Olakunde Babayemi O, Adeyinka Daniel A, Olakunde Olubunmi A, Ozigbu Chamberline E, Ndukwe Chinwendu D, Oladele Tolu, Wakdok Sabastine, Udemezue Samuel, Ezeanolue Echezona E
a National Agency for the Control of AIDS , Abuja , Nigeria.
b National AIDS & STIs Control Programme, Federal Ministry of Health , Abuja , Nigeria.
AIDS Care. 2019 Oct;31(10):1255-1260. doi: 10.1080/09540121.2019.1587364. Epub 2019 Mar 4.
Antiretroviral (ARV) drugs are effective in the prevention of mother-to-child transmission of HIV (PMTCT), however many sub-Saharan African countries are yet to achieve universal ARV coverage among pregnant women living with HIV. This study examined factors associated with ARV coverage for PMTCT in 41 sub-Saharan Africa countries. Country-level aggregated data were obtained from the Joint United Nations Programme on HIV/AIDS, World Health Organization, and United Nations Children's Fund. Using Spearman's rho and point-biserial correlation, we conducted bivariate analyses between ARV coverage for PMTCT and the following variables: stigma, antenatal care (ANC) uptake, institutional delivery, community delivery of ARV drugs, number of HIV testing and counselling (HTC) facilities, and density of skilled health workers. We also performed a multivariate median regression with the significant correlates. < .05 was considered statistically significant for all the tests. The median ARV coverage for PMTCT was 76% (IQR: 55-85%). ARV coverage for PMTCT was significantly associated with HTC facilities ( = 0.46, = .004), institutional delivery ( = 0.48, = .002), ANC uptake: at least one visit ( = 0.54, = .001), and stigma (=-0.52, = .003). In the multivariate analysis, only stigma remained statistically significant ( = -0.6, 95% CI = -1.13, -0.07, = .03). To eliminate perinatal transmission of HIV in sub-Saharan Africa, interventions that will address stigma-related barriers to uptake of PMTCT services are needed. More research on country-specific population-level correlates of ARV coverage for PMTCT is recommended.
抗逆转录病毒（ARV）药物在预防艾滋病毒母婴传播（PMTCT）方面是有效的，然而许多撒哈拉以南非洲国家尚未在感染艾滋病毒的孕妇中实现普遍的抗逆转录病毒药物覆盖。本研究调查了撒哈拉以南非洲41个国家中与PMTCT的抗逆转录病毒药物覆盖相关的因素。国家层面的汇总数据来自联合国艾滋病毒/艾滋病联合规划署、世界卫生组织和联合国儿童基金会。我们使用斯皮尔曼等级相关系数和点二列相关，对PMTCT的抗逆转录病毒药物覆盖与以下变量进行了双变量分析：耻辱感、产前护理（ANC）利用率、机构分娩、抗逆转录病毒药物的社区发放、艾滋病毒检测和咨询（HTC）设施数量以及熟练卫生工作者的密度。我们还对显著相关因素进行了多元中位数回归分析。所有检验中，P < 0.05被认为具有统计学意义。PMTCT的抗逆转录病毒药物覆盖中位数为76%（四分位间距：55 - 85%）。PMTCT的抗逆转录病毒药物覆盖与HTC设施（r = 0.46，P = 0.004）、机构分娩（r = 0.48，P = 0.002）、ANC利用率：至少一次就诊（r = 0.54，P = 0.001）以及耻辱感（r = -0.52，P = 0.003）显著相关。在多变量分析中，只有耻辱感仍然具有统计学意义（β = -0.6，95%置信区间 = -1.13，-0.07，P = 0.03）。为了消除撒哈拉以南非洲的艾滋病毒围产期传播，需要采取干预措施来解决与耻辱感相关的妨碍PMTCT服务利用的障碍。建议针对特定国家的PMTCT抗逆转录病毒药物覆盖的人群层面相关因素开展更多研究。
