title: Mother-to-child transmission of HIV in Kenya: results from a nationally representative study.
abstract: BACKGROUND
  Kenya has an estimated 13,000 new infant HIV infections that occur annually. We measured the burden of HIV infection among women of childbearing age and assessed access to and coverage of key prevention of mother-to-child transmission interventions.
  
  
  METHODS
  The second Kenya AIDS Indicator Survey was a nationally representative 2-stage cluster sample of households. We analyzed data from women aged 15-54 years who had delivered a newborn within the preceding 5 years and from whom we obtained samples for HIV testing.
  
  
  RESULTS
  Of 3310 women who had ≥1 live birth in the preceding 5 years, 2862 (86.5%) consented to HIV testing in the survey, and 171 (6.1%) were found to be infected. Ninety-five percent received prenatal care, 93.1% were screened for HIV during prenatal care, and of those screened, 97.8% received their test results. Seventy-six women were known to be infected in their last pregnancy. Of these, 54 (72.3%) received antepartum antiretroviral prophylaxis, and 51 (69.1%) received intrapartum prophylaxis; 56 (75.3%) reported their newborns received postpartum prophylaxis. Of the 76 children born to these mothers, 63 (82.5%) were tested for HIV at the first immunization visit or thereafter, and 8 (15.1%) were HIV infected.
  
  
  CONCLUSIONS
  We found a substantial burden of HIV in Kenyan women of childbearing age and a cumulative 5-year mother-to-child transmission rate of 15%. Although screening has improved over the past 5 years, fewer than three-quarters of infected pregnant women are receiving antiretroviral prophylaxis. Universal antiretroviral therapy for HIV-infected pregnant women will be essential in achieving Kenyan's target to eliminate mother-to-child transmission to <5% by 2015.
authors.affiliation: *National AIDS and Sexually Transmitted Infection (STI) Control Programme, Ministry of Health, Nairobi, Kenya; †Field Epidemiology and Laboratory Training Programme, Ministry of Health, Nairobi, Kenya; ‡Global Health Sciences, University of California, San Francisco, CA; §Division of Global HIV/AIDS, Center for Global Health, US Centers for Disease Control and Prevention, Nairobi, Kenya; and ‖National Public Health Laboratory Services, Ministry of Health, Nairobi, Kenya.
authors.forename: Martin
authors.initials: M
authors.lastname: Sirengo
authors.forename: Lilly
authors.initials: L
authors.lastname: Muthoni
authors.forename: Timothy A
authors.initials: TA
authors.lastname: Kellogg
authors.forename: Andrea A
authors.initials: AA
authors.lastname: Kim
authors.forename: Abraham
authors.initials: A
authors.lastname: Katana
authors.forename: Sophie
authors.initials: S
authors.lastname: Mwanyumba
authors.forename: Davies O
authors.initials: DO
authors.lastname: Kimanga
authors.forename: William K
authors.initials: WK
authors.lastname: Maina
authors.forename: Nicolas
authors.initials: N
authors.lastname: Muraguri
authors.forename: Benjamin
authors.initials: B
authors.lastname: Elly
authors.forename: George W
authors.initials: GW
authors.lastname: Rutherford
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D044966:Anti-Retroviral Agents / Q000627:therapeutic use; D003430:Cross-Sectional Studies; D005260:Female; D006679:HIV Seropositivity / Q000175:diagnosis / Q000453:epidemiology* / Q000635:transmission*; D007722:Health Knowledge, Attitudes, Practice; D006306:Health Surveys; D006801:Humans; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control* / Q000706:statistics & numerical data*; D007630:Kenya / Q000453:epidemiology; D050498:Live Birth; D008875:Middle Aged; D018743:Perinatal Care / Q000706:statistics & numerical data; D011247:Pregnancy; D011264:Pregnancy Trimesters; D011295:Prenatal Care / Q000706:statistics & numerical data; D015995:Prevalence; D055815:Young Adult
chemical_list: D044966:Anti-Retroviral Agents
references.citation: J Acquir Immune Defic Syndr. 2010 May 1;54(1):42-50
references.pmid: 20224420
references.citation: Lancet. 2012 Dec 15;380(9859):2095-128
references.pmid: 23245604
references.citation: J Acquir Immune Defic Syndr. 2014 May 1;66 Suppl 1:S27-36
references.pmid: 24732818
references.citation: J Acquir Immune Defic Syndr. 2014 May 1;66 Suppl 1:S3-12
references.pmid: 24732819