PMTCT Service Uptake among Adolescents and Adult Women Attending Antenatal Care in Selected Health Facilities in Zimbabwe

Reuben Musarandega, Rhoderick Machekano, Memory Chideme, Cephas Muchuchuti, Angela Mushavi, Agnes Mahomva, Laura Guay

Research output: Contribution to journalArticle

Abstract

BACKGROUND:: Age-disaggregated analyses of prevention of mother-to-child transmission (PMTCT) program data to assess the uptake of HIV services by pregnant adolescent women are limited but are critical to understanding the unique needs of this vulnerable, high risk population. METHODS:: We conducted a retrospective analysis of patient-level PMTCT data collected from 2011 to 2013 in 36 health facilities in 5 districts of Zimbabwe using an electronic database. We compared uptake proportions for PMTCT services between adolescent (< 19 years) and adult (> 19 years) women. Multivariable binomial regression analysis was used to estimate the association of the women’s age group with each PMTCT service indicator. RESULTS:: The study analysed data from 22,215 women aged 12 to 50 years (22.5% adolescents). Adolescents were more likely to present to ANC before 14 weeks gestational age compared to older women (adjusted relative risk (aRR)=1.34; 95% confidence interval (CI): 1.22–1.47) with equally low rates of completion of four ANC visits. Adolescents were less likely to present with known HIV status (aRR=0.34; 95% CI: 0.29–0.41) but equally likely to be HIV tested in ANC. HIV prevalence was 5.5% in adolescents versus 20.1% in adults. While > 84% of both HIV-positive groups received ARVs for PMTCT, 44% of eligible adolescents were initiated on ART versus 51.3% of eligible adults, though not statistically significant. CONCLUSIONS:: Pregnant adolescents must be a priority for primary HIV prevention services and expanded HIV treatment services among pregnant women to achieve an AIDS-free generation in Zimbabwe and similar high HIV burden countries.This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.

Original languageEnglish (US)
JournalJournal of Acquired Immune Deficiency Syndromes
DOIs
StateAccepted/In press - Feb 20 2017

Fingerprint

Zimbabwe
Prenatal Care
Health Facilities
Mothers
HIV
Pregnant Women
Confidence Intervals
Licensure
Primary Prevention
Gestational Age
Acquired Immunodeficiency Syndrome
Age Groups
Regression Analysis
Databases

ASJC Scopus subject areas

  • Pharmacology (medical)
  • Infectious Diseases

Cite this

PMTCT Service Uptake among Adolescents and Adult Women Attending Antenatal Care in Selected Health Facilities in Zimbabwe. / Musarandega, Reuben; Machekano, Rhoderick; Chideme, Memory; Muchuchuti, Cephas; Mushavi, Angela; Mahomva, Agnes; Guay, Laura.

In: Journal of Acquired Immune Deficiency Syndromes, 20.02.2017.

Research output: Contribution to journalArticle

Musarandega, Reuben ; Machekano, Rhoderick ; Chideme, Memory ; Muchuchuti, Cephas ; Mushavi, Angela ; Mahomva, Agnes ; Guay, Laura. / PMTCT Service Uptake among Adolescents and Adult Women Attending Antenatal Care in Selected Health Facilities in Zimbabwe. In: Journal of Acquired Immune Deficiency Syndromes. 2017.
@article{524d24277cf44e0e921d0c9ef08a8a5e,
title = "PMTCT Service Uptake among Adolescents and Adult Women Attending Antenatal Care in Selected Health Facilities in Zimbabwe",
abstract = "BACKGROUND:: Age-disaggregated analyses of prevention of mother-to-child transmission (PMTCT) program data to assess the uptake of HIV services by pregnant adolescent women are limited but are critical to understanding the unique needs of this vulnerable, high risk population. METHODS:: We conducted a retrospective analysis of patient-level PMTCT data collected from 2011 to 2013 in 36 health facilities in 5 districts of Zimbabwe using an electronic database. We compared uptake proportions for PMTCT services between adolescent (< 19 years) and adult (> 19 years) women. Multivariable binomial regression analysis was used to estimate the association of the women’s age group with each PMTCT service indicator. RESULTS:: The study analysed data from 22,215 women aged 12 to 50 years (22.5{\%} adolescents). Adolescents were more likely to present to ANC before 14 weeks gestational age compared to older women (adjusted relative risk (aRR)=1.34; 95{\%} confidence interval (CI): 1.22–1.47) with equally low rates of completion of four ANC visits. Adolescents were less likely to present with known HIV status (aRR=0.34; 95{\%} CI: 0.29–0.41) but equally likely to be HIV tested in ANC. HIV prevalence was 5.5{\%} in adolescents versus 20.1{\%} in adults. While > 84{\%} of both HIV-positive groups received ARVs for PMTCT, 44{\%} of eligible adolescents were initiated on ART versus 51.3{\%} of eligible adults, though not statistically significant. CONCLUSIONS:: Pregnant adolescents must be a priority for primary HIV prevention services and expanded HIV treatment services among pregnant women to achieve an AIDS-free generation in Zimbabwe and similar high HIV burden countries.This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.",
author = "Reuben Musarandega and Rhoderick Machekano and Memory Chideme and Cephas Muchuchuti and Angela Mushavi and Agnes Mahomva and Laura Guay",
year = "2017",
month = "2",
day = "20",
doi = "10.1097/QAI.0000000000001327",
language = "English (US)",
journal = "Journal of Acquired Immune Deficiency Syndromes",
issn = "1525-4135",
publisher = "Lippincott Williams and Wilkins",

}

TY - JOUR

T1 - PMTCT Service Uptake among Adolescents and Adult Women Attending Antenatal Care in Selected Health Facilities in Zimbabwe

AU - Musarandega, Reuben

AU - Machekano, Rhoderick

AU - Chideme, Memory

AU - Muchuchuti, Cephas

AU - Mushavi, Angela

AU - Mahomva, Agnes

AU - Guay, Laura

PY - 2017/2/20

Y1 - 2017/2/20

N2 - BACKGROUND:: Age-disaggregated analyses of prevention of mother-to-child transmission (PMTCT) program data to assess the uptake of HIV services by pregnant adolescent women are limited but are critical to understanding the unique needs of this vulnerable, high risk population. METHODS:: We conducted a retrospective analysis of patient-level PMTCT data collected from 2011 to 2013 in 36 health facilities in 5 districts of Zimbabwe using an electronic database. We compared uptake proportions for PMTCT services between adolescent (< 19 years) and adult (> 19 years) women. Multivariable binomial regression analysis was used to estimate the association of the women’s age group with each PMTCT service indicator. RESULTS:: The study analysed data from 22,215 women aged 12 to 50 years (22.5% adolescents). Adolescents were more likely to present to ANC before 14 weeks gestational age compared to older women (adjusted relative risk (aRR)=1.34; 95% confidence interval (CI): 1.22–1.47) with equally low rates of completion of four ANC visits. Adolescents were less likely to present with known HIV status (aRR=0.34; 95% CI: 0.29–0.41) but equally likely to be HIV tested in ANC. HIV prevalence was 5.5% in adolescents versus 20.1% in adults. While > 84% of both HIV-positive groups received ARVs for PMTCT, 44% of eligible adolescents were initiated on ART versus 51.3% of eligible adults, though not statistically significant. CONCLUSIONS:: Pregnant adolescents must be a priority for primary HIV prevention services and expanded HIV treatment services among pregnant women to achieve an AIDS-free generation in Zimbabwe and similar high HIV burden countries.This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.

AB - BACKGROUND:: Age-disaggregated analyses of prevention of mother-to-child transmission (PMTCT) program data to assess the uptake of HIV services by pregnant adolescent women are limited but are critical to understanding the unique needs of this vulnerable, high risk population. METHODS:: We conducted a retrospective analysis of patient-level PMTCT data collected from 2011 to 2013 in 36 health facilities in 5 districts of Zimbabwe using an electronic database. We compared uptake proportions for PMTCT services between adolescent (< 19 years) and adult (> 19 years) women. Multivariable binomial regression analysis was used to estimate the association of the women’s age group with each PMTCT service indicator. RESULTS:: The study analysed data from 22,215 women aged 12 to 50 years (22.5% adolescents). Adolescents were more likely to present to ANC before 14 weeks gestational age compared to older women (adjusted relative risk (aRR)=1.34; 95% confidence interval (CI): 1.22–1.47) with equally low rates of completion of four ANC visits. Adolescents were less likely to present with known HIV status (aRR=0.34; 95% CI: 0.29–0.41) but equally likely to be HIV tested in ANC. HIV prevalence was 5.5% in adolescents versus 20.1% in adults. While > 84% of both HIV-positive groups received ARVs for PMTCT, 44% of eligible adolescents were initiated on ART versus 51.3% of eligible adults, though not statistically significant. CONCLUSIONS:: Pregnant adolescents must be a priority for primary HIV prevention services and expanded HIV treatment services among pregnant women to achieve an AIDS-free generation in Zimbabwe and similar high HIV burden countries.This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.

UR - http://www.scopus.com/inward/record.url?scp=85013748300&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85013748300&partnerID=8YFLogxK

U2 - 10.1097/QAI.0000000000001327

DO - 10.1097/QAI.0000000000001327

M3 - Article

C2 - 28234687

AN - SCOPUS:85013748300

JO - Journal of Acquired Immune Deficiency Syndromes

JF - Journal of Acquired Immune Deficiency Syndromes

SN - 1525-4135

ER -