Risk Factors for Mother to Child Transmission of HIV in Southwest Ethiopia

Abstract

Objective: One in four Ethiopian children born to human immunodeficiency virus (HIV) positive mothers were found to have acquired the virus, although the country has been implementing the World Health Organization’s(WHO) four-pronged prevention approaches. This study was therefore aimed at identifying the factors responsible for mother to child transmission of HIV among children who received HIV exposure care.
Methods: An unmatched case-control study was conducted on randomly selected 64 cases and 256 controls from December 2011 to May 2012. The cases were HIV positive children less than 18 months of age, and the controls were HIV negative children less than 18 months of age born to HIV positive mothers. Data on the parents’sociodemographic characteristics and parents’ clinical profiles before the final child’s HIV status determination were collected. A logistic regression was used to identify predictors.
Results: The records of 60 casesand 235 controls were included for analysis. Mixed breastfeeding(adjusted odd ratio [AOR]: 22.03; 95% confidence interval [CI]:5.31–91.49), maternal CD4 count <200 cells/mm3 before delivery (AOR: 17.14, 95% CI: 4.73-62.06), no maternal WHO clinical staging after delivery (AOR: 3.38; 95% CI: 5-35.76), children born to mothers from rural areas (AOR:7.64; 95%CI: 2–29.22),and no paternalantiretroviral therapy(ART)enrollment or an unknown enrollment status (AOR: 11.11; 95% CI: 2.94- 50) were factors independently associated with the child’s HIV infection.
Conclusions: Mixed breastfeeding, maternal CD4 count, no maternal WHO clinical staging, children to mother from rural areas, and no paternal ART enrollment or an unknown status were independent predictors. Behavioral change communication should be intensified, and emphasis should be given for mothers with lower CD4 count and those from rural settings.