title: Declining rate of infection with maternal human immunodeficiency virus at delivery units in north-central Nigeria.
abstract: HIV testing during labour and delivery provides a critical opportunity for administering appropriate interventions to prevent mother-to-child-transmission (PMTCT). We studied current HIV rates and infection trend among women tested during delivery following scale-up of PMTCT and antiretroviral therapy (ART) programs in Jos, north central Nigeria. Between March 2010 and January 2012, provider-initiated HIV testing and counselling was offered in early labour. Women were recruited from a government tertiary health centre, a faith-based hospital, and a private health centre. Those who previously tested HIV negative during antenatal care (ANC) and those who presented at the labour ward with unknown HIV status were tested. A total of 944 subjects (727 re-tested for HIV infection and 217 with unknown HIV status) were enrolled and tested during labour. The HIV incidence and sero-conversion rates during pregnancy among women who repeated HIV testing at delivery was 1.7 per 100 person-years of observation (pyo) and 0.6% (4/727), respectively, while the rate among those who tested for the first time in labour was 1.8% (4/217). Women who accessed ANC were older and had achieved a higher educational status than those who did not access ANC. A 3- to 5-fold decline in HIV incidence and prevalence rates was detected among women tested at delivery when compared to data from a report in 2004. It is not certain whether the decline in maternal HIV infection is due to the major state-wide scale-up of PMTCT and HIV treatment programs. A broader and purposefully designed evaluation study would be required to verify observed occurrence.
authors.forename: Godwin E
authors.initials: GE
authors.lastname: Imade
authors.forename: Atiene S
authors.initials: AS
authors.lastname: Sagay
authors.forename: Jonah
authors.initials: J
authors.lastname: Musa
authors.forename: Amaka N
authors.initials: AN
authors.lastname: Ocheke
authors.forename: David S
authors.initials: DS
authors.lastname: Adeniyi
authors.forename: Monica
authors.initials: M
authors.lastname: Idighri
authors.forename: Rosemary
authors.initials: R
authors.lastname: Powl
authors.forename: Ayuba
authors.initials: A
authors.lastname: Sendeht
authors.forename: Jerry P
authors.initials: JP
authors.lastname: Ogwuche
authors.forename: Michael
authors.initials: M
authors.lastname: Elujoba
authors.forename: Chris O
authors.initials: CO
authors.lastname: Egbodo
authors.forename: Tinuade
authors.initials: T
authors.lastname: Oyebode
authors.forename: Patrick H
authors.initials: PH
authors.lastname: Daru
authors.forename: Oche
authors.initials: O
authors.lastname: Agbaji
authors.forename: Ishaya C
authors.initials: IC
authors.lastname: Pam
authors.forename: Seema T
authors.initials: ST
authors.lastname: Meloni
authors.forename: Prosper
authors.initials: P
authors.lastname: Okonkwo
authors.forename: Phyllis J
authors.initials: PJ
authors.lastname: Kanki
mesh_terms: D000367:Age Factors; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D005260:Female; D015658:HIV Infections / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology* / Q000635:transmission; D006801:Humans; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control*; D008403:Mass Screening; D009549:Nigeria / Q000453:epidemiology; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000175:diagnosis / Q000453:epidemiology; D011295:Prenatal Care; D012959:Socioeconomic Factors
chemical_list: D019380:Anti-HIV Agents