Predictors of maternal HIV infection at the primary care level in inner city Ibadan

Abstract

National HIV prevalence rate is derived from the sentinel surveys, which are carried out once in two years and remain anonymized. Epidemiological data are largely unavailable on the pregnant HIV-positive mothers particularly at the grass root level. This information is urgently needed when developing a realistic intervention programme.

Three hundred and forty-three consenting pregnant women attending a randomly selected primary health care clinic in inner city Ibadan from April to November 2001 were enrolled at booking and followed up till delivery of their babies. Sociodemographic and reproductive health data were collected by questionnaire and all mothers were screened for HIV/AIDS using an enzyme-linked immunosorbent assay based rapid test.

Results showed that about one in three teenage mothers screened positive, having the highest HIV rate. HIV prevalence rate reduced, though not significantly, in mothers 20-29 years and those 30-39 years with mothers in these groups having similar rates. No mother over 39 years screened positive. Following logistic regression analysis, young age 15-19 years, was associated with a significantly increased risk for infection at the primary health care level (P =0.046). Christian religion was associated with a lower risk (P =0.038), and mothers who booked late in pregnancy (P =0.025) or had husbands in the lower socio-economic class (P =0.001) were less likely to be infected. None of the women were aware of their HIV status prior to the study.

With a predominantly heterosexual mode of HIV transmission, it is necessary to identify infected pregnant women early through voluntary counselling and testing (VCT), so that they can be given the option to take preventive drugs, which would among other benefits reduce mother-to-child transmission, and help infected mothers stay healthy and productive for longer.