Mother-To-Child Transmission of HIV in Adolescents and Young Women: Findings From a National Prospective Cohort Survey, Zimbabwe, 2013-2014.
Mother-To-Child Transmission of HIV in Adolescents and Young Women: Findings From a National Prospective Cohort Survey, Zimbabwe, 2013-2014.
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DOI：
10.1016/j.jadohealth.2019.10.023
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发表时间：
2020-04
期刊：
影响因子：
--
通讯作者：
Dinh TH
中科院分区：
文献类型：
--
作者：
Burrage AB;Mushavi A;Shiraishi RW;Barr BT;Shambira G;Nyakura J;Balachandra S;Kilmarx PH;Dinh TH
我们评估了津巴布韦青少年、年轻女性和成年母亲18个月累计母婴艾滋病毒传播（MTCT）风险和妊娠期间未使用抗逆转录病毒药物的风险因素。我们分析了2013年2月至8月从151个免疫接种诊所招募的1，171对4-12周龄艾滋病毒暴露婴儿的前瞻性调查数据。对艾滋病毒暴露婴儿进行随访，直至诊断为艾滋病毒、死亡或年龄18个月。调查结果进行了加权和调整复杂的调查设计和无回应。18个月累积MTCT风险在≤19岁的青少年中最高（12%），其次是20-24岁的年轻女性（7.5%）和≥25岁的成年女性（6.9%）。在这些人群中，超过94%的孕妇在妊娠21周前接受过≥1次产前检查，超过95%的孕妇接受过≥1次艾滋病毒检测，超过98%的孕妇知道自己的艾滋病毒状况。在已知的艾滋病毒阳性母亲中，怀孕期间母亲抗逆转录病毒药物的覆盖率分别为76.8%（95%置信区间：65.1-85.5）、83.8%（78.6-87.9）和87.8%（84.6-90.4）。在产前诊断为HIV阳性的母亲中，没有接受过产前保健的母亲在怀孕期间未使用抗逆转录病毒药物的调整优势比增加（调整后的比值比：7.7 [3.7-16.0]），无艾滋病毒检测（7.3 [2.3-23.5]），无血小板CD 4计数检测（2.1 [1.3-3.4]），妊娠期母体HIV鉴定（2.9 [1.8-4.8]）。年龄不是危险因素。在预防母婴传播服务覆盖面相似的情况下，与成年人相比，青少年和年轻妇女18个月的母婴传播累积风险较高。应开展更多的研究，审查原因，以制定有针对性的干预措施。
We assessed 18-month cumulative mother-to-child HIV transmission (MTCT) risk and risk factors for no antiretroviral medication use during pregnancy among adolescent, young women, and adult mothers in Zimbabwe. We analyzed data from a prospective survey of 1,171 mother–infant pairs with HIV-exposed infants aged 4–12 weeks who were recruited from 151 immunization clinics from February to August 2013. HIV-exposed infants were followed until diagnosed with HIV, death, or age 18 months. Findings were weighted and adjusted for complex survey design and nonresponse. The 18-month cumulative MTCT risk was highest among adolescent aged ≤19 years (12%) followed by young women aged 20–24 years (7.5%) and adult women aged ≥25 years (6.9%). Across these groups, more than 94% had ≥1 antenatal care visit by 21 weeks of gestation, more than 95% had ≥1 HIV test, and more than 98% knew their HIV status. Of known HIV-positive mothers, maternal antiretroviral medication coverage during pregnancy was 76.8% (95% confidence interval: 65.1–85.5), 83.8% (78.6–87.9), and 87.8% (84.6–90.4) among adolescent, young women, and adult mothers, respectively. Among HIV-positive mothers diagnosed prenatally, the adjusted odds ratio of no ARV use during pregnancy was increased among those who had no antenatal care attendance (adjusted odds ratio: 7.7 [3.7–16.0]), no HIV testing (7.3 [2.3–23.5]), no prepartum CD4 count testing (2.1 [1.3–3.4]), and maternal HIV identification during pregnancy (2.9 [1.8–4.8]). Age was not a risk factor. With similar coverage of prevention of MTCT services, the 18-month cumulative MTCT risk was higher among adolescents and young women, compared with adults. Additional research should examine the causes to develop targeted interventions.
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DOI：
10.1097/qai.0000000000001176
发表时间：
2017-01-01
期刊：
Journal of acquired immune deficiency syndromes (1999)
影响因子：
--
作者：
Ronen K;McGrath CJ;Langat AC;Kinuthia J;Omolo D;Singa B;Katana AK;NgʼAngʼA LW;John-Stewart G
通讯作者：
John-Stewart G
影响因子：
33.9
作者：
Brown, Kristin;Williams, Daniel B.;Voetsch, Andrew C.
通讯作者：
Voetsch, Andrew C.
DOI：
10.7196/samj.8207
发表时间：
2014-12-01
期刊：
SAMJ: South African Medical Journal
影响因子：
--
作者：
Fatti, G;Shaikh, N;Grimwood, A
通讯作者：
Grimwood, A
影响因子：
3.7
作者：
Mustapha, Mariama;Musiime, Victor;Nabukeera-Barungi, Nicolette
通讯作者：
Nabukeera-Barungi, Nicolette
影响因子：
3.7
作者：
Wiegert, Katherine;Dinh, Thu-Ha;Kilmarx, Peter H.
通讯作者：
Kilmarx, Peter H.