Adolescent access to care and risk of early mother-to-child HIV transmission

dc.contributor.authorRamraj, Trisha
dc.contributor.authorJackson, Debra
dc.contributor.authorDinh, Thu-Ha
dc.contributor.authorOlorunju, Steve
dc.contributor.authorLombard, Carl
dc.contributor.authorSherman, Gayle
dc.date.accessioned2018-10-19T07:15:23Z
dc.date.available2018-10-19T07:15:23Z
dc.date.issued2017
dc.description.abstractPURPOSE: 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.en_US
dc.description.accreditationISI
dc.identifier.citationRamraj, T. et al. (2017). Adolescent access to care and risk of early mother-to-child HIV transmission. Journal of Adolescent Health, 62: 434–443en_US
dc.identifier.issn1054-139X
dc.identifier.urihttps://doi.org/10.1016/j.jadohealth.2017.10.007
dc.identifier.urihttp://hdl.handle.net/10566/4141
dc.language.isoenen_US
dc.privacy.showsubmitterFALSE
dc.publisherElsevieren_US
dc.rights© 2017 Society for Adolescent Health and Medicine. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
dc.status.ispeerreviewedTRUE
dc.subjectAdolescenten_US
dc.subjectAccess to careen_US
dc.subjectEarly mother-to-child HIV transmissionen_US
dc.titleAdolescent access to care and risk of early mother-to-child HIV transmissionen_US
dc.typeArticleen_US

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