Table 3.
Associations between key PMTCT interventions and weighted perinatal infant HIV positive status in HIV exposed infants, South Africa, pooled data 2011–2013
| Indicators | Frequency of HIV exposed infants with PCR results*, n = 5889 (Nw = 762 314) | Frequency of HIV infected infant n = 160, (Nw = 20 130) | Unadjusted OR, (95% CI) | Adjusted OR†, Model 1§ | Adjusted OR†, Model 2|| | Adjusted OR†, Model 3¶ | Adjusted OR‡, final Model** |
|---|---|---|---|---|---|---|---|
|
CD4:†† | |||||||
| ≤350 cells/mm3 |
1682 (224 217) |
35 (3977) |
0.87 (0.51–1.50) |
0.98 (0.42–2.05) |
0.96 (0.46–2.01) |
||
| >350 cells/mm3 |
1927 (258 908) |
35 (5258) |
Ref |
Ref |
Ref |
||
| Missing |
2230 (272 433) |
90 (10 895) |
2.01 (1.30–3.1) |
0.79 (0.40–1.55) |
0.78 (0.40–1.51) |
||
|
Advanced regimen group (as defined in Figure 1): | |||||||
| (1a) |
1472 (187 986) |
19 (2201) |
Ref |
Ref |
Ref |
||
| (1b) |
727 (96 677) |
14 (1638) |
1.45 (0.70–3.005) |
1.84 (0.81–4.18) |
1.82 (0.8–4.1) |
||
| (1c) |
163 (35 699) |
2 (330) |
0.79 (0.18–3.46) |
0.43 (0.05–3.56) |
0.44 (0.05–3.56) |
||
| (1d) |
821 (102 640) |
20 (2619) |
2.21 (1.08–4.52) |
2.06 (0.78–5.44) |
2.07 (0.79–5.43) |
||
| (1e) |
1087 (151 221) |
26 (3515) |
2.01 (1.09–3.7) |
2.43 (1.13–5.23) |
2.37 (1.1–5.15)‡‡ |
||
|
Other ARV regimen group (as defined in Figure 1): | |||||||
| (2a) |
205 (27 856) |
2 (368) |
1.13 (0.25–5.06) |
1.32 (0.25–6.83) |
1.25 (0.24–6.39) |
||
| (2b) |
507 (62419) |
19 (2446) |
3.44 (1.66–7.14) |
4.12 (1.53–11.43) |
4.16 (1.53–11.35)‡‡ |
||
|
No known ARV group (as defined in Figure 1): | |||||||
| (3a) |
63 (8119) |
8 (995) |
11.78 (4.83–28.75) |
9.04 (2.14–38.19) |
9.0 (2.17–37.38)‡‡‖ |
||
| (3b) |
643 (76 929) |
48 (5875) |
7.0 (3.85–12.65) |
11.90 (4.64–30.49) |
11.58 (4.46–30.05)‡‡ |
||
|
Infant feeding practices: | |||||||
| FF |
2212 (289 615) |
46 (6218) |
Ref |
Ref |
Ref |
||
| EBF |
1452 (192 577) |
41 (6044) |
1.77 (1.09–2.87) |
1.98 (1.08–3.66) |
1.80 (0.95–3.42) |
||
| Mixed BF |
365 (46 619) |
12 (1379) |
1.67 (0.88–3.12) |
1.48 (0.76–2.88) |
1.04 (0.52–2.10) |
||
|
Delivery type: | |||||||
| Cesarean |
1322 (178 656) |
31 (4385) |
Ref |
Ref |
Ref |
||
| Vaginal | 4404 (563 637) | 124 (15234) | 0.91 (0.58–1.42) | 0.46 (0.20–1.05) | 0.82 (0.43–1.59) | ||
PMTCT – prevent mother–to–child transmission, EBF – exclusive breastfeeding, FF – formula feeding (no breastmilk), MF – breastfeeding with other fluids or solids, ARV – antiretroviral, CI – confidence interval, OR – odds ratio, Nw – weighted population number, Ref – reference group
*55 (unweighted) exposed infants with missing HIV DNA test results excluded from this analysis.
†Adjusted for maternal age, SES, marital status, education, gestational age at first ANC visit, total number of lifetime pregnancies, whether or not the current pregnancy was planned, province, survey year and whether or not the infant weighed less than 2∙5kg at birth.
‡Adjusted for maternal age, SES, marital status, education, gestational age at first ANC visit, total number of lifetime pregnancies, whether or not the current pregnancy was planned, province, survey year and whether or not the infant weighed less than 2∙5kg at birth.
§Observations used = 3571; –2LL = 107 170; Wald P < 0.0001.
||Observations used = 3571; –2LL = 101 093; Wald P < 0.0001.
¶Observations used = 3571; –2LL = 101 775; Wald P < 0.0001.
**Observations used = 3571; –2LL = 95 350.75; Wald P < 0.0001.
††Self–reported databased on mother’s last CD4 cell count.
‡‡Significant relationship between characteristic and MTCT.