Mother-to-Child Transmission of HIV in Kenya: Results From a Nationally Representative Study

Sirengo, Martin MBChB, MMed*; Muthoni, Lilly MBChB; Kellogg, Timothy A. MS; A. Kim, Andrea PhD, MPH§; Katana, Abraham MBChB, MSc§; Mwanyumba, Sophie BS; Kimanga, Davies O. MBChB, MMed*; Maina, William K. MBChB, MPH*; Muraguri, Nicolas MBChB, MPH*; Elly, Benjamin MBChB, MMed§; Rutherford, George W. MD, AM; for the KAIS Study Group

JAIDS Journal of Acquired Immune Deficiency Syndromes: 1 May 2014 - Volume 66 - Issue - p S66–S74
doi: 10.1097/QAI.0000000000000115
Supplement Article

Background: Kenya has an estimated 13,000 new infant HIV infections that occur annually. We measured the burden of HIV infection among women of childbearing age and assessed access to and coverage of key prevention of mother-to-child transmission interventions.

Methods: The second Kenya AIDS Indicator Survey was a nationally representative 2-stage cluster sample of households. We analyzed data from women aged 15–54 years who had delivered a newborn within the preceding 5 years and from whom we obtained samples for HIV testing.

Results: Of 3310 women who had ≥1 live birth in the preceding 5 years, 2862 (86.5%) consented to HIV testing in the survey, and 171 (6.1%) were found to be infected. Ninety-five percent received prenatal care, 93.1% were screened for HIV during prenatal care, and of those screened, 97.8% received their test results. Seventy-six women were known to be infected in their last pregnancy. Of these, 54 (72.3%) received antepartum antiretroviral prophylaxis, and 51 (69.1%) received intrapartum prophylaxis; 56 (75.3%) reported their newborns received postpartum prophylaxis. Of the 76 children born to these mothers, 63 (82.5%) were tested for HIV at the first immunization visit or thereafter, and 8 (15.1%) were HIV infected.

Conclusions: We found a substantial burden of HIV in Kenyan women of childbearing age and a cumulative 5-year mother-to-child transmission rate of 15%. Although screening has improved over the past 5 years, fewer than three-quarters of infected pregnant women are receiving antiretroviral prophylaxis. Universal antiretroviral therapy for HIV-infected pregnant women will be essential in achieving Kenyan's target to eliminate mother-to-child transmission to <5% by 2015.

*National AIDS and Sexually Transmitted Infection (STI) Control Programme, Ministry of Health, Nairobi, Kenya;

Field Epidemiology and Laboratory Training Programme, Ministry of Health, Nairobi, Kenya;

Global Health Sciences, University of California, San Francisco, CA;

§Division of Global HIV/AIDS, Center for Global Health, US Centers for Disease Control and Prevention, Nairobi, Kenya; and

National Public Health Laboratory Services, Ministry of Health, Nairobi, Kenya.

Correspondence to: Martin Sirengo, MBChB, MMed, National AIDS and STI Control Programme, Ministry of Health, Kenyatta National Hospital Grounds, 19361-00202 Nairobi, Kenya (e-mail: msirengo@nascop.or.ke).

Kenya AIDS Indicator Survey (KAIS) 2012 was supported by the National AIDS and STI Control Programme (NASCOP), Kenya National Bureau of Statistics (KNBS), National Public Health Laboratory Services (NPHLS), National AIDS Control Council (NACC), National Council for Population and Development (NCPD), Kenya Medical Research Institute (KEMRI), U.S. Centers for Disease Control and Prevention (CDC/Kenya, CDC/Atlanta), United States Agency for International Development (USAID/Kenya), University of California, San Francisco (UCSF), Joint United Nations Team on HIV/AIDS, Japan International Cooperation Agency (JICA), Elizabeth Glaser Paediatric AIDS Foundation (EGPAF), Liverpool Voluntary Counselling and Testing (LVCT), African Medical and Research Foundation (AMREF), World Bank, and Global Fund. This publication was made possible by support from the U.S. President's Emergency Plan for AIDS Relief through cooperative agreements (PS001805, GH000069, and PS001814) from the U.S. Centers for Disease Control and Prevention, Division of Global HIV/AIDS. This work was also funded in part by support from the Global Fund, World Bank, and the Joint United Nations Team for HIV/AIDS.

The findings and conclusions in this article are those of the authors and do not necessarily represent the official position of the U.S. Centers for Disease Control and Prevention and the Government of Kenya.

The authors have no conflicts of interest to disclose.

© 2014 by Lippincott Williams & Wilkins