Tendências na Prevenção da Transmissão Vertical do HIV nas Unidades Sanitárias-Ajuda do PEPFAR em Moçambique, 2017–2023.

Abstract

Introduction: Mozambique implements the prevention of mother-to-child transmission (PMTCT) of HIV as part of the national program since 2022. Despite the gains, vertical transmission rates continue high, estimated at 9% in 2023. We describe the progress of PMTCT in health facilities (HF) with PEPFAR support.

Methods: We analyzed routine data of 656 HF with PEPFAR support, during the 2017 - 2023 fiscal years (October-September). We calculated the following proportions: pregnant women (PW) at first antenatal care consultation (ANC1) that knew their HIV status; HIV positive PW at ANC; PW on antiretroviral treatment (ART); PW on ART with a documented viral load (VL); PW with suppressed VL (VLS, defined as <1.000 copies/ml); HIV exposed children (HEI) tested up to 12 months, with a HIV positive result; HEI positive in ART. Data were analyzed by fiscal year (October - September).

Results: During 2017-2023, the proportion of PW knowing their HIV status at ANC1 increased from 90,4% (863.181/954.933) to 99,9% (1.047.870/1.049.225); the proportion of PW on ART remained above 99%; the proportion of PW with VL test increased from 24,5% (9.862/40.293) to 74,9% (46.292/61.818); and the VLS increased from 51,4% (5.073/9.862) to 88,5% (40.950/46.292). During 2017-2023, HEI testing increased from 76,5% (64.322/84.038) to 96,0% (82.689/86.132), and testing positivity decreased from 8,5% (5.487/64.322) to 2,5% (2.075/82.689); during 2018-2023, the proportion of HIV positive HEI on ART increased from 82,7% (3.521/4.256) to 93,3% (1.936/2.075).

Conclusions: Health facilities with PEPFAR support achieved progress in PMTCT. Continued implementation of sound interventions to improve ART initiation and retention, VLS and ART linkage of HEI testing HIV positive can lead to additional reduction of vertical transmission and its elimination as a public health problem in the country.