Optimization of Mother-to-Child HIV Transmission Prevention in Guinea: Impact of the Improvement Plan on Performance Indicators at Large-Cohort Sites

Abstract

Introduction This study assessed the prevention of mother‒to‒child transmission (PMTCT) in Guinea, focusing on the impact of the World Health Organization’s Option B + strategy for human immunodeficiency virus. This pilot study, conducted across 66 high-burden PMTCT sites, aimed to enhance service accessibility and utilization. The study evaluated the indicators of the mother-to-child transmission of human immunodeficiency virus before and after the implementation of the Option B + strategic plan. Methods Data from 66 large-cohort PMTCT sites from 2019 to 2022 were analysed to compare PMTCT metrics before (2019–2020) and after (2021–2022) the improvement initiative. Key indicators were reviewed, and trends were statistically analysed using Mann‒Whitney tests, with a p value less than 0.05 indicating statistical significance. Results The implementation of the strategy significantly increased the antiretroviral therapy rate among HIV-positive pregnant women from 66–94%, and full antiretroviral prophylaxis coverage was achieved in infants. However, early infant diagnosis via polymerase chain reaction testing fell short of the national target, highlighting deficiencies in laboratory and specimen transport capacities. The study also revealed regional disparities in the use of PMTCT services. Conclusion The improvement plan effectively enhanced antiretroviral therapy and prophylaxis use, demonstrating the benefits of structured interventions and capacity development. Despite improvements, challenges such as insufficient polymerase chain reaction (PCR) testing and uneven access to services remain. Future initiatives should aim to equip PMTCT sites with essential resources and promote community-driven health-seeking behaviours in underserved areas.