 24 months born to HIV positive mothers were: Infant factors: Infant and young child feeding option used in the first 8 weeks of life (p <0.001) ART status (p<0.001), Immunization status (p=0.031) and duration of receiving Nevirapine syrup of the infant (p=0.002) significantly increased the risk of infection. Maternal factors: High baseline viral load during pregnancy (p=0.046), Body Mass Index > 30kg/m2 (p=0.008), receipt of ART during pregnancy (p<0.001), receipt of nutrition counseling (p=0.002) and non-disclosure of HIV status to spouse of the mother during pregnancy (p<0.001). Paternal factors: Acceptance to test for HIV (p<0.001), non-disclosure of HIV status to spouse (p<0.001) and receipt of ART (p<0.001). Multivariate analysis showed a significant relationship with HIV infection of infants who were mixed fed the infant (OR: 4.971, 95%CI: 1.71 - 14.48, p=0.003), receipt of ART (NVP) of the infant (OR: 0.0062, 95%CI:0.002 - 0.019, p<0.001), mother not disclosing of HIV status to spouse (OR:2.736, 95%CI:1.074 - 6.971, p=0.035) and Father not disclosing of HIV status to spouse (OR:4.38, 95%CI:1.764 - 11.235, p=0.002). The results show that mixed feeding of infants and parental non-disclosure of HIV status are key drivers that significantly increase the risk of infant infection while infant prophylactic Niverapine reduces the risk of infection. It is recommended that exclusively breastfeed of infants born to HIV positive women, HIV testing and spousal disclosure of HIV status be promoted among PLHIV.
Non-Disclosure, HIV DNA-PCR Test, HIV Infection, Exclusive Breastfeeding, Mixed Feeding, Risk Factors
To cite this article
Gloria Kirungi Kasozi, Afayoa Robert, Risk Factors Associated with HIV Infection Among Infants Below 24 Months Born to HIV Positive Mothers, International Journal of HIV/AIDS Prevention, Education and Behavioural Science. Vol. 3, No. 5, 2017, pp. 54-62. doi: 10.11648/j.ijhpebs.20170305.12
Copyright © 2017 Authors retain the copyright of this article.
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The Joint United Nations Programme on HIV/AIDS, 2011. http://files.unaids.org/en/media/unaids/contentassets/documents/epidemiology/2012/gr2012/20121120_FactSheet_Global_en.pdf
UNAIDS HIV/AIDS Fact sheet. 2016. http://www.unaids.org/sites/default/files/media_asset/UNAIDS_FactSheet_en.pdf
United Nations. UN General Assembly Special Session report, 2010.
Ministry of Health. Uganda Population-Based HIV Impact Assessment.2017.
Mildmay Uganda 2010/2011 annual report. 2012.
Mildmay Annual Impact report. 2016. https://www.mildmay.org/wp-content/uploads/2013/07/MildmayAR2016_FINAL.pdf
The Joint United Nations Programme on HIV/AIDS, Annual report 1997. 1998.
World Health Organisation. Programming for male involvement in reproductive health. Report of the meeting of WHO. WHO/PAHO, Washington DC, USA. 2001.
The Joint United Nations Programme on HIV/AIDS, Annual report. 2009.
Chilongozi D, Wang L, Brown L, et al. Morbidity and mortality among a cohort of human immunodeficiency virus type 1-infected and uninfected pregnant women and their infants from Malawi, Zambia, And Tanzania. Pediatr Infect Dis J. 2008; 27: 808–814.
Pitt J, Brambilla D, Reichelderfer P, Landay A, Mcintosh K, Burns D, Hillyer Gv, Mendez H, Fowler Mg, 1997. Maternal immunologic and virologic risk factors for infant human immunodeficiency virus type-1 infection: findings from the women and infant transmission study. J infect dis. 1997 mar; 175 (3):567-75. Department Of Pediatrics, Columbia University College Of Physicians And Surgeons, New York City, NY 10032, USA.
Newell Ml, Coovadia H, Cortina-Borja M, et al. Mortality of infected and uninfected infants born to hiv-infected mothers in Africa: a pooled, analysis. Lancet. 2004; 364:1236–1243.
Atashili J, Kalilani L, Seksaria V, et al. Potential impact of infant feeding recommendations on mortality and hiv-infection in children born to HIV infected mothers in Africa: a simulation. BMC infect dis. 2008; 8:66.
Jaana Auvinen, Tarja Suominen & Maritta Välimäki, Male participation and prevention of human immunodeficiency virus mother-to-child transmission in Africa, psychology, Health & Medicine, 15:3, 288-313. 2010.
Kelsey Jl, Whittemore As, Evans As, Thompson Wd.,. Methods in observational epidemiology. 1996. Oxford University Press.
Magoni M, Bassani L, Okongo P, Kituuka P, Germinario Ep, Giuliano M, Vella S. Mode of infant feeding and HIV infection in children in a program for prevention of mother to child transmission in Uganda. AIDS. 2005 Mar 4; 19(4):433-7.
Coutsoudis A, Pillay K, Spooner E, Kuhn L, Coovadia Hm. Influence of infant-feeding patterns on early mother to child transmission of HIV-1 in Durban, South Africa: a prospective cohort study. South African vitamin A study group. Lancet. 1999 Aug 7; 354(9177):471-6.
Marangwanda et al, Abstract No. D11905. Woman's disclosure of HIV status: a criticalcomponent of the PMTCT intervention.
Bii Sc, Otieno-Nyunya B & Siika A. Infant feeding practices among HIV infected women receiving prevention of mother-to-child transmission services at Kitale District Hospital, Kenya. East Afr Med J. 2008; 85:156–161.
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