Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2014 Apr 15;65(5):e170-8.
doi: 10.1097/QAI.0000000000000068.

Timing of maternal HIV testing and uptake of prevention of mother-to-child transmission interventions among women and their infected infants in Johannesburg, South Africa

Karl-Günter Technau  1 , Emma Kalk, Ashraf Coovadia, Vivian Black, Sam Pickerill, Claude A Mellins, Elaine J Abrams, Renate Strehlau, Louise Kuhn
Affiliations

Timing of maternal HIV testing and uptake of prevention of mother-to-child transmission interventions among women and their infected infants in Johannesburg, South Africa

Karl-Günter Technau et al. J Acquir Immune Defic Syndr. .

Abstract

Background: By 2011, South African prevention of mother-to-child transmission (PMTCT) of HIV programs had reduced perinatal HIV transmission at 6 weeks of age to 2.7%. We investigated the profile of newly diagnosed vertically infected children and their mothers to identify shortfalls in the PMTCT program.

Methods: In this operational follow-up study, fieldworkers enrolled mothers of newly diagnosed HIV-infected children up to 2 years of age at 5 major health care facilities in Johannesburg. Structured questionnaires and clinical record reviews were conducted and analyzed to describe the population and assess factors associated with PMTCT uptake.

Results: Two hundred eighty-nine mother-child pairs were enrolled. Timing of maternal HIV diagnosis influenced PMTCT access and feeding choices and was associated with infants' age at HIV diagnosis (7 vs. 11 vs. 31 weeks where mothers tested before, during, or after the pregnancy, respectively; P < 0.0001). Women diagnosed before pregnancy (12%) were older (median, 31 years) than those diagnosed during the index pregnancy (53%; median, 27 years). Women diagnosed after delivery (35%) were younger (median, 25 years, P < 0.0001), of lower parity, and less likely to be South African citizens. In 81 cases (29%), late maternal diagnosis precluded any PMTCT access. Where women were diagnosed during or before pregnancy, the recommended PMTCT guidelines for mother and infant were followed in 86 (61%) pairs.

Conclusions: Failure to diagnose maternal HIV infection before delivery was the main reason for missing PMTCT prophylaxis and early infant testing. Timely maternal diagnosis enables PMTCT uptake, but implementation and follow-up gaps require attention to improve infant outcomes.

PubMed Disclaimer

Conflict of interest statement

The authors have no conflict of interest to disclose.

Figures

Figure 1
Figure 1
PMTCT Cascade (adapted from South African National PMTCT Guidelines 2010)
Figure 2
Figure 2
Study Population
See this image and copyright information in PMC

References

    1. National Department of Health. The National Antenatal Sentinel HIV and Syphilis Prevalence Survey. South Africa: National Department of Health; 2011.
    1. UNAIDS. Global report: UNAIDS report on the global AIDS epidemic 2010. Geneva: UNAIDS; 2010.
    1. World Health Organization. PMTCT strategic vision 2010–2015: preventing mother-to-child transmission of HIV to reach the UNGASS and Millennium Development Goals: moving towards the elimination of paediatric HIV, December 2009. Geneva: World Health Organization; 2010.
    1. World Health Organization. Rapid advice : use of antiretroviral drugs for treating pregnant women and preventing HIV infection in infants, version 2. Geneva: World Health Organization; 2009. Revised 2010. ed. - PubMed
    1. National strategic Plan 2007–2011. Mid Term Review 2010. South Africa: SANAC; 2009.

Publication types