Background. Many countries are working to reduce or eliminate mother-to-child transmission (MTCT) of HIV. Prevention efforts\nhave been conceptualized as steps in a cascade but cascade completion rates during and after pregnancy are low. Methods. A\ncross-sectional survey was performed across 26 communities in Cameroon, Cote dââ?¬â?¢Ivoire, South Africa, and Zambia. Women\nwho reported a pregnancy within two years were enrolled. Participant responses were used to construct the PMTCT cascade with\nall of the following steps required for completion: at least one antenatal visit, HIV testing performed, HIV testing result received,\ninitiation of maternal prophylaxis, and initiation of infant prophylaxis. Factors associated with cascade completion were identified\nusing multivariable logistic regression modeling. Results. Of 976 HIV-infected women, only 355 (36.4%) completed the PMTCT\ncascade. Although most women (69.2%) did not know their partnerââ?¬â?¢s HIV status; awareness of partner HIV status was associated\nwith cascade completion (aOR 1.4, 95% CI 1.01ââ?¬â??2.0). Completion was also associated with receiving an HIV diagnosis prior to\npregnancy compared with HIV diagnosis during or after pregnancy (aOR 14.1, 95% CI 5.2ââ?¬â??38.6). Conclusions. Pregnant women\nwith HIV infection in Africa who were aware of their partnerââ?¬â?¢s HIV status and who were diagnosed with HIV before pregnancy\nwere more likely to complete the PMTCT cascade.
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