HIV burden and the global fast-track targets progress among pregnant women in Tanzania calls for intensified case finding: Analysis of 2020 antenatal clinics HIV sentinel site surveillance.


Journal

PloS one
ISSN: 1932-6203
Titre abrégé: PLoS One
Pays: United States
ID NLM: 101285081

Informations de publication

Date de publication:
2023
Historique:
received: 04 05 2023
accepted: 28 09 2023
medline: 23 10 2023
pubmed: 12 10 2023
entrez: 12 10 2023
Statut: epublish

Résumé

For successful HIV response, updated information on the burden and progress toward HIV elimination targets are required to guide programmatic interventions. We used data from the 2020 HIV sentinel surveillance to update on the burden and factors associated with HIV infection, HIV status awareness, and ART coverage among pregnant women in Tanzania mainland. We conducted the surveillance in 159 antenatal clinics (ANC) from all 26 regions of Tanzania's mainland from September to December 2020. This cross-sectional study included all pregnant women (≥15 years) on their first ANC visit in the current pregnancy during the survey period. Routine HIV counselling and testing were done at the facility. A multivariable logistic regression model accounting for the survey design was used to examine factors associated with HIV infections. 38,783 pregnant women were enrolled (median age (IQR) = 25 (21-30) years). HIV prevalence was 5.9% (95%CI: 5.3% - 6.6%), ranging from 1.9% in the Manyara region to 16.4% in the Njombe region. Older age, lower and no education, not being in a marital union, and living in urban or semi-urban areas were associated with higher odds of HIV infection. HIV status awareness among women who tested positive was 70.9% (95% CI: 67.5%- 74.0%). ART coverage among those aware of their status was 91.6% (86.5%- 94.9%). Overall, 66.6% (95% CI: 62.4%- 70.6%) of all pregnant women who tested positive for HIV knew their HIV status and were on ART. HIV is increasingly prevalent among pregnant women in Tanzania mainland especially among older, those with lower or no formal education, those outside marital union, and pregnant women living in urban and semi-urban areas. Behind the global fast-target to end HIV/ AIDS, about a third of pregnant women living with HIV initiating ANC were not on ART. Interventions to increase HIV testing and linkage to care among women of reproductive age should be intensified.

Sections du résumé

BACKGROUND
For successful HIV response, updated information on the burden and progress toward HIV elimination targets are required to guide programmatic interventions. We used data from the 2020 HIV sentinel surveillance to update on the burden and factors associated with HIV infection, HIV status awareness, and ART coverage among pregnant women in Tanzania mainland.
METHODOLOGY
We conducted the surveillance in 159 antenatal clinics (ANC) from all 26 regions of Tanzania's mainland from September to December 2020. This cross-sectional study included all pregnant women (≥15 years) on their first ANC visit in the current pregnancy during the survey period. Routine HIV counselling and testing were done at the facility. A multivariable logistic regression model accounting for the survey design was used to examine factors associated with HIV infections.
RESULTS
38,783 pregnant women were enrolled (median age (IQR) = 25 (21-30) years). HIV prevalence was 5.9% (95%CI: 5.3% - 6.6%), ranging from 1.9% in the Manyara region to 16.4% in the Njombe region. Older age, lower and no education, not being in a marital union, and living in urban or semi-urban areas were associated with higher odds of HIV infection. HIV status awareness among women who tested positive was 70.9% (95% CI: 67.5%- 74.0%). ART coverage among those aware of their status was 91.6% (86.5%- 94.9%). Overall, 66.6% (95% CI: 62.4%- 70.6%) of all pregnant women who tested positive for HIV knew their HIV status and were on ART.
CONCLUSION
HIV is increasingly prevalent among pregnant women in Tanzania mainland especially among older, those with lower or no formal education, those outside marital union, and pregnant women living in urban and semi-urban areas. Behind the global fast-target to end HIV/ AIDS, about a third of pregnant women living with HIV initiating ANC were not on ART. Interventions to increase HIV testing and linkage to care among women of reproductive age should be intensified.

Identifiants

pubmed: 37824470
doi: 10.1371/journal.pone.0285962
pii: PONE-D-23-13445
pmc: PMC10569580
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

e0285962

Informations de copyright

Copyright: This is an open access article, free of all copyright, and may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose. The work is made available under the Creative Commons CC0 public domain dedication.

Déclaration de conflit d'intérêts

The authors have declared that no competing interests exist.

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Auteurs

Erick Mboya (E)

Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.

Mucho Mizinduko (M)

Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.

Belinda Balandya (B)

Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.

Jeremiah Mushi (J)

Ministry of Health, Dodoma, Tanzania.

Amon Sabasaba (A)

Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.

Davis Elias Amani (DE)

Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.

Doreen Kamori (D)

Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.

George Ruhago (G)

Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.

Prosper Faustine (P)

Ministry of Health, Dodoma, Tanzania.

Werner Maokola (W)

Ministry of Health, Dodoma, Tanzania.

Veryeh Sambu (V)

Ministry of Health, Dodoma, Tanzania.

Mukome Nyamuhagata (M)

Ministry of Health, Dodoma, Tanzania.

Boniphace S Jullu (BS)

St. Francis University College of Health and Allied Sciences, Morogoro, Tanzania.

Amir Juya (A)

Tanzania Field Epidemiology and Laboratory Training Program, Dar es Salaam, Tanzania.

Joan Rugemalila (J)

Muhimbili National Hospital, Dar es Salaam, Tanzania.

George Mgomella (G)

Centre for Diseases Control, Country Office, Dar es Salaam, Tanzania.

Sarah Asiimwe (S)

Global Fund, Tanzania Country Team, Tanzania.

Andrea B Pembe (AB)

Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.

Bruno Sunguya (B)

Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.

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Classifications MeSH