Patterns of Unmet Needs and Factors Affecting Prevention of HIV Mother-to-ChildTransmission for First Immunization Service Uptake among Mothers with Infants at Machakos Hospital Mother Child Health Clinic

Abstract

Mother-to-child HIV transmission rates in Kenya have remained high at 10-15% at 18 months. Elimination of mother-to-child transmission of HIV is achievable through prevention of mother-to-child transmission (PMTCT) interventions. The PMTCT package comprises HIV testing and counseling, ARV prophylaxis, safe delivery, safe infant feeding practices, early infant diagnosis, and postnatal follow-up. All these aspects are important and a gap in any of them will negatively impact the effectiveness of PMTCT and eventually elimination of mother-to-child transmission of HIV. This was a cross-sectional study aiming to measure the proportion of mothers with unknown HIV status and to determine the associated factors, it involved 400 mothers accompanying their infants for routine immunization at the mother-child health clinic (MCH) at Machakos Hospital, Kenya. Information on HIV testing was obtained from their antenatal records and offered opt-out HIV testing to those with unknown HIV status. The collected data was entered into Epi info version 3.5.1 and analyzed using the same tool. Overall, 304 (76.0%) mothers had unknown status at MCH, of whom 25 (8.6%) tested HIV-positive. HIV positivity was three times higher among mothers who were never tested during pregnancy/delivery. Married women had 3.2-fold greater odds of having unknown status as compared to those who were single (AOR 3.2, 95% CI 1.4–7.0) while education was associated with ten-fold reduced odds of unknown status. Therefore, strict implementation of the PMTCT guidelines to ensure that mothers are tested at every opportune time Interventions are needed to improve women’s ANC attendance, uptake of HIV testing, and disclosure of HIV status during pregnancy to achieve the elimination of MTCT