Analysis of Related Factors of Mother-to-Child Transmission of AIDS and Evaluation of Measures to Prevent Mother-to-Child Transmission

AIDS is still a major public health facing the world. With the implementation of AIDS prevention projects and the continuous maturity of technology, more and more HIV-positive women choose to have children. However, the children born to these women are a special group. Exposure to HIV and antiviral drugs during the fetal period can increase the success rate of children’s elimination of the mother, which is worthy of attention and research. This article focuses on the analysis of the related factors of mother-to-child transmission of AIDS and the evaluation of mother-to-child blocking measures, using the method of field research to conduct experiments on AIDS patients in this city who are pregnant and provide them with antidrug treatment and some barrier measures. Then, the mother-to-child transmission rate was recorded, and the experimental results showed that the antidrug treatment plan is related to mother-to-child transmission. After antidrug treatment, the transmission rate of single-drug treatment is reduced by 5%, and the transmission rate of combined drug treatment is reduced by 10%. It can be seen from this that antidrug treatment is an effective measure to block mothers and babies.

The Distribution of Human Papillomavirus Type 30 (HPV30) Lineages Among Women With Normal Cervical Cytology in China

Background: Human papillomavirus type 30 (HPV30) is involved in cervical diseases. In human immunodeficiency virus (HIV) positive women, the prevalence HPV30 is almost the same as HPV16. However, HPV30 has seldom been investigated. In order to better understand the prevalence and intratype lineage distribution of HPV30 in China, HPV30 infection among women with normal cytology was investigated.Methods: Prevalence of HPV30 was investigated by the screening of type specific polymerase chain reaction (PCR); intratype lineage distribution was performed by the phylogenetic analysis of the L2 DNA sequences of HPV30 isolates; the diversity of genetic variants of HPV30 isolates was also evaluated. Results: (1) The infection rate of HPV30 was 0.56% (9/1600). (2) All the nine HPV30 isolates belonged to lineage A, none belonged to lineage B. (3) Compared with the HPV30 prototype reference, 87 variations including 79 substitutions, four insertions and four deletions were observed in this study. (4) Sample 4 contained a C base deletion of the E2 gene resulting in an amino acid sequence shift. (5) Sample had a truncated L2 protein.Conclusions: The infection rate of HPV30 is 0.56% in this study. All of the HPV30 isolates belongs to lineage A. Natural L2 and E2 defective isolates of HPV30 were found.

Features of the Neonatal Period in Perinatally HIV-Exposed Children Receiving Combined Сhemoprophylaxis of mother-to-child Transmission of HIV

The aim. To study the features of the course of the neonatal period in children, perinatally exposed to HIV, who receive an enhanced regimen of chemoprophylaxis of HIV mother-to-child transmission.Patients and methods. A retrospective longitudinal cohort study of mother – child pairs for the period from 2017 to 2019 was carried out. The clinical observation group included HIV-positive women with a high risk of vertical transmission of the immunodeficiency virus (n = 213) and their newborn children (n = 214), who were prescribed an enhanced chemoprophylaxis regimen of HIV transmission from mother to child. Results. According to the results of the study of HIV-positive mothers we revealed a high prevalence of secondary diseases and a high per partum viremia – 1700 (222–18342) copies/ml. 35.9 % of children were born prematurely, 27.5 % – had low birth weight by gestational age. In newborns, diseases of the respiratory (24.3 %) and nervous (17.2 %) systems prevailed. 17.2 % of children developed intrauterine infection; HIV RNA was detected in 3.7 %. Congenital malformations were observed in 7.4 % of children. Symptoms of enteropathy were noted in 24.7 % of newborns. A decrease in red blood counts was found in all children by the 28th day of life (pw < 0.001).Conclusion. The study confirms the need for increased attention and improvement of approaches to medical support of children who were perinatally exposed to high risk of vertical HIV infection.

Identification of the Human Papillomavirus Genotypes, According to the Human Immunodeficiency Virus Status in a Cohort of Women from Maputo, Mozambique

Background: Human papillomavirus (HPV) infection is now a well-established cause of cervical cancer and other anogenital cancers. An association between human immunodeficiency virus (HIV) infection and higher HPV incidence and prevalence are commonly reported. This study was conducted to demonstrate HPV prevalence, genotypes and its characteristics, according to the HIV status in women from Maputo in Mozambique. Methods: A total of 233 participants with ages ranging from fourteen to forty-five were included. Cervical samples were collected, DNA extracted, and HPV genotyping was performed using the HPV Direct Flow CHIP Kit. Results: In total, 177 HIV-negative and 56 HIV-positive women were included in the analysis. The overall HPV prevalence was 63% and was significantly higher among HIV-positive women (79% versus 58% among HIV-negative women; p = 0.005). The prevalence of multiple HPV type infections was 32%. High-risk HPV types 52, 68, 35, 18 and 16 were the most frequent. A higher proportion of HIV-positive women had multiple HPV types compared with HIV-negative women. Conclusions: This study demonstrated a high prevalence of HPV in the study cohort. HIV-positive women were identified as having the highest HPV prevalence and infection with multiple HPV types across all ages. High-risk genotypes were the most commonly found.

Factors Associated with Uptake of Contraceptives Among HIV Positive Women on Dolutegravir Based Anti-Retroviral Treatment - A Crossectional Survey in Urban Uganda.

Background In May 2018, following the preliminary results of a study in Botswana that reported congenital anomalies in babies born to HIV-positive women taking dolutegravir drug, the WHO issued a teratogenicity alert. However, there are scarce data on the impact of this guidance on contraceptive uptake among women taking dolutegravir. We assessed the uptake of contraceptives in HIV-positive women of reproductive age on dolutegravir regimens. Methods We conducted a cross-sectional survey from April 2019 to July 2019 in five government health facilities in central Uganda, where dolutegravir-based regimens were offered as the preferred first-line antiretroviral treatment. We randomly selected 359 non-pregnant women aged 15-49 years taking dolutegravir-based regimens and interviewed them using semi-structured interviewer-administered questionnaires. We collected data on demographics, contraceptive use, individual, social, and health system factors. We described patients’ characteristics using descriptive statistics and assessed factors associated with contraceptive uptake using a modified Poisson regression model. Results A total of 359 women were included in the study. The mean age was 37 years (standard deviation=6.8) and overall contraceptive uptake was 38.4%. The most utilized method was injectable method at 58.4% followed by condoms (15%), intrauterine device (10.7%), pills (6.4%), implants (5.4%), and sterilization (0.7%) Predictors for contraceptive uptake were parity of 3-4 children (Adjusted Prevalence Ratio (APR) =1.48, 95% confidence interval (CI): 1.14, 1.92). There was reduced uptake in the age range of 40-49 years (APR=0.45, CI: 0.21-0.94), unemployed (APR: 0.6, CI: 0.42- 0.94), women not discussing family planning with their partner (APR=0.39, CI: 0.29-0.52) and not receiving family planning counseling (APR= 0.56, CI: 0.34-0.92). Conclusion We observed a low-level uptake of contraceptives, with injectables as the most used method. Family planning counseling and partner discussion on family planning were associated with contraceptive uptake among the women who used dolutegravir based regimens. There is a need for more strategies to integrate FP services and increase male involvement in HIV care programs.

Socio-Demographic Factors and Epidemiological Characteristics of HIV-Positive Pregnant Women with High Risk of Vertical Transmission of the Immunodeficiency Virus

The purpose of this study was to determine the features of the course of pregnancy, delivery, and the postpartum period in HIV-positive women with a high risk of HIV vertical transmission. Methods and Results: A retrospective, longitudinal cohort study of mother-child pairs for the period from 2017 to 2019 was conducted in the Irkutsk City Perinatal Center (level III). The clinical observation group included HIV-positive women (n=213) and their newborn children with a high risk of perinatal immunodeficiency virus transmission (n=214). The findings of the conducted study demonstrated that most HIV-seropositive women with a high risk of HIV vertical transmission had an aggravated social history, a high prevalence of pelvic inflammatory diseases, and a high incidence of opportunistic and AIDS-defining conditions. Evaluation of PMTCT preventive complex showed that the target parameters in women with a high risk of HIV transmission were not reached: the first stage was performed for 49.3% of pregnant women with good ART adherence, the second stage – for 97.1% of obstetric patients, the third stage – in 100% of HIV perinatally exposed children. HIV RNA was detected in 3.7% of children, which evidences their antenatal infection. Conclusion: Development of efficient communication with HIV-positive women aimed at preservation of their health and decrease of logistic barriers to access to medical care.

An evaluation of a combined psychological and parenting intervention for HIV-positive women depressed in the perinatal period, to enhance child development and reduce maternal depression: study protocol for the Insika Yomama cluster randomised controlled trial

Background The combination of poverty, HIV and depression in the perinatal period represents a major public health challenge in many Southern African countries. In some areas, up to a third of HIV-positive women experience perinatal depression. Perinatal depression is associated with negative effects on parenting and key domains of child development including cognitive, behavioural and growth, especially in socio-economically disadvantaged communities. Several studies have documented the benefits of psychological interventions for perinatal depression in low- and middle-income countries, but none have evaluated an integrated psychological and parenting intervention for HIV-positive women using task-sharing. This randomised controlled trial aims to evaluate the effect of a home-based intervention, combining a psychological treatment for depression and a parenting programme for perinatally depressed HIV-positive women. Methods This study is a cluster randomised controlled trial, consisting of 48–60 geospatial clusters. A total of 528 pregnant HIV-positive women aged ≥ 16 years who meet the criteria for depression on the Edinburgh Postnatal Depression Scale (EPDS, score ≥ 9)) are recruited from antenatal clinics in rural KwaZulu-Natal, South Africa. The geospatial clusters are randomised on an allocation ratio of 1:1 to either the intervention or Enhanced Standard of Care (ESoC). The intervention group receives 10 home-based counselling sessions by a lay counsellor (4 antenatal and 6 postnatal sessions) and a booster session at 16 months. The intervention combines behavioural activation for depression with a parenting programme, adapted from the UNICEF/WHO Care for Child Development programme. The ESoC group receives two antenatal and two postnatal counselling support and advice telephone calls. In addition, measures have been taken to enhance the routine standard of care. The co-primary outcomes are child cognitive development at 24 months assessed on the cognitive subscale of the Bayley Scales of Infant Development-Third Edition and maternal depression at 12 months measured by the EPDS. Analysis The primary analysis will be a modified intention-to-treat analysis. The primary outcomes will be analysed using mixed-effects linear regression. Discussion If this treatment is successful, policymakers could use this model of mental healthcare delivered by lay counsellors within HIV treatment programmes to provide more comprehensive services for families affected by HIV. Trial registration ISRCTN registry #11284870 (14/11/2017) and SANCTR DOH-27-102020-9097 (17/11/2017).

Prevalence and factors associated with fertility desire among HIV-positive women in Rwanda in the context of improved life expectancy

Background The knowledge of the key factors associated with fertility desire among people living with HIV/AIDS is crucial for the efficient planning of maternal and child health care programs. Fertility desire has generally increased among women of reproductive age in Rwanda. However, its level and determinants among women living with HIV/AIDS (WLHA) are currently not well known in the context of Rwanda. The present study aimed to fill in this knowledge gap. Methods Data were extracted from the 2015 Rwanda demographic and health survey (RDHS) for 243 HIV-positive women of reproductive age. Univariate and multivariable logistic regression analyses were conducted in order to identify the most influential factors. Results The prevalence of desire to have another child in HIV-positive women was found to be as high as 40.7%. Multivariable logistic regression analyses showed that the woman’s age of 35–49 years (AOR = 0.051, 95% CI: 0.013–0.204), woman’s parity of 3 children or above (AOR = 0.177, 95% CI: 0.037–0.837), being employed (AOR = 0.298, 95% CI: 0.113–0.782) and currently using contraceptives (AOR = 0.146; 95% CI: 0.057–0.375) were significantly associated with low odds of fertility desire among HIV- positive women in Rwanda. Women younger than 25 years, with no living child, or who were unemployed or who were not using any contraceptive were significantly associated with greater odds of desire to have another child than did other HIV- positive women. A woman whose partner's desire for children is different from hers was associated with about four times higher odds (AOR = 3.752; 95% CI: 1.203–11.702) of desire for more children than women who desire the same as their partners. Conclusion Fertility desire in WLHA is currently high in Rwanda. It is significantly influenced by demographic and socioeconomic factors. The Rwanda’s health care system should be prepared to intensify the required services for the prevention of the vertical transmission of HIV, the delivery of maternal and child health care services, and the support to WLHA in planning their fertility. Interventions should target low-parity young women, with a particular focus on meeting their contraceptive needs.

Socio-Cultural and Societal Demands Influencing Pregnancy among HIV Positive Women in Kakamega County, Kenya

Globally, the number of women living with HIV who desire pregnancy has been increasing and little is known as what motivates them, with test and treat women accessing ART desiring pregnancy will increase. Kakamega County has been leading in the region on women living with HIV accessing antenatal services. Past literature in the subject matter failed to look at socio-cultural and societal factors influencing pregnancy among HIV positive women in Kakamega County, Kenya; a gap that informed this study. A descriptive cross-sectional research design was employed. The target population were women aged 18-49 years receiving their family planning services in sub-county hospitals in Kakamega County. Key informants were made up of health care workers at comprehensive care clinics. Purposive sampling was used to select 4 sub-county hospitals, systematic random sampling to select 319 known HIV positive women and 4 focus group discussions. Questionnaires focused on group discussions and key informant interviews were used to collect data. Data collected were entered into Statistical Package for Social Sciences version 25.0. Descriptive results were presented in proportionate tables. The results showed that age, education, employment status and parity influenced the desire for pregnancy among HIV positive women in Kakamega County. Society influenced the number of children a woman should have. The community held a negative perception of childless women, especially HIV positive women; the community members did not attach value and pride over the childless HIV positive women. The socio-cultural and societal demand on HIV positive women influenced pregnancy; however, there decreasing association, which meant that the society was 71% less likely to influence the number of children; the spouse was 63% less likely to influence pregnancy. In conclusion, age, education level, marital status parity and employment status, medical cover influenced pregnancy among the known HIV positive women in Kakamega County. Socio-cultural and societal demands were predictors of pregnancy among known HIV positive women in Kakamega County. The community should treat HIV positive women with respect and dignity, thus permitting them to continue their family legacy and sire children. It recommends that there is a need for the county government, department of health services to provide health education to the community on stigma reduction and discrimination meted on these women and negative perception of childlessness women in the society especially known HIV positive women. Further works on the myths and misconception that barrenness is blamed on women leaving men scot-free for the cloud to be the culprits of childlessness in the family.