Risk factors associated with HIV seroconversion among pregnant women in Southern province - Zambia

Abstract

HIV/AIDS remains a major challenge particularly among women of child bearing age . Globally, there are about 36.6 million people living with HIV infection and about 70 % (25 million) of these live in sub Saharan Africa Africa. HIV burden needs greater attention in the planning of EMTCT programmes. This study aimed at determining the possible risks and the prevalence of HIV seroconversion in pregnant women of Southern province in Zambia from 2012 to 2016. Also to assess adherence to the recommended number of HIV tests. It was imperative to undertake this study as the results would provide important insights to policy makers and for other important decisions in an effort to reduce HIV seroconversion in pregnant women. This was a retrospective cohort study design. Data was obtained from the Smart Care data base in the department of Information Technology at Ministry of Health Headquarters in Lusaka. Cross tabulations were used to determine associations and logistic regression analysis was used to determine the best predictors at p-value less than 0.05 and 95% confidence interval. Chi square for trends was used to assess the trend of HIV seroconversion prevalence. Complete case analysis was used to take care of missing data. Data was missing completely at random and the missing values were distributed across all variables thus this was the suitable method. From the study population (n=3,489), 242 seroconverted, giving an overall prevalence of 6.9%. The p value (0.035) for trend analysis was statistically significan t. There was no evidence of association for m arit al status and partner HIV test. Those with primary education had 91% reduced risk (p-value 0.02, CI 0.01-0.68) and those with secondary education had 85% reduced risk of seroconverting (p-value 0.05, CI 0.02-1.01). These were statistically significant at multivariable analysis. 148 (6.3%) of those married seroconverted. Majority (86.2%) of the study participants had two HIV tests. The trend for HIV seroconversion in pregnant women of Southern province was downwards from 2015 to 2016. Primary and secondary education levels were independently significant factors associated with HIV seroconversion. Adherence to the recommended number of HIV tests was poor as majority of participants only had two tests Key terms: HIV Seroconversion, Elimination of Mother to Child Transmission (EMTCT), Antenatal Care (ANC), Smart Care data.