High risk exposure to HIV among sexually active individuals who tested negative on rapid HIV Tests in the Tshwane District of South Africa-The importance of behavioural prevention measures

Vertical transmission of HIV among pregnant women who initially had false-negative rapid HIV tests in four South African antenatal clinics

INTRODUCTION

There is a risk of mother-to-child transmission of HIV (MTCT) during pregnancy and breastfeeding. The aim of this study was to assess vertical transmission of HIV among pregnant women who initially had false-negative rapid HIV tests in South African antenatal care (ANC) clinics.

METHODS

Pregnant participants were enrolled in a diagnostic study that used nucleic acid amplification testing (NAAT) to screen for early HIV infection among individuals who tested negative on rapid HIV tests used at the point-of-care (POC) facilities. Participants were enrolled from four ANC clinics in the Tshwane district of South Africa. All NAAT-positive participants were recalled to the clinics for further management. Vertical transmission was assessed among exposed infants whose HIV polymerase chain reaction (PCR) results were available.

RESULTS

This study enrolled 8208 pregnant participants who tested negative on rapid HIV tests between 2013 and 2016. Their median age was 26 years (interquartile range [IQR]: 23-30). NAAT detected HIV infections in 0.6% (n = 49; 95% confidence interval {CI}: 0.5-0.8) of all study participants. The distribution of these infections among the four clinics ranged from 0.3%- 1.1%, but this was not statistically significant (p = 0.07). Forty-seven participants (95.9%) were successfully recalled and referred for antiretroviral treatment initiation as part of prevention of MTCT (PMTCT). Most women with newly diagnosed HIV infection presented for the first ANC visit in the second (61.9%, n = 26) and third (31.0%, n = 13) trimesters. HIV PCR results were available for thirty-two infants, three of whom tested positive (9.4%; 95% CI: 1.98-25.02).

CONCLUSIONS

This study showed that supplemental HIV testing for pregnant women led to earlier linkage to the PMTCT programme. Inaccurate diagnosis of HIV infection at ANC clinics is likely to undermine the efforts of eliminating MTCT particularly in HIV-endemic settings.

Understanding The Combined Effects Of The Knowledge Of HIV/AIDS Prevention Methods On Condom Use: A Case Of Njombe And Tanga Regions Of Mainland Tanzania

Aim

This study assesses how the combined effects of knowledge of the HIV/AIDS prevention methods (ie, abstinence (A), being faithful (B), condom use (C), and diagnosis or testing (D)) influence behavioral change in terms of condom use.

Methods

The study employed a cross-sectional design. Data were collected using a household survey conducted in 2017 in the Tanga and Njombe Regions of Tanzania through a structured questionnaire. The dependent variable was condom use during the last sexual intercourse. The main independent variable was knowledge of HIV prevention methods, referred to in this study as "knowledge of ABCD of HIV/AIDS prevention". A respondent with knowledge of three or more of the ABCD was classified as having good knowledge of HIV prevention. Those with knowledge of two, one, or none of the ABCD were classified as having average, fair, and poor knowledge of HIV prevention methods, respectively. Data analysis included univariate analysis, bivariate analysis, and multivariate logistic regression analysis. The study included 660 respondents aged 15-64 years.

Results

The study indicates that the majority (52.2%) of the respondents had average knowledge of the HIV prevention methods. That is, they were knowledgeable of any two of the A, B, C, and D of HIV prevention methods. Condom use during the last sexual intercourse was reported by 46.5% of respondents. Multivariate analysis showed that condom use was 1.48-times more likely among respondents with good knowledge of ABCD of HIV/AIDS prevention than those with poor knowledge.

Conclusion

The predictive effect of knowledge of the HIV prevention methods on condom use was more visible when assessed in combination than when treated at A, B, C, and D in isolation. This suggests that successful behavioral change towards HIV/AIDS aversion requires dedicated efforts that promote comprehensive knowledge of all the methods through which the epidemic can be transmitted.