Full text

Turn on search term navigation

This is an open access article, free of all copyright, and may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose. The work is made available under the Creative Commons CC0 public domain dedication: https://creativecommons.org/publicdomain/zero/1.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.

Abstract

Background

Early infant diagnosis (EID) facilitates early initiation into HIV care for identified HIV-positive infants. According to the Uganda Ministry of Health, EID testing algorithm, testing for infants exposed to HIV (IEH) should occur at <6 weeks, 9 and 18 months of age, and 6 weeks after stopping breastfeeding. Uganda has faced challenges with loss to follow-up (LTFU) of IEH for EID. We assessed complete testing coverage (CTC) to the EID algorithm for IEH and associated factors.

Methods

We analyzed data from the ‘Impact of the National Program for the Prevention of Vertical Transmission (PVT) of HIV in Uganda (2017−2019)’ study. Mothers living with HIV whose infants tested HIV-negative at 4–12 weeks were enrolled in a prospective cohort (2017 − 2018) and followed until the IEH tested positive, died, was LTFU, or reached 18 months of age. We computed the proportion of IEH tested according to the EID algorithm among surviving infants. CTC was defined as undergoing HIV tests at three designated time points (excluding the 6 weeks after breastfeeding cessation) if HIV negative. IEH who were diagnosed with HIV but were tested at all recommended tests until that point were also considered to have CTC. We evaluated factors associated with CTC using modified Poisson regression.

Results

Among 1,804 IEH, 912 (51%) were male. Of the 1,804 IEH at baseline, 27 (1%) died. Among the 1,777 IEH included in the primary outcome analysis, 1,282 (72%) completed the study and 941 (53%) infants had CTC according to the EID testing algorithm including 40 (2%) who tested HIV-positive. Perceived discrimination due to HIV status [RR = 0.77, 95%CI (0.65–0.92)], having fewer pregnancies [RR = 0.97, 95%CI (0.68–0.99)], and reporting sexual violence [RR = 0.82, 95%CI (0.73–0.93)] by the mother of IEH were associated with non-CTC.

Conclusion

About half of IEH were tested at the recommended time points. Interventions to address stigma and sexual violence for mothers may improve CTC for the EID algorithm. Investigations are needed to explore associations between sexual violence, parity, and CTC for the EID algorithm.

Details

Title
Complete testing coverage for the early infant diagnosis algorithm and associated factors among infants exposed to HIV, Uganda, 2017–2019
Author
Akunzirwe, Rebecca  VIAFID ORCID Logo  ; Harris, Julie R; Kawungezi, Peter Chris; Wanyana, Mercy W; Lutalo, Tom; Namukanja, Phoebe Monalisa; Delaney, Augustina; Migisha, Richard  VIAFID ORCID Logo  ; Nyamugisa, Esther; Ondo, Doreen; Kasibante, Philip; Kadobera, Daniel; Bulage, Lilian; Zalwango, Jane Frances; Ario, Alex Riolexus; Nabitaka, Linda Kisaakye
First page
e0324338
Section
Research Article
Publication year
2025
Publication date
Jun 2025
Publisher
Public Library of Science
e-ISSN
19326203
Source type
Scholarly Journal
Language of publication
English
ProQuest document ID
3217666313
Copyright
This is an open access article, free of all copyright, and may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose. The work is made available under the Creative Commons CC0 public domain dedication: https://creativecommons.org/publicdomain/zero/1.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.