Mintsa-Ndong Armel, Ndong-Ella Corneille, Boussougou Roselyne K, Busugu Léatitia M, Mba Alexandre, Agwambouet Franck A, Barro Nicolas, Djoba Siawaya Joel F
1 Unité de Virologie, Laboratoire National de Santé Publique, Libreville, Gabon.
2 UFR-SVT, Département de Biochimie-Microbiologie, Université de Ouagadougou, Ouagadougou, Burkina Faso.
Int J STD AIDS. 2018 Mar;29(3):221-226. doi: 10.1177/0956462417722132. Epub 2017 Jul 31.
In many developing countries, mothers' awareness remains a challenge despite the scaling up of antenatal care and programs preventing mother-to-child (MTC) HIV transmission. The present study was done in Libreville, Gabon where all antenatal care (delivery included) is free of charge. Here we assessed the timing of antenatal antiretroviral (ARV) prophylaxis initiation, HIV-exposed infants' age at their first postnatal HIV check visit and investigated the association between mothers' awareness or knowledge on their ARV therapy and infants' HIV infection. We interviewed HIV-positive mothers on their first and subsequent laboratory visits to investigate infants' HIV status and tested infants for HIV RNA and antibody between 2012 and 2014. We established that (1) of 718 HIV-positive mothers, only 6% were fully aware and knew what ARV treatment they were on during pregnancy; (2) half of the women (54%) start their antenatal ARV prophylaxis initiation during the second trimester of pregnancy; (3) 64% of HIV-exposed infants had their first HIV infection screening between birth and three months of age; (4) the overall prevalence of HIV infection in infants born from infected mothers was 8.9%; and (5) infants born from mothers uncertain about taking prophylactic ARV therapy were 13.3 times more likely to be infected by HIV than infants born from mothers certain about taking prophylactic ARV therapy. In conclusion, the study showed that despite free antenatal care, early access and adherence to components of MTC, HIV transmission preventive care remains unsatisfactory.
在许多发展中国家，尽管扩大了产前护理以及预防母婴传播艾滋病毒的项目，但母亲的认知仍然是一项挑战。本研究在加蓬的利伯维尔开展，当地所有产前护理（包括分娩）都是免费的。在此，我们评估了产前抗逆转录病毒药物预防开始的时间、暴露于艾滋病毒的婴儿首次产后艾滋病毒检查时的年龄，并调查了母亲对其抗逆转录病毒治疗的认知或了解与婴儿艾滋病毒感染之间的关联。我们在2012年至2014年期间，对艾滋病毒呈阳性的母亲进行了首次及后续实验室访视，以调查婴儿的艾滋病毒状况，并对婴儿进行了艾滋病毒RNA和抗体检测。我们发现：（1）在718名艾滋病毒呈阳性的母亲中，只有6%完全了解并知道她们在怀孕期间接受的抗逆转录病毒治疗是什么；（2）一半的女性（54%）在怀孕中期开始进行产前抗逆转录病毒药物预防；（3）64%暴露于艾滋病毒的婴儿在出生至三个月大之间进行了首次艾滋病毒感染筛查；（4）感染母亲所生婴儿的艾滋病毒感染总体患病率为8.9%；（5）母亲不确定是否接受预防性抗逆转录病毒治疗所生的婴儿感染艾滋病毒的可能性是母亲确定接受预防性抗逆转录病毒治疗所生婴儿的13.3倍。总之，该研究表明，尽管有免费的产前护理、早期获得并坚持母婴传播艾滋病毒预防护理的各个组成部分，但艾滋病毒传播预防护理仍不尽人意。
