Risk Factors for Mother-to-Child Transmission of HIV Infection in Ghana: Evidence from the 2021-2022 HIV Positive Babies Audit

Abstract

Background: Globally, mother-to-child transmission (MTCT) remains the major route of HIV infection in pediatric populations. Sub-Saharan Africa accounts for about 90% of MTCT of HIV worldwide. Ghana has a high rate of MTCT of HIV despite global and national preventive measures that have been carried out over the years to reduce the rate. Objective: This study aimed to examine the risk factors associated with MTCT of HIV in Ghana. Method: A 1:1 unmatched case-control study was conducted using data from the 2021-2022 HIV Positive Babies Audit by the National AIDS/STI Control Programme. A total of 184 cases and 184 controls were included in the study. The data was coded, cleaned with Microsoft Excel 2016 and analysed using Stata IC (version 16.0). Only variables with missing values of 5% or less were used for the regression analyses. After univariable logistic regression analysis, all variables with p values of ≤ 0.20 were entered into multivariable logistic regression analysis. P value < 0.05 was considered statistically significant 95% confidence interval (CI). Results: Not being on antiretroviral (ARV) prophylaxis (AOR=4.35,95% CI:2.41 – 7.83, p < 0.001) and having ARV prophylaxis for less than 12 weeks (AOR=75.70, 95% CI:17.18 – 333.62, p< 0.001) were independently associated with the risk of MTCT of HIV. Conclusion: ARV prophylaxis for the HIV-exposed baby is key for reducing the burden of MTCT of HIV in Ghana. All HIV-exposed babies in Ghana should be put on ARV prophylaxis for 12 weeks.