Impact of Repeated Prevention of Mother to Child Transmission of HIV (PMTCT) Services on Vertical Transmission of HIV Infection in Southwest Nigeria

Abstract

Background: In Nigeria about 50,000 children are infected with HIV annually, mostly through mother to child transmission, thus making her the greatest contributor (30%) to the global paediatric HIV burden. Since the inception of the PMTCT programme in Nigeria in 2001, the number of HIV+ pregnant women that had accessed the service was more than 200,000. Some accessing the service more than one time during different pregnancies. Objectives: The study was conducted primarily to determine, if there was any, the impact of maternal exposure to repeated PMTCT care on the rate of mother to child transmission of HIV infection. Other secondary objectives included calculating the proportion of PMTCT clients who are accessing the PMTCT service for the first time, the 2nd, 3rd or 4th time Methods: This was a retrospective case-control multicenter study. PMTCT clients who have had repeated PMTCT services form the case while the control group consisted of first-timers PMTCT clients. Results: The control group consists of 387 HIV positive nursing mothers who were assessing the PMTCT service for the first time while the case group consisted 116 who were repeated users of the PMTCT service. Of the repeated PMTCT clients (case group), 95% (n=110) were accessing the PMTCT service for the 2 nd time while 5%(n=6)were third time users of the PMTCT service. None had used the service for more than 3 rd time. HIV vertical transmission rate was 0% among babies of mothers who were having repeated PMTCT service(case group) while only 1.4% babies whose mothers were receiving PMTCT service for the first time(control) were vertically infected. Conclusion: Though the vertical transmission of HIV was slightly higher among babies whose mothers were exposed to the PMTCT service for the first time. The difference in the transmission rates between the two groups was not statistically significant P>0.05, X 2 = 1.309, df=1) and there was no statistical association between the number of vertically HIV infected infants and the number of time the mother was exposed to PMTCT services.