title: PMTCT Service Uptake Among Adolescents and Adult Women Attending Antenatal Care in Selected Health Facilities in Zimbabwe.
abstract: Age-disaggregated analyses of prevention of mother-to-child transmission (PMTCT) program data to assess the uptake of HIV services by pregnant adolescent women are limited but are critical to understanding the unique needs of this vulnerable high-risk population.
  
  
  
  We conducted a retrospective analysis of patient-level PMTCT data collected from 2011 to 2013 in 36 health facilities in 5 districts of Zimbabwe using an electronic database. We compared uptake proportions for PMTCT services between adolescent (≤19 years) and adult (>19 years) women. Multivariable binomial regression analysis was used to estimate the association of the women's age group with each PMTCT service indicator.
  
  
  
  The study analyzed data from 22,215 women aged 12-50 years (22.5% adolescents). Adolescents were more likely to present to antenatal care (ANC) before 14 weeks of gestational age compared with older women [adjusted relative risk (aRR) = 1.34; 95% confidence interval: 1.22 to 1.47] with equally low rates of completion of 4 ANC visits. Adolescents were less likely to present with known HIV status (aRR = 0.34; 95% confidence interval: 0.29 to 0.41) but equally likely to be HIV tested in ANC. HIV prevalence was 5.5% in adolescents vs 20.1% in adults. While >84% of both HIV-positive groups received antiretroviral drugs for PMTCT, 44% of eligible adolescents were initiated on antiretroviral therapy vs 51.3% of eligible adults, though not statistically significant.
  
  
  
  Pregnant adolescents must be a priority for primary HIV prevention services and expanded HIV treatment services among pregnant women to achieve an AIDS-free generation in Zimbabwe and similar high HIV burden countries.
authors.affiliation: *Elizabeth Glaser Pediatric AIDS Foundation, Harare, Zimbabwe; †Research Department, Elizabeth Glaser Pediatric AIDS Foundation, Washington, DC; ‡AIDS and TB Unit, Zimbabwe Ministry of Health and Child Care, Harare, Zimbabwe; and §Department of Epidemiology and Biostatistics, Milken Institute School of Public Health, George Washington University, Washington, DC.
authors.forename: Reuben
authors.initials: R
authors.lastname: Musarandega
authors.forename: Rhoderick
authors.initials: R
authors.lastname: Machekano
authors.forename: Memory
authors.initials: M
authors.lastname: Chideme
authors.forename: Cephas
authors.initials: C
authors.lastname: Muchuchuti
authors.forename: Angela
authors.initials: A
authors.lastname: Mushavi
authors.forename: Agnes
authors.initials: A
authors.lastname: Mahomva
authors.forename: Laura
authors.initials: L
authors.lastname: Guay
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000517:prevention & control / Q000635:transmission*; D006268:Health Facilities / Q000706:statistics & numerical data*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control*; D008297:Male; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000188:drug therapy*; D011295:Prenatal Care / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D015030:Zimbabwe / Q000453:epidemiology