Sociodemographic Predictors of HIV Infection among Pregnant Women in Botswana: Cross-Sectional Study at 7 Health Facilities

Hamda, Shimeles Genna; Tshikuka, Jose Gaby; Joel, Dipesalema; Monamodi, Gotsileene; Masupe, Tiny; Setlhare, Vincent

doi:10.1177/2325958220925659

Cited by 4 publications

(3 citation statements)

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“…Consistent with previous studies, individual and household level factors, including age, low education levels, and locality (fishing and small towns), were associated with HIV infection [23,42,[44][45][46][47]. Specifically, in the general population factors such as age, low education level, poverty drug use, alcohol use, and sexual abuse in childhoodincrease the risk of HIV among women [48][49][50]. Similarly, among WESW, studies in SSA [23,44] and other parts of the world [44] have documented that older WESW and those with less education are more susceptible to HIV infection.…”

Section: Plos Onesupporting

confidence: 70%

Prevalence and predictors of HIV and sexually transmitted infections among vulnerable women engaged in sex work: Findings from the Kyaterekera Project in Southern Uganda

et al. 2022

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Introduction Women engaged in sex work (WESW) have an elevated risk of the human immunodeficiency virus (HIV) and sexually transmitted infections (STI). Estimates are three times higher than the general population. Understanding the predictors of HIV and STI among WESW is crucial in developing more focused HIV and STI prevention interventions among this population. The study examined the prevalence and predictors of HIV and STI among WESW in the Southern part of Uganda. Methodology Baseline data from the Kyaterekera study involving 542 WESW (ages 18–55) recruited from 19 HIV hotspots in the greater Masaka region in Uganda was utilized. HIV and STI prevalence was estimated using blood and vaginal fluid samples bioassay. Hierarchical regression models were used to determine the predictors of HIV and STI among WESW. Results Of the total sample, 41% (n = 220) were found to be HIV positive; and 10.5% (n = 57) tested positive for at least one of the three STI (Neisseria gonorrhoeae, Chlamydia trachomatis and Trichomonas vaginalis) regardless of their HIV status. Older age (b = 0.09, 95%CI = 0.06, 0.13, p≤0.001), lower levels of education (b = -0.79, 95%CI = -1.46, -0.11, p≤0.05), fewer numbers of children in the household (b = -0.18, 95%CI = -0.36, -0.01), p≤0.05), location (i.e., fishing village (b = 0.51, 95%CI = 0.16, 0.85, p≤0.01) or small town (b = -0.60, 95%CI = -0.92, -0.28, p≤0.001)), drug use (b = 0.58, 95%CI = 0.076, 1.08, p≤0.05) and financial self-efficacy (b = 0.05, 95%CI = -0.10, 0.00, p≤0.05), were associated with the risk of HIV infections among WESW. Domestic violence attitudes (b = -0.24, 95%CI = -0.42, -0.07, p≤0.01) and financial distress (b = -0.07, 95%CI = -0.14, -0.004, p≤0.05) were associated with the risk of STI infection among WESW. Conclusion Study findings show a high prevalence of HIV among WESW compared to the general women population. Individual and family level, behavioural and economic factors were associated with increased HIV and STI infection among WESW. Therefore, there is a need for WESW focused HIV and STI risk reduction and economic empowerment interventions to reduce these burdens.

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Section: Plos Onesupporting

confidence: 70%

Prevalence and predictors of HIV and sexually transmitted infections among vulnerable women engaged in sex work: Findings from the Kyaterekera Project in Southern Uganda

et al. 2022

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“…Botswana in particular has emerged as a unique place to study HIV in pregnancy given the availability of free antenatal care, free HIV testing and widespread uptake of ART (including UTT since May 2016) [ 12 ]. In addition, it has a stable total fertility rate of 2.8, 95% of women deliver in hospital and the uptake of HIV testing during pregnancy has been consistently >95% over the past decade [ 13 , 14 ]. Collectively, these factors have mitigated major barriers to providing high‐quality HIV care to pregnant women, but it is not yet known if these strategies or the implementation of UTT has translated into decreasing HIV prevalence.…”

Section: Introductionmentioning

confidence: 99%

Cross‐sectional trends in HIV prevalence among pregnant women in Botswana: an opportunity for PrEP?

et al. 2022

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Introduction Young women in sub‐Saharan Africa are at particularly high risk of HIV acquisition. Recent shifts towards “test and treat” strategies have potential to reduce transmission in this age group but have not been widely studied outside of clinical trials. Using data from nationwide surveillance among pregnant women in Botswana, where a “test and treat” program was implemented in 2016, we describe trends in HIV prevalence over time and highlight opportunities for targeted prevention. Methods The Tsepamo study abstracted data from obstetric records of all women delivering at eight government hospitals in Botswana between 2015 and 2019, accounting for 45% of all births in the country (n = 120,755). We used a stratified analysis to identify prevalence trends and evaluated decreases in HIV prevalence over time using the Cochrane–Armitage test for linear trend. A multivariable logistic regression analysis was also performed to identify factors associated with declines in HIV prevalence. Results Overall HIV prevalence was 24.1% among 120,755 women who delivered during the study period. Prevalence differed by site of delivery, ranging from 16.1% to 28.2%, and increased markedly with age. Lower educational attainment (adjusted odds ratio [aOR] = 3.28; 95% confidence interval [CI] 3.07–3.50) and being unmarried (aOR = 1.98; 95% CI 1.88–2.08) were associated with HIV infection. HIV prevalence was 10.0% with a first pregnancy, 21.0% with a second and 39.2% with a third or greater (aOR = 2.20; for any prior pregnancy; 95% CI 2.10–2.29). The same age‐adjusted trends were seen when data were limited to women aged 15–24, with a two‐ to three‐fold increase in HIV prevalence between a first and third pregnancy. Prevalence decreased linearly during the 5‐year study period from 25.8% to 22.7% (p <0.001). Among age‐specific strata, the greatest absolute decline occurred in those aged 35–39, with an 8.7% absolute decrease in HIV prevalence from 2015 to 2019. Minimal declines were seen in those 15–24, with a decrease of only 1.5% over the same period. Conclusions While overall trends in Botswana show HIV prevalence declining among pregnant women, prevalence among the youngest age group has remained stagnant. Preventative interventions utilizing pre‐exposure prophylaxis should be prioritized during the high‐risk period surrounding a woman's first pregnancy.

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“…This contrasts with other studies where age, number of sexual partners and consistent use of condom were likely factors for HIV infection in Cameroon [11] while education, residence and alcohol abuse were shown to contribute to HIV prevalence among pregnant women in Botswana. [13] Similarly a retrospective study that used a weighted sample of 46,645 women aged 15-49 years from 10 African countries, established that the key enablers for uptake of ANC services were higher education level for the partners, higher income, and availability of the services, while long distances to the facilities were identified as barriers. [3] Our finding could mean that those with health problems, including HIV, adhere more to subsequent ANC visits.…”

Section: Discussionmentioning

confidence: 99%

Prevalence of HIV among pregnant mothers receiving antenatal care at Kator Primary Health Care Centre, Juba, South Sudan

Alier¹,

Cham²,

Oliwa³

et al. 2022

SSMJ

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Introduction: The HIV/AIDS scourge remains a major public health threat in South Sudan particularly to the unborn children due to vertical transmission. Objective: This study aimed to assess the prevalence of HIV among pregnant mothers receiving antenatal care (ANC) services at Kator Primary Healthcare Centre in Juba. Method: The study used a cross-sectional design in which systematically selected ANC records of January to June 2021 were collected and analyzed using SPSS Version 16.0. Fisher’s exact values were obtained to test for significance. Results: The HIV prevalence rate among pregnant mothers receiving ANC services at Kator PHCC was 2.25%. The modal age group was 21-25 years. HIV prevalence was highest among mothers who attained primary education or less, urban dwellers and married mothers in their 3rd trimester of pregnancy. Conclusion: HIV prevalence among pregnant mothers receiving ANC services at Kator PHCC in Juba is comparable to the national average.

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Sociodemographic Predictors of HIV Infection among Pregnant Women in Botswana: Cross-Sectional Study at 7 Health Facilities

Cited by 4 publications

References 16 publications

Prevalence and predictors of HIV and sexually transmitted infections among vulnerable women engaged in sex work: Findings from the Kyaterekera Project in Southern Uganda

Prevalence and predictors of HIV and sexually transmitted infections among vulnerable women engaged in sex work: Findings from the Kyaterekera Project in Southern Uganda

Cross‐sectional trends in HIV prevalence among pregnant women in Botswana: an opportunity for PrEP?

Prevalence of HIV among pregnant mothers receiving antenatal care at Kator Primary Health Care Centre, Juba, South Sudan

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