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首页> 外文期刊>AIDS care. >Non-disclosure to male partners and incomplete PMTCT regimens associated with higher risk of mother-to-child HIV transmission: a national survey in Kenya
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Non-disclosure to male partners and incomplete PMTCT regimens associated with higher risk of mother-to-child HIV transmission: a national survey in Kenya

机译：对男性合作伙伴的不披露和不完整的PMTCT方案，与母婴艾滋病毒艾滋病毒传播较高的风险：肯尼亚的国家调查

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Health worker experience and community support may be higher in high HIV prevalence regions than low prevalence regions, leading to improved prevention of mother-to-child HIV transmission (PMTCT) programs. We evaluated 6-week and 9-month infant HIV transmission risk (TR) in a high prevalence region and nationally. Population-proportionate-to-size sampling was used to select 141 clinics in Kenya, and mobile teams surveyed mother-infant pairs attending 6-week and 9-month immunizations. HIV DNA testing was performed on HIV-exposed infants. Among 2521 mother-infant pairs surveyed nationally, 2423 (94.7%) reported HIV testing in pregnancy or prior diagnosis, of whom 200 (7.4%) were HIV-infected and 188 infants underwent HIV testing. TR was 8.8% (4.0%-18.3%) in 6-week and 8.9% (3.2%-22.2%) in 9-month cohorts including mothers with HIV diagnosed postpartum, of which 53% of infant infections were due to previously undiagnosed mothers. Of 276 HIV-exposed infants in the Nyanza survey, TR was 1.4% (0.4%-5.3%) at 6-week and 5.1% (2.5%-9.9%) at 9-months. Overall TR was lower in Nyanza, high HIV region, than nationally (3.3% vs. 7.2%, P=0.02). HIV non-disclosure to male partners and incomplete ARVs were associated with TR in both surveys [aOR=12.8 (3.0-54.3); aOR=5.6 (1.2-27.4); aOR=4.5 (1.0-20.0), aOR=2.5, (0.8-8.4), respectively]. TR was lower in a high HIV prevalence region which had better ARV completion and partner HIV disclosure, possibly due to programmatic efficiencies or community/peer/partner support. Most 9-month infections were among infants of mothers without prior HIV diagnosis. Strategies to detect incident or undiagnosed maternal infections will be important to achieve PMTCT.
机译：高艾滋病毒患病率地区的卫生工作者经验和社区支持可能高于低流行区域，导致预防母婴艾滋病毒传播（PMTCT）计划。我们在高流行地区和全国性评估了6周和9个月的婴儿艾滋病毒传播风险（TR）。人口比例对大小的抽样用于选择肯尼亚的141个诊所，移动团队调查母婴对参加6周和9个月的免疫接种。 HIV DNA测试对艾滋病毒暴露的婴儿进行。在全国调查的2521对母婴对中，2423（94.7％）报告的妊娠或事先诊断的艾滋病毒检测，其中200（7.4％）是艾滋病毒感染和188名婴儿接受了HIV测试。在6周内，TR为8.8％（4.0％-18.3％），在9个月的群组中，8.9％（3.2％-22.2％），包括患有艾滋病毒的母亲诊断的母亲，其中53％的婴儿感染是由于先前未确诊的母亲。在Nyanza调查中的276名艾滋病毒暴露的婴儿中，TR为6周的1.4％（0.4％-5.3％），9个月，5.1％（2.5％-9.9％）。 Nyanza，高艾滋病毒区的整体TR较低，比全国（3.3％对7.2％，P = 0.02）。艾滋病毒对男性合作伙伴界不公开和不完全的ARV在两个调查中都与TR相关联[AOR = 12.8（3.0-54.3）; AOR = 5.6（1.2-27.4）; AOR = 4.5（1.0-20.0），AOR = 2.5，（0.8-8.4）]。 TR在高艾滋病毒患病率区域较低，具有更好的ARV完成和合作伙伴HIV披露，可能是由于编程效率或社区/同行/合作伙伴支持。大多数9个月的感染是母亲的婴儿，没有先生的艾滋病毒诊断。检测事件或未确诊的母体感染的策略对于实现PMTCT是重要的。

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