Upendra Shrestha, Lok Raj Pandey, Man Bahadur Kc, Ali Mirzazadeh, Keshab Deuba
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引用次数: 0
Abstract
Despite global advancements, pregnant women living with HIV in Nepal remain at risk for vertical transmission. This study examined demographic and clinical characteristics, antiretroviral therapy (ART) retention, and transmission outcomes among this population. A retrospective cohort analysis was conducted using data from Nepal's national electronic HIV register, including 322 women who became pregnant between 2020 and 2023. We analyzed sociodemographic profiles, clinical status at diagnosis, ART initiation timing, retention rates at 6, 12, and 24 months, and infant HIV status. The mean age was 26.9 years; over half (56.2%) were aged 25-39 years. Nearly 40% were illiterate, 87.6% unemployed, and 66.8% reported unsafe sexual behavior as the mode of HIV transmission. Over half (58.1%) were diagnosed prior to pregnancy, and 75.5% were in WHO Stage 1. ART began on the same day in 34.8% and within a week in 40.1%, with 56.8% already on ART during pregnancy. Retention was high: 96.9% at 6 months, 94.8% at 12 months, and 96.0% at 24 months. Vertical transmission occurred in 4.3% of pregnancies. Higher transmission rates were observed among younger mothers (6.9%), Dalit women (11.5%), those in advanced HIV stages (11.1%), with delayed ART initiation (8.6%), high viral loads (13.3%), and home deliveries (17.6%). In Nepal, approximately 1 in 23 infants born to women living with HIV still acquire the infection. Strengthening early diagnosis, improving ART uptake, and addressing disparities in care especially among high-risk groups are essential to eliminating vertical transmission and improving maternal and child health outcomes.
期刊介绍:
The Journal of Community Health is a peer-reviewed publication that offers original articles on research, teaching, and the practice of community health and public health. Coverage includes public health, epidemiology, preventive medicine, health promotion, disease prevention, environmental and occupational health, health policy and management, and health disparities. The Journal does not publish articles on clinical medicine. Serving as a forum for the exchange of ideas, the Journal features articles on research that serve the educational needs of public and community health personnel.