Mother's knowledge on prevention of mother-to-child transmission of HIV, Ethiopia: A cross sectional study

Comprehensive knowledge of mother-to-child HIV/AIDS transmission, prevention, and associated factors among reproductive-age women in East Africa: insights from recent demographic and national health surveys

BACKGROUND

More than 90% of babies acquire HIV/AIDS through vertical transmission, primarily due to low maternal comprehensive knowledge about Mother-To-Child Transmission (MTCT) of HIV/AIDS and its prevention, which is a cornerstone for eliminating MTCT of HIV/AIDS. However, there are limitations in terms of population data and literature evidence based on recent Demographic and Health Surveys (DHS) reports in East Africa. Therefore, this study aims to assess the comprehensive knowledge and PMTCT of HIV/AIDS among women, as well as the associated factors in East Africa.

METHODS

Our data was obtained from the most recent DHS conducted in East African countries between 2011 and 2022. For our research, we included DHS data from ten nations, resulting in a total weighted sample of 133,724 women for our investigation. A generalized linear model (GLM) with a log link and binomial family to directly estimate prevalence ratios (PR) and 95% confidence intervals (CI) for the association between the independent variables, and the outcome variable. Finally, we reported the adjusted prevalence ratios along with their corresponding 95% CIs. Factors with p-values ≤ 0.2 for univariate logistic regression and < 0.05 were considered statistically significant factors of HIV/AIDS knowledge and prevention in the final model.

RESULTS

In this study, 59.41% (95% CI: 59.15-59.67) of respondents had a comprehensive knowledge about MTCT of HIV/AIDS and its prevention among reproductive-age women in East Africa. Being in the older age group, better education level, being from a rich household, employment status, having ANC follow up, institutional delivery, and modern contraception usage were associated with higher prevalence ratios of comprehensive knowledge about MTCT of HIV/AIDS and its prevention. However, being single in marital status, rural women, and traditional contraception utilization were associated with lower ratios of comprehensive knowledge about MTCT of HIV/AIDS and its prevention.

CONCLUSION

Our findings indicate a significant deficiency in comprehensive knowledge and prevention of HIV/AIDS MTCT among women in East Africa. These results emphasize the need for significant improvements in maternal-related health services. It is crucial to effectively target high-risk populations during interventions, raise awareness about this critical public health issue, and address the catastrophic consequences associated with MTCT. By implementing these measures, we can make substantial progress in reducing the transmission of HIV/AIDS from mother to child and ensuring better health outcomes for both mothers and their children.

Knowledge of HIV transmission during pregnancy among women of reproductive age in Ghana

INTRODUCTION

Human immunodeficiency virus (HIV) remains a significant health challenge affecting many people including those from sub-Saharan Africa (SSA). Even though HIV can be transmitted through various means, mother-to-child transmission (MTCT) remains the major route of transmission in children under the age of five. This study examined the correlates of knowledge of HIV transmission during pregnancy among reproductive-age women in Ghana.

METHODS

Data for this study were obtained from the 2014 Ghana Demographic and Health Survey. The sample consisted of 9,106 women aged 15 to 49 years. We conducted both descriptive and multivariable logistic regression analyses to determine the prevalence and factors associated with knowledge of HIV transmission during pregnancy. The results were presented using frequencies, percentages, and adjusted odds ratios (aOR) with their corresponding 95% confidence intervals (CI).

RESULTS

Approximately, 69.41% of women of reproductive age knew of HIV transmission during pregnancy. Women who had two (aOR = 1.32, 95% CI [1.01, 1.72]) or three (aOR = 1.37, 95% CI [1.07, 1.76]) births were more knowledgeable of HIV transmission during pregnancy. Women who read the newspaper (aOR = 1.56, 95% CI [1.31, 1.86]), listened to the radio (aOR = 1.23, 95% CI [1.05, 1.45]), lived in rural areas (aOR = 1.30, 95% CI [1.09, 1.54]) or ever been tested for HIV (aOR = 1.20, 95% CI [1.05, 1.37]) were more likely to be knowledgeable of HIV transmission during pregnancy than their counterparts in the reference categories. Compared to those in the Western Region, women in the Upper East (aOR = 0.45, 95% CI [0.32, 0.63]), Upper West (aOR = 0.54, 95% CI [0.35, 0.85]), Ashanti (aOR = 0.75, 95% CI [0.58, 0.97]) and Greater Accra Regions (aOR = 0.74, 95% CI [0.56, 0.98]) were less knowledgeable of HIV transmission during pregnancy.

CONCLUSIONS

The study highlights a gap in the knowledge of HIV transmission during pregnancy among women in Ghana. Continuous public education is required to educate women on HIV transmission from mothers to their children during pregnancy and how this may be interrupted. Such programs should involve the use of the media and take into consideration the demographic and geographic characteristics highlighted as determinants in this study. This will ultimately contribute to the reduction of MTCT of HIV in Ghana.

HIV testing and knowledge on mother-to-child transmission among pregnant women attending antenatal care at Vanga Hospital, Democratic Republic of Congo

Background

Human immunodeficiency virus (HIV) causes an infectious disease that can be transmitted from an infected mother to her child. Prevention of Mother-to-Child Transmission (PMTCT) programs provide a range of services to women and children that can reduce the risk of vertical transmission of HIV. Unfortunately, PMTCT programs face many challenges in the rural Democratic Republic of Congo (DRC).

Methods

A cross-sectional study was conducted among 460 pregnant women attending antenatal care at Vanga Hospital in the Vanga health zone, DRC from March 11th to June 25th, 2019. Serological tests were performed and a pre-tested questionnaire regarding HIV knowledge was given to all participants. Data were analyzed with STATA 13.0. Descriptive statistics of key variables were computed and logistic regression was used to assess the association between participant's characteristics and knowledge of MTCT.

Results

Among the participants, 95.4% (439/460) reported that they have heard about HIV, 82.4% (378/460) indicated sexual intercourse as one of the routes of HIV transmission but only 30.4% (139/460) mentioned MTCT as one of the routes. In addition, only 10.1% (46/460) had knowledge of the existence of PMTCT. Participants' age (>29 years), education level, previous antenatal care, and previous HIV tests were significantly associated with knowledge of MTCT. Also, age (>29 years) and education level were significantly associated with previous HIV test uptake. Most pregnant women 82.3% (376/460) reported that they have never been tested in the past for HIV infection and the prevalence was at 0.9% (4/460).

Conclusions

Knowledge of MTCT of HIV, previous uptake of HIV testing, and prevalence was low. The rural setting of Vanga and insufficient HIV sensitization activities are considered contributors to this. While the low prevalence is a positive finding, much needs to be done to improve the uptake of HIV testing and knowledge of HIV MTCT.

Systematic review and meta-analysis of knowledge on PMTCT of HIV/AIDS and Association factors among reproductive age women in Ethiopia, 2022

BACKGROUND

Despite increased interventions implemented for the prevention of mother-to-child transmission of HIV, There is still a vertical transmission. Hence, this study tried to assess the pooled prevalence of knowledge on PMTCT and factors associated with residence, ANC follow-up, and knowledge about HIV/AIDS among reproductive age women in Ethiopia.

METHODS

The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline was followed to review either published or unpublished studies in Ethiopia regarding knowledge on PMTCT. A comprehensive search of international databases, including Google Scholar, Cochrane Library, PubMed, HINARI, Embrace, Web of Science, Scopus, ProQuest, CINAHL, and Global Health, were searched. The data were analyzed using STATA/SE version 14. The random-effect model was used to estimate the effect size, and I-squared statistics and Egger's test were used to assess the heterogeneity and publication bias, respectively.

RESULTS

14 out of 14,091 assessed articles met inclusion criteria and were included in the analysis. The estimated pooled level of knowledge on PMTCT among reproductive-age groups was 62.15% [(95% CI: 43.63-80.66)]. Residence [(OR = 4.8, 95%CI: 2.99, 7.85)], ANC follow-up [(OR = 4.2, 95%CI: 2.21, 7.98)], and having sufficient knowledge about the diseases [(OR = 4.9, 95% CI: 3.6, 6.66)] were found to be significant predictors of knowledge on PMTCT among reproductive-age groups.

CONCLUSION

Strategies to improve the knowledge of PMTCT in Ethiopia should focus on rural women, improving knowledge about HIV/AIDS, and ANC follow-up. Efforts are also needed to involve husbands and related organization in the prevention of mother to child transmission of HIV.

Factors associated with loss to follow up among HIV-exposed children: a historical cohort study from 2000 to 2017, in Porto Alegre, Brazil

BACKGROUND

There are many inequalities in terms of prevention and treatment for pregnant women with HIV and exposed children in low and middle-income countries. The Brazilian protocol for prenatal care includes rapid diagnostic testing for HIV, compulsory notification, and monitoring by the epidemiological surveillance of children exposed to HIV until 18 months after delivery. The case is closed after HIV serology results are obtained. Lost to follow-up is defined as a child who was not located at the end of the case, and, therefore, did not have a laboratory diagnosis. Lost to follow-up is a current problem and has been documented in other countries. This study analyzed factors associated with loss to follow-up among HIV-exposed children, including sociodemographic, behavioral, and health variables of mothers of children lost to follow-up.

METHODS

This historical cohort study included information on mothers of children exposed to HIV, born in Porto Alegre, from 2000 to 2017. The research outcome was the classification at the end of the child's follow-up (lost to follow-up or not). Factors associated with loss to follow-up were investigated using the Poisson regression model. Relative Risk calculations were performed. The significance level of 5% was adopted for variables in the adjusted model.

RESULTS

Of 6,836 children exposed to HIV, 1,763 (25.8%) were classified as lost to follow-up. The factors associated were: maternal age of up to 22 years (aRR 1.25, 95% CI: 1.09-1.43), the mother's self-declared race/color being black or mixed (aRR 1.13, 95% CI: 1.03-1.25), up to three years of schooling (aRR 1.45, 95% CI: 1.26-1.67), between four and seven years of schooling (aRR 1.14, 95% CI: 1.02-1.28), intravenous drug use (aRR 1.29, 95% CI: 1.12-1.50), and HIV diagnosis during prenatal care or at delivery (aRR 1.37, 95% CI: 1.24-1.52).

CONCLUSION

Variables related to individual vulnerability, such as race, age, schooling, and variables related to social and programmatic vulnerability, remain central to reducing loss to follow-up among HIV-exposed children.

Factors associated with pregnancy uptake decisions among seropositive HIV people receiving antiretroviral therapy in sub‐Saharan Africa: A systematic review

Aim

This study determined the factors associated with pregnancy uptake decision among seropositive HIV people receiving antiretroviral therapy in sub‐Saharan Africa.

Design

Systematic review.

Methods

The population, intervention, comparison and outcomes framework was adopted to search for literature after a scoping review using the preferred reporting items for systematic reviews and meta‐analyses guidelines adopted in searching, and screening articles from four databases (PubMed, Cumulative Index to Nursing and Allied Health Literature, Embase, and Google scholar) to find 12 articles suitable for this study.

Results

Motivators of pregnancy uptake among HIV‐positive women include desire to have children, knowledge about PMTCT, cultural duty for married women to have children, and household income. Demotivating factors included the modern method of contraception and burden associated with pregnancy.

Conclusion

There is a need to improve on services that reduce conception‐related risks especially for women who choose to conceive and to incorporate fertility‐related counselling into HIV treatment services.

Pregnant Women’s Knowledge, Attitude, and Practice Towards the Prevention of Mother to Child Transmission of HIV/AIDS in Dil Chora Referral Hospital, Dire Dawa, Eastern Ethiopia: A Cross-Sectional Study

Background

Methods

Results

Conclusion

Knowledge about vertical transmission of HIV and associated factors among women living with HIV or AIDS attending antiretroviral therapy clinic, Western Ethiopia

Background:

The United Nations Program on HIV or AIDS has committed to eliminating the vertical transmission of human immunodeficiency virus. However, significant number of newborn and children are acquiring HIV every year. Therefore, the aim of this study was to assess knowledge of mother on vertical transmission of HIV and associated factors among non-pregnant women receiving antiretroviral therapy in the West Wollega, Western Ethiopia.

Methods:

A facility-based cross-sectional study design was used on a sample of 422 non-pregnant women attending antiretroviral therapy clinic in West Wollega from 26 February to 26 March 2019. Systematic sampling was used to select the study participants. Pretested and structured interviewer-administered questionnaires and telephone interview were used to collect the data. Multivariable logistic regression model was used to identify factors associated with the knowledge of mother on vertical transmission of HIV. Odds ratio along with 95% confidence interval were estimated to measure the strength of the association. Level of statistical significance was declared at p-value less than 0.05.

Result:

Out of total participants, 94.1% (95% confidence interval: (91.7%, 96.2%)) of them were knowledgeable about vertical transmission of HIV. Urban resident (adjusted odds ratio: 2.36, 95% confidence interval: (1.27, 4.39)), primary school (adjusted odds ratio: 2.94, 95% confidence interval: (1.11, 7.83)), secondary school (adjusted odds ratio: 3.39, 95% confidence interval: (1.53, 7.55)), being on antiretroviral therapy for greater than 2 years (adjusted odds ratio: 2.67, 95% confidence interval: 1.02, 6.99)), and having child living with HIV (adjusted odds ratio: 1.54, 95% confidence interval: (1.07, 3 .83)) were significantly associated with the knowledge of mother on vertical transmission of HIV.

Conclusion:

The study indicated that 5.9% of the women lack knowledge about vertical transmission of HIV. This knowledge associated with sociodemographic factors, such as residence, educational status, experiences of having child living with HIV, and being on antiretroviral therapy for greater than 2 years. Thus, interventions toward the elimination of new newborn HIV infections should consider these factors.

Knowledge, Attitude and Perception of HIV/Aids Among Antenatal Women and its Correlation with their Socio-Demographic Profile: Study from a Tertiary Care Centre of Northern India

Purpose of Study

To evaluate the knowledge, attitude and perception of HIV/AIDS among antenatal women and to correlate them with their socio-demographic profile.

Methods

We conducted this study on 400 pregnant women attending the antenatal clinic of our hospital for the first time irrespective of their period of gestation, age and parity. All the participants were interviewed with the help of a predesigned questionnaire which included their socio-demographic details and questions to assess their knowledge and attitude toward HIV/AIDS. Data were analyzed using SPSS version 22 and expressed in the form of percentage, frequency distribution, mean, standard deviation and p value.

Results

Antenatal women of the study population were having unsatisfactory knowledge about HIV/AIDS and prevention of MTCT. 26% women were totally unaware of any entity like HIV. 44% participants did not know the most common way of spread of HIV. Only half of the subjects knew the correct preventive measures for HIV/AIDS. 54% knew about MTCT, but only 24% knew about its transmission through breast milk. Knowledge and attitude was found to be significantly improving with socioeconomic status.

Conclusion

Indian antenatal women have poor awareness and wrong perception about HIV/AIDS and its mother to child transmission (MTCT). Targeted educational interventions can be formulated to increase awareness among antenatal women about prevention of vertical transmission of HIV.

Fertility Desire, Knowledge of Prevention of MCT of HIV and Associated Factors Among Men and Women Attending ART Clinic at Public Health Institutions of West Shoa Zone, Oromia, Ethiopia, 2020

Background

Globally, the human immunodeficiency virus (HIV) affects young people in their reproductive years. Most of the studies conducted in Ethiopia focus on the fertility desire of women of reproductive age and did not give due consideration to the men’s fertility perspective. Thus, this study aimed to assess the fertility desire, knowledge of prevention of mother to child of HIV (PMTCT), and associated factors among HIV-positive men and women attending ART clinic at west Shewa zone, Oromia region, Ethiopia, 2020.

Methods

Facility-based cross-sectional study design was applied to identify fertility desire, PMTCT knowledge, and associated factors among 590 HIV-positive reproductive age group men and women attending ART clinics at public health institutions of West Shewa zone. Data were collected by pre-tested structured questionnaires and analyzed using SPSS version 22. Binary logistic regression analysis was used to examine the association of predictors on fertility desire and knowledge about PMTCT. Odds ratio, 95% CI, and P value 0.05 were used to measure the statistical association.

Results

The prevalence of fertility desire and knowledge of PMTCT in the study area were 58.8% and 30.7%, respectively. The odds of fertility desire were higher among the respondents aged >25 years [AOR=4.64, 95% CI (2.75–7.85)], housewives [AOR=3.14, 95% CI (1.90–5.21)], merchants [AOR=5.31, 95% CI (2.55–11.05)], ART use for ≤5 years [AOR=5.13, 95% CI (2.37–11.12)] and among those voluntarily tested to know their HIV status [AOR=2.16, 95% CI (1.30–3.58)]. Besides, the odds of fertility desire were low among husband who cannot read and write [AOR=0.07, 95% CI (0.02–0.23)], primary education [AOR=0.22, 95% CI (0.09–0.56)], and secondary education [AOR= 0.32, 95% CI (0.14–0.73)] when compared with husband education of college and above. Likewise, the odds of PMTCT knowledge were higher among the respondents aged less than 25 years [AOR=2.53, 95% CI (1.32–4.86)] who undergone voluntary testing during HIV diagnosis reasons [AOR=1.55, 95% CI (1.03–2.35)], and ART use for more than five years [AOR=1.94, 95% CI (1.26–2.98)].

Conclusion

Younger age, husband education, occupation, recent HIV test, and voluntary testing were significantly associated with fertility desire. Likewise, the younger age group, voluntary testing and counseling, and those on ART for more than five years had higher odds of PMTCT knowledge. Therefore, strengthening voluntary testing and counseling strong counseling on PMTCT throughout the follow-up care and involvement partners is of paramount importance should be insured to decrease MTCT.

Mapping of mothers' suffering and child mortality in Sub-Saharan Africa

Child death and mothers who suffer from child death are a public health concern in Sub-Saharan Africa. The location and associated factors of child death and mothers who suffer child death were not identified. To monitor and prioritize effective interventions, it is important to identify hotspots areas and associated factors. Data from nationally representative demographic and health survey and Multiple Indicator Cluster administrated in 42 Sub-Sahara Africa countries, which comprised a total of 398,574 mothers with 1,521,312 children. Spatial heterogeneity conducted hotspot regions identified. A mixed-effect regression model was run, and the adjusted ratio with corresponding 95% confidence intervals was estimated. The prevalence of mothers who suffer child death 27% and 45-49 year of age mother 48%. In Niger, 47% of mothers were suffering child death. Women being without HIV knowledge, stunted, wasted, uneducated, not household head, poor, from rural, and from subtropical significantly increased the odds of the case (P < 0.05). The spatial analysis can support the design and prioritization of interventions. Multispectral interventions for mothers who suffer from child death are urgently needed, improve maternal health and it will reduce the future risk of cases.

Levels of mother-to-child HIV transmission knowledge and associated factors among reproductive-age women in Ethiopia: Analysis of 2016 Ethiopian Demographic and Health Survey Data

BACKGROUND

The world community has committed to eliminating the mother-to-child transmission of human immunodeficiency virus. Even though different studies have been done in Ethiopia, to the knowledge of the investigators, the Ethiopian women's level of knowledge on the mother-to-child transmission of human immunodeficiency virus is not well studied and the existing evidence is inconclusive. The current study is aimed to study the Ethiopian women's level of knowledge on the mother-to-child transmission of human immunodeficiency virus and its associated factors using the 2016 Ethiopian Demographic and Health Survey Data.

METHODS

Data of 15,683 women were extracted from the 2016 Ethiopia Demographic and Health Survey. Descriptive statistics and multilevel ordinal logistic regression were respectively used for the descriptive and analytical studies.

RESULTS

41.1% [95% CI: 39.5%, 42.7%] of the Ethiopian reproductive-age women have adequate knowledge of the mother-to-child transmission of human immunodeficiency virus. 77%, 84% and 87.8% of the women respectively know that human immunodeficiency virus can be transmitted during pregnancy, delivery, and breastfeeding. There are wider regional variations in the women's level of knowledge of the mother-to-child transmission of human immunodeficiency virus. Being an urban resident, having better educational status, being from a wealthy household, owning of mobile phone, frequency of listening to the radio, frequency of watching television, and being visited with field workers were significantly associated with having adequate knowledge of the mother-to-child transmission of human immunodeficiency virus.

CONCLUSION

Despite all collective measures put in a place by different stakeholders to prevent the mother-to-child transmission of HIV in Ethiopia, a large proportion of the Ethiopian women do not know about the mother-to-child transmission of the disease. Stakeholders working on HIV prevention and control should give due emphasis to promoting mobile phone technology and other media like radio and television by giving due focus to rural residents and poor women to promote the current low level of the knowledge. Emphasis should also be given to the information, education, and communication of the mother-to-child transmission of the disease through community-based educations.

Knowledge and determinants of women's knowledge on vertical transmission of HIV and AIDS in South Africa

BACKGROUND

HIV/AIDS is still one of the major public health concerns globally. It is one of the major contributory causes of deaths among women in the reproductive age (15-49 years) and has resulted in about 14 million orphaned children globally. Knowledge of Mother-to Child transmission is one of the strategies to fight against HIV. This study, therefore, sought to assess the knowledge and determinants of women's knowledge on vertical transmission of HIV and AIDS in their reproductive age in South Africa.

METHODS

Data were obtained from the South Africa Demographic and Health Survey (SADHS) 2016. Both descriptive (frequencies and percentages) and inferential analysis (multilevel mixed-effects complementary log-log regression model) were conducted and the statistical significance was set at p < 0.05.

RESULTS

The prevalence of knowledge of mother to child transmission of HIV and AIDS during pregnancy, delivery, breastfeeding and at least knowledge of one source are 87.0%, 81.1%, 80.3% and 91.4% respectively. At the individual level, those with secondary [AOR = 1.28, CI = 1.04,1.57] and higher [AOR = 1.55, CI = 1.21,1.99], those who read newspaper less than once a week [AOR = 1.16, CI = [1.05,1.28], at least once a week [AOR = 1.14, CI = 1.04,1.25], and those who listen to the radio less than once a week [AOR = 1.22, CI = 1.03,1.43] had higher odds of knowledge on MTCT of HIV and AIDS. However, those with parity 0 [AOR = 0.73, CI = [0.63,0.85] had lower odds of knowledge of MTCT of HIV and AIDS compared with those with parity 4 or more. At the contextual level, those in the poorest wealth quintile [AOR = 0.82,CI = 0.69,0.97] had lower odds of having knowledge of MTCT of HIV and AIDS. Those in the urban areas [AOR = 1.17, CI = [1.04,1.31], those in Limpopo [AOR = 1.35, CI = [1.12,1.64], Gauteng [AOR = 1.35, CI = [1.12,1.62] and North west[AOR = 1.49, CI = [1.22,1.81] had higher odds of knowledge of mother to child transmission of HIV and AIDS.

CONCLUSION

The study has demonstrated that there is relatively high knowledge of mother to child transmission of HIV and AIDS in South Africa. The factors associated with the knowledge are educational level, exposure to mass media, parity, wealth status, place of residence and the region of residence. To further increase the knowledge, it is imperative to adopt various messages and target respondents in different part of SSA through the mass media channels. This should be done taking cognizant of the rural-urban variations and socio-economic status.

A Mobile Phone-Based Life-Skills Training Program for Substance Use Prevention Among Adolescents: Cluster-Randomized Controlled Trial

Background

Life skills are abilities for adaptive and positive behavior that enable individuals to deal effectively with the demands and challenges of everyday life. Life-skills training programs conducted within the school curriculum are effective in preventing the onset and escalation of substance use among adolescents. However, their dissemination is impeded due to their large resource requirements. Life-skills training provided via mobile phones may provide a more economic and scalable approach.

Objective

The goal of this study was to test the appropriateness (ie, acceptance, use, and evaluation) and short-term efficacy of a mobile phone–based life-skills training program to prevent substance use among adolescents within a controlled trial.

Methods

The study design was a two-arm, parallel-group, cluster-randomized controlled trial with assessments at baseline and follow-up assessments after 6 and 18 months. This report includes outcomes measured up to the 6-month follow-up. The efficacy of the intervention was tested in comparison to an assessment-only control group. The automated intervention program SmartCoach included online feedback and individually tailored text messages provided over 22 weeks. The contents were based on social cognitive theory and addressed self-management skills, social skills, and substance use resistance skills. Linear mixed models and generalized linear mixed models, as well as logistic or linear regressions, were used to investigate changes between baseline and 6-month follow-up in the following outcomes: 30-day prevalence rates of problem drinking, tobacco use, and cannabis use as well as quantity of alcohol use, quantity of cigarettes smoked, cannabis use days, perceived stress, well-being, and social skills.

Results

A total of 1759 students from 89 Swiss secondary and upper secondary school classes were invited to participate in the study. Of these, 1473 (83.7%) students participated in the study; the mean age was 15.4 years (SD 1.0) and 55.2% (813/1473) were female. Follow-up assessments at 6 months were completed by 1233 (83.7%) study participants. On average, program participants responded to half (23.6 out of 50) of the prompted activities. Program evaluations underlined its appropriateness for the target group of secondary school students, with the majority rating the program as helpful and individually tailored. The results concerning the initial effectiveness of this program based on 6-month follow-up data are promising, with three of nine outcomes of the intention-to-treat analyses showing beneficial developments of statistical significance (ie, quantity of alcohol use, quantity of tobacco use, and perceived stress; P<.05) and another three outcomes (ie, problem drinking prevalence, cannabis use days, and social skills) showing beneficial developments of borderline significance (P<.10).

Conclusions

The results showed good acceptance of this intervention program that could be easily and economically implemented in school classes. Initial results on program efficacy indicate that it might be effective in both preventing or reducing substance use and fostering life skills; however, data from the final 18-month follow-up assessments will be more conclusive.

Trial Registration

ISRCTN Registry ISRCTN41347061; https://doi.org/10.1186/ISRCTN41347061

Knowledge about mother to child transmission of HIV/AIDS, its prevention and associated factors among reproductive-age women in sub-Saharan Africa: Evidence from 33 countries recent Demographic and Health Surveys

BACKGROUND

In sub-Saharan Africa (SSA) 90 percent of babies acquired HIV/AIDS from infected mothers. Maternal knowledge about mother to child transmission (MTCT) of HIV/AIDS and its prevention is a cornerstone for elimination of MTCT of HIV/AIDS. Despite this, there is limited evidence about knowledge about MTCT of HIV/AIDS and its prevention and associated factors in SSA. Therefore, this study aimed to assess knowledge of MTCT of HIV/AIDS, its prevention (PMTCT) and, associated factors among reproductive-age women in sub-Saharan Africa.

OBJECTIVE

To assess Knowledge about mother to child transmission of HIV/AIDS and its prevention and associated factors among reproductive-age women in Sub-Saharan Africa.

METHODS

The recent SSA countries' Demographic and Health Surveys (DHS), which were conducted from 2008/09 to 2018/19, was our data source. We appended 33 countries' DHS data for our analysis. For our study, a total weighted sample of 350,888 reproductive-age women was used. Due to the hierarchical nature of the DHS data, we conducted a multilevel analysis. Finally, the adjusted odds ratio with its 95% confidence interval was reported, and variables with p-value≤0.05 were considered as significant predictors of knowledge of MTCT of HIV/AIDS and its prevention.

RESULTS

In this study, 56.21% (95% CI: 56.05-56.38) of respondents had correct knowledge about MTCT of HIV/AIDS and its prevention among reproductive-age women in SSA. In the multilevel logistic regression analysis: being in the older age group, better education level, being from a rich household, having mass media exposure, having parity of one and above were associated with higher odds of knowledge about MTCT of HIV/AIDS and its prevention. However, being perceiving distance from the health facility as a big problem was associated with lower odds of knowledge about MTCT of HIV/AIDS and its prevention.

CONCLUSION

Knowledge about MTCT of HIV/AIDS and its prevention among reproductive-age women in SSA was low. Therefore, it is better to consider the high-risk groups during the intervention to increase awareness about this essential public health issue and to tackle its devastating outcome.

Cessation of breastfeeding and associated factors in the era of elimination of mother to child transmission of HIV at Ndejje health center, Uganda: a retrospective cohort study

Background

Breastfeeding an infant exposed to Human Immunodeficiency Virus (HIV) carries the risk of HIV acquisition whilst not breastfeeding poses a higher risk of death from malnutrition, diarrhea, and pneumonia. In Uganda, mothers living with HIV are encouraged to discontinue breastfeeding at 12 months but data are limited. We examined the frequency and factors associated with cessation of breastfeeding at 1 year among mothers living with HIV at Ndejje Health Center IV, a large peri-urban health facility in Uganda.

Methods

This retrospective cohort study involved all mothers living with HIV and enrolled in HIV care for ≥12 months between June 2014 and June 2018. We abstracted data from registers, held focus group discussions with mothers living with HIV and key informant interviews with healthcare providers. Cessation of breastfeeding was defined as the proportion of mothers living with HIV who had discontinued breastfeeding at 1 year. We summarized quantitative data descriptively, tested differences in outcome using Chi-square and t - tests, and established independently associated factors using modified Poisson regression analysis at 5% statistical significance level. We thematically analyzed qualitative data to enrich and triangulate the quantitative results.

Results

Of 235 participants, 150 (63.8%) had ceased breastfeeding at 1 year and this was independently associated with the infant being male (Adjusted Risk Ratio [aRR] 1.25, 95% confidence interval [CI] 1.04, 1.50), the mother being multiparous (aRR 1.26, 95% CI 1.04–1.53), and the initiation of breastfeeding being on the same-day as birth (aRR 0.06, 95% CI 0.01–0.41). The reasons for ceasing breastfeeding included male infants over breastfeed than females, maternal literacy and knowledge adequacy about breastfeeding, support and reminders from the partner, and boys can bite once they get teeth.

Conclusion

Suboptimal proportion of infants were ceased from breastfeeding at 1 year and this might increase the risk of mother to child transmission of HIV. Cessation of breastfeeding was more likely among male infants and multiparous mothers but less likely when breastfeeding was initiated on the same-day as birth. Interventions to enhance cessation of breastfeeding should target none multiparous mothers and those with female infants.