Proportion of HIV exposed infants aged 0-6 months that missed nevirapine prophylaxis in Mulago National Referral Hospital, Uganda: a cross-sectional study.

BACKGROUND: Nevirapine prophylaxis has been found to lower the risk of HIV transmission in breastfed infants. While about 95% of HIV positive pregnant and lactating mothers use Antiretroviral therapy in Uganda, a smaller percentage of HIV exposed infants (HEI) receive nevirapine (NVP) prophylaxis. This study aimed to determine the proportion of HEI who missed NVP prophylaxis and associated factors. METHODS: This was a cross-sectional study done using quantitative methods, conducted at Mulago National Referral Hospital (MNRH). A total of 228 mother-infant pairs were enrolled. The proportion of HEI who missed NVP, maternal, infant and health facility factors associated were determined using a pre-tested questionnaire. Bivariate analysis and binary logistic regression model were used to determine the proportion and factors associated with missing NVP prophylaxis. RESULTS: The proportion of HEI who missed NVP prophylaxis was 50/228 (21.9%). Factors significantly associated with HEI missing NVP prophylaxis included delivery from outside government health facilities (AOR = 8.41; P = 0.001), mothers not undergoing PMTCT counselling (AOR = 12.01; P = 0.001), not on ART (AOR = 8.47; P = 0.003) and not having disclosed their HIV status to their partners (AOR = 2.80; P = 0.001). The HEI that missed nevirapine and were HIV positive were 35 (70.0%). The HEI that were HIV infected despite receiving nevirapine prophylaxis were 5 out of 40(12.5%). CONCLUSION: One in five HEI missed NVP prophylaxis and nearly three quarters of those who missed NVP prophylaxis were HIV infected. Improving uptake of nevirapine by HEI will require interventions that can aid to strengthen PMTCT counselling.

Proportion of HIV exposed infants aged 0-6 months that missed nevirapine prophylaxis in Mulago National Referral Hospital, Uganda: a cross-sectional study.

Background: Nevirapine prophylaxis has been found to lower the risk of HIV transmission in breast-fed infants. While about 95% of pregnant and lactating mothers use Antiretroviral therapy in Uganda, a smaller percentage of HIV exposed infants (HEI)receive nevirapine (NVP)prophylaxis. This study aimed to determine the proportion of HEI whomissed NVP prophylaxis and associated factors. Methods: This was a cross-sectional study done using quantitative methods. It was conducted at Mulago National Referral Hospital. A total of 228mother-infant pairs were enrolled.The proportion of HEI who missed NVP, maternal, infant and health facility factors associated were measured using a pre-tested questionnaire. Bivariate analysis and binary logistic regression model were used to determine the proportion and factors associated with missing NVP prophylaxis. Results: The proportion of HEI who missed NVP prophylaxis was 50/228(21.9%). Factors significantly associated with HEI missing NVP prophylaxis included; delivery from outside government health facilities [AOR=8.41 95% (CI 3.22-21.99)], mothers; not undergoing PMTCT counselling [AOR=12.01 95% (CI 4.53-31.87)], not on ART[AOR=8.47 95% (CI 2.06-34.88)] and not having disclosed their HIV status to their partners [AOR=2.80 95% (CI 1.13-6.95)].The HEI that missed nevirapine and were HIV positive were 35(70.0%). Conclusion: One in five HEI missed NVP prophylaxis and nearly three quarters of those who missed NVP prophylaxis were HIV infected. Improving uptake of nevirapine by HEI will require interventions tostrengthen PMTCT counselling, assisted partner notification, reduction of HIV stigma and support to the private sector in the provision of PMTCT services.

Accuracy of Sexual and Reproductive Health Information among Adolescent Girls: A Cross-Sectional Study.

BACKGROUND: The leading cause of death for girls aged 15-19 years globally is complications from pregnancy and childbirth. Girls have poor access to sexual and reproductive health (SRH) services, including information. STUDY OBJECTIVE: To describe the accuracy of SRH information (SRHI) and its associated factors among adolescent girls in Uganda METHODS: We conducted a cross-sectional study among girls aged 13-19 years in an urban district and a rural district. The accuracy of SRHI was assessed using a set of 13 questions covering "sex and reproduction," "condom use," and "HIV and other sexually transmitted diseases." Accuracy was categorized as low (≤7 items correct), moderate (8-11 items correct), and high accuracy (≥12 items) according to the number of correct answers. Poisson regression analysis was used to determine factors associated with accurate SRHI using STATA version 14. RESULTS: Of the 600 girls (mean age: 16.9 years; SD = 3.84), 75.3% were in school. The mean SRHI knowledge score was 9.9. The SRHI accuracy score was low among 6.3% of adolescents, moderate among 80.7%, and high among 13%. Parents with permissive parenting styles had adolescents with low SRHI accuracy compared with disciplinarian/authoritarian parents (IRR = 0.93 [0.885-0.987]; P = .004), whereas parents talking about sex with their adolescents was associated with accurate SRHI (IRR = 1.1 [1.051-1.153]; P < .001). Adolescents who had ever been pregnant had low SRHI accuracy (0.98 [0.911-0.989]; P = .019). There was no difference in SRHI accuracy between the urban and rural districts (P = .45). CONCLUSION: The low accuracy of SRHI calls for interventions aimed at engaging and training parents, who are considered to be the first in line to provide accurate information to adolescents irrespective of their location. The interventions and training should be culturally appropriate, and parents need to be supported with skills aimed at demystifying SRHI.