Retention of pregnant women living with HIV across health care levels in Sierra Leone.

IF 1.6 Q4 RESPIRATORY SYSTEM

Public Health Action Pub Date : 2026-03-06 eCollection Date: 2026-03-01 DOI:10.5588/pha.25.0052

I S Turay, A J Bah, T Sesay, D Nair, E Foday, R Samuels, F Lansana, R Zachariah, M Mustapha, J S Kanu, B D Fofanah, F Kanu, J A Koroma, M S Kanu, W K Lahai, M A Sesay, G N Kamara, I F Kamara, S Lakoh

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Abstract

Setting: The study was conducted across three health facilities in Sierra Leone, Princess Christian Maternity Hospital (tertiary), Rokupa Government Hospital (secondary), and George Brook Community Health Centre (primary).

Objectives: To assess retention rates and identify factors associated with continued engagement of pregnant women living with HIV (PWLHIV) in antenatal and postnatal care.

Methods: A retrospective cohort study using 2024 routinely collected antenatal and elimination of mother-to-child transmission (eMTCT) data. Retention during antenatal and postnatal care was retrospectively assessed. Data were analysed, applying Poisson regression models to estimate relative risks.

Results: Of 397 PWLHIV enrolled, 84 (21.1%) were retained in antenatal care and 79 (25.9%) in postnatal care. Higher antenatal retention was linked to being newly diagnosed with HIV (adjusted relative risk [aRR] = 7.67), having no formal education (aRR = 2.99), and older age. These factors also predicted postnatal retention, with adjusted relative risks of 14.30 for newly diagnosed women, 1.34 for older women, and 2.96 for those with no formal education.

Conclusion: Retention of pregnant and postpartum women living with HIV is low. Newly diagnosed, older, and less-educated women have better retention, while younger and already aware women struggle with engagement. We recommend enhanced counselling and targeted re-engagement strategies.

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在塞拉利昂各级卫生保健机构中保留感染艾滋病毒的孕妇。

环境：该研究在塞拉利昂的三个卫生机构进行，分别是基督教公主妇产医院（三级）、Rokupa政府医院（二级）和George Brook社区卫生中心（一级）。目的：评估艾滋病毒感染孕妇（PWLHIV）继续参与产前和产后护理的保留率并确定相关因素。方法：使用2024年常规收集的产前和消除母婴传播（eMTCT）数据进行回顾性队列研究。回顾性评估产前和产后护理期间的滞留情况。对数据进行分析，应用泊松回归模型估计相对风险。结果：入选的397例PWLHIV中，84例（21.1%）保留产前护理，79例（25.9%）保留产后护理。较高的产前滞留与新诊断为艾滋病毒（调整后的相对危险度[aRR] = 7.67）、未接受过正规教育（aRR = 2.99）和年龄较大有关。这些因素也预测了产后滞留，新诊断妇女的调整相对风险为14.30，老年妇女为1.34，未受过正规教育的妇女为2.96。结论：孕妇和产后艾滋病病毒感染者的滞留率较低。新确诊的、年龄较大、受教育程度较低的女性留存率更高，而年龄较小、已经意识到这一点的女性则很难获得留存率。我们建议加强咨询和有针对性的重新参与战略。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Public Health Action RESPIRATORY SYSTEM-

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期刊介绍： Launched on 1 May 2011, Public Health Action (PHA) is an official publication of the International Union Against Tuberculosis and Lung Disease (The Union). It is an open access, online journal available world-wide to physicians, health workers, researchers, professors, students and decision-makers, including public health centres, medical, university and pharmaceutical libraries, hospitals, clinics, foundations and institutions. PHA is a peer-reviewed scholarly journal that actively encourages, communicates and reports new knowledge, dialogue and controversy in health systems and services for people in vulnerable and resource-limited communities — all topics that reflect the mission of The Union, Health solutions for the poor.