Predictors of HIV Vertical Transmission in Exposed Infants in Northwest, Ethiopia: A Retrospective Cohort Study

Abstract

Background and Aims: Although the global plan aimed to eliminate mother-to-child transmission of HIV by 2015, an estimated 130,000 children were newly infected, and 84,000 children died from HIV related causes in 2022. In Ethiopia, 3200 children became newly infected and 1,900 children died from HIV related causes in 2022. A new target has now been set for 2030. Vertical transmission remains the predominant route of pediatric HIV infection. This study aimed to assess HIV vertical transmission and its predictors among HIV-exposed infants in Northwest Ethiopia. Methods: -value < 0.05 were considered statistically significant. Results: The rate of vertical transmission of HIV was 3.6%. Mothers residing outside the catchment area (AOR = 4.74; 95% CI: 1.17-20.63) and those not receiving antiretroviral therapy (AOR = 6.82; 95% CI: 1.33-38.73) had significantly higher odds of vertical HIV transmission. Conversely, maternal HIV diagnosis prior to pregnancy (AOR = 0.08; 95% CI: 0.009-0.84), receiving Nevirapine prophylaxis (AOR = 0.14; 95% CI: 0.03-0.65), and delivery at a health facility (AOR = 0.08; 95% CI: 0.01-0.66) were significantly protective against mother-to-child transmission. Conclusion: The rate of vertical HIV transmission was found to be high. Therefore, we recommend further PMTCT service expansion; focus on maternal HIV diagnosis in the preconception period; improve provision of infant Nevirapine prophylaxis and maternal ART help to minimize HIV vertical transmission. Reduce home delivery also helps to decrease HIV vertical transmission.