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
. 2018 Apr;62(4):434-443.
doi: 10.1016/j.jadohealth.2017.10.007. Epub 2017 Dec 19.

Adolescent Access to Care and Risk of Early Mother-to-Child HIV Transmission

Trisha Ramraj  1 , Debra Jackson  2 , Thu-Ha Dinh  3 , Steve Olorunju  4 , Carl Lombard  5 , Gayle Sherman  6 , Adrian Puren  7 , Vundli Ramokolo  8 , Nobuntu Noveve  8 , Yages Singh  8 , Vuyolwethu Magasana  8 , Sanjana Bhardwaj  9 , Mireille Cheyip  10 , Mary Mogashoa  10 , Yogan Pillay  11 , Ameena E Goga  12
Affiliations

Adolescent Access to Care and Risk of Early Mother-to-Child HIV Transmission

Trisha Ramraj et al. J Adolesc Health. 2018 Apr.

Abstract

Purpose: Adolescent females aged 15-19 account for 62% of new HIV infections and give birth to 16 million infants annually. We quantify the risk of early mother-to-child transmission (MTCT) of HIV among adolescents enrolled in nationally representative MTCT surveillance studies in South Africa.

Methods: Data from 4,814 adolescent (≤19 years) and 25,453 adult (≥20 years) mothers and their infants aged 4-8 weeks were analyzed. These data were gathered during three nationally representative, cross-sectional, facility-based surveys, conducted in 2010, 2011-2012, and 2012-2013. All infants were tested for HIV antibody (enzyme immunoassay), to determine HIV exposure. Enzyme immunoassay-positive infants or those born to self-reported HIV-positive mothers were tested for HIV infection (total nucleic acid polymerase chain reaction). Maternal HIV positivity was inferred from infant HIV antibody positivity. All analyses were weighted for sample realization and population live births.

Results: Adolescent mothers, compared with adult mothers, have almost three times less planned pregnancies 14.4% (95% confidence interval [CI]: 12.5-16.5) versus 43.9% (95% CI: 42.0-45.9) in 2010 and 15.2% (95% CI: 13.0-17.9) versus 42.8% (95% CI: 40.9-44.6) in 2012-2013 (p < .0001), less prevention of MTCT uptake (odds ratio [OR] in favor of adult mothers = 3.36, 95% CI: 2.95-3.83), and higher early MTCT (adjusted OR = 3.0, 95% CI: 1.1-8.0), respectively. Gestational age at first antenatal care booking was the only significant predictor of early MTCT among adolescents.

Conclusions: Interventions that appeal to adolescents and initiate sexual and reproductive health care early should be tested in low- and middle-income settings to reduce differential service uptake and infant outcomes between adolescent and adult mothers.

Keywords: Adolescent; Early mother-to-child transmission; PMTCT; SAPMTCTE; South Africa.

PubMed Disclaimer

Conflict of interest statement

Conflicts of Interest: The authors have no conflicts of interest to disclose.

Figures

Figure 1
Figure 1
Weighted early MTCT among adolescents compared with adult mothers in the 2010, 2011–2012, and 2012–2013 PMTCT surveys, South Africa.
See this image and copyright information in PMC

References

    1. The United Nations Population Fund. [Accessed March 07, 2016];The State of World Population: The power of 1.8 billion adolescents, youth and the transformation of the future. 2014 Available at: https://www.unfpa.org/sites/default/files/pub-pdf/EN-SWOP14-Report_FINAL....
    1. United Nations Children’s Emergency Fund. Synthesis report of the rapid assessment of adolescent and HIV programme context in five countries: Botswana, Cameroon, Jamaica, Swaziland and Zimbabwe. New York: United Nations Children’s Emergency Fund; 2015.
    1. United Nations Children’s Emergency Fund. [Accessed March 07, 2016];Children and AIDS: 2015 statistical update. 2015 Available at: http://www.childrenandaids.org/sites/default/files/executive_summary_dig....
    1. World Health Organization. [Accessed November 05, 2014];WHO guidelines on preventing early pregnancy and poor reproductive health outcomes among adolescents in developing countries. 2011 Available at: http://www.who.int/maternal_child_adolescent/documents/preventing_early_... - PubMed
    1. The United Nations Population Fund. [Accessed November 05, 2014];Adolescent Pregnancy: A review of the Evidence. 2013 Available at: https://www.popline.org/node/578624.

Publication types