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Correlates of antiretroviral coverage for prevention of mother-to-child transmission of HIV in sub-Saharan Africa

机译：抗逆转录病毒覆盖预防亚撒哈拉非洲艾滋病毒母儿童传播的关联

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Antiretroviral (ARV) drugs are effective in the prevention of mother-to-child transmission of HIV (PMTCT), however many sub-Saharan African countries are yet to achieve universal ARV coverage among pregnant women living with HIV. This study examined factors associated with ARV coverage for PMTCT in 41 sub-Saharan Africa countries. Country-level aggregated data were obtained from the Joint United Nations Programme on HIV/AIDS, World Health Organization, and United Nations Children's Fund. Using Spearman's rho and point-biserial correlation, we conducted bivariate analyses between ARV coverage for PMTCT and the following variables: stigma, antenatal care (ANC) uptake, institutional delivery, community delivery of ARV drugs, number of HIV testing and counselling (HTC) facilities, and density of skilled health workers. We also performed a multivariate median regression with the significant correlates. P<.05 was considered statistically significant for all the tests. The median ARV coverage for PMTCT was 76% (IQR: 55-85%). ARV coverage for PMTCT was significantly associated with HTC facilities (r=0.46, p=.004), institutional delivery (r=0.48, p=.002), ANC uptake: at least one visit (r=0.54, p=.001), and stigma (r=-0.52, p=.003). In the multivariate analysis, only stigma remained statistically significant (beta=-0.6, 95% CI=-1.13, -0.07, p=.03). To eliminate perinatal transmission of HIV in sub-Saharan Africa, interventions that will address stigma-related barriers to uptake of PMTCT services are needed. More research on country-specific population-level correlates of ARV coverage for PMTCT is recommended.
机译：抗逆转录病毒（ARV）药物在预防艾滋病毒（PMTCT）的母婴传播方面是有效的，然而许多撒哈拉以南非洲国家尚未在艾滋病毒患有患有艾滋病毒的孕妇中实现普遍的ARV覆盖。这项研究检查了与41个撒哈拉以南非洲国家的PMTCT与ARV报道相关的因素。国家一级汇总数据是从联合国艾滋病毒/艾滋病，世界卫生组织和联合国儿童基金联合中获得的。使用Spearman的Rho和Point-Biserial相关性，我们在ARV覆盖范围与以下变量之间进行了双变量分析：耻辱，产前护理（ANC）吸收，制度分娩，ARV药物的社区递送，艾滋病毒检测和咨询人数（HTC）熟练卫生工作者的设施和密度。我们还具有显着相关性的多元中位数回归。 P <.05被认为是所有测试的统计学意义。 PMTCT的中位ARV覆盖率为76％（IQR：55-85％）。 PMTCT的ARV覆盖率与HTC设施显着相关（r = 0.46，p = .004），机构递送（r = 0.48，p = .002），ANC吸收：至少一次访问（r = 0.54，p = .001 ）和耻辱（r = -0.52，p = .003）。在多变量分析中，仅耻辱仍然存在统计学意义（β= -0.6,95％CI = -1.13，-0.07，P = .03）。为了消除亚撒哈拉以南非洲艾滋病毒的围产期传播，需要解决与耻辱相关的障碍对吸收PMTCT服务的干预措施。建议更多关于国家特异性人口水平的研究，以PMTCT的ARV覆盖范围相关。

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