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Study: Giving Prep to pregnant women curbs HIV infections

HIV Testing

Test tube with blood sample for HIV genotype test. Pregnant women are more likely to catch the virus and infect their unborn children.

Photo credit: File

What you need to know:

  • Women who are pregnant and living in areas with high rates of HIV are more likely to contract the virus and pass it on to their unborn children.

Providing pre-exposure prophylaxis (Prep) to pregnant women attending antenatal clinics can reduce HIV infections, a new study has shown.

A study published in the National Library of Medicine journal, titled “Pre-exposure prophylaxis uptake and early continuation among pregnant and post-partum women within maternal and child health clinics in Kenya”, found that providing Prep to all pregnant women is just as effective as focusing on those who are at a higher risk of HIV.

Women who are pregnant and living in areas with high rates of HIV are more likely to contract the virus and pass it on to their unborn children.

This, as the National Syndemic Diseases Control Council (NSDCC) said HIV infections in adolescents aged 10 to 19 stand at 88,853 with 3,244 young people in this category contracting the virus.

NSDCC explained that, though the overall number of new HIV infections in the country has dropped by 12,286 from 34,540 in 2021 to 22,154 in 2022, there is an increase in the number of young people contracting the virus based on statistics from those who actually test.

According to NSDCC, their findings further show that the number of people living with the virus reduced by 59,483 from 1,437,267 last year to 1,377,784 this year.

“The number of deaths reduced by 3,900 from 22,373 to 18,473 while HIV prevalence in females was at 5.3 per cent and males 2.6 per cent,” NSDCC boss Ruth Laibon-Masha told Nation in an interview, while highlighting that the number of Kenyans on antiretroviral therapy treatment had gone up by 175,488 from 1,122,334 to 1,297,822.

“Nyanza, Western and Coast regions continue to lead in the number of positive cases.”

“In adults aged 15-24, the number of HIV infections now stands at 145,142 while new HIV infections recorded stand at 7,307,” NSDCC noted while further disclosing that the total number of children orphaned as a result of HIV/AIDs stands at 592,374 with 59,624 children on antiretroviral (ARV) treatment.

The Prep study introduced a new programme to offer Prep in 16 maternal and child health clinics in Kisumu County, with the aim to prevent both HIV acquisition and vertical transmission. The programme was evaluated to determine its effectiveness.

The study assessed 9, 376 pregnant and post-partum women, who were evaluated for behavioural risk factors and their willingness to initiate Prep.

Overall, 2,030 (22 per cent) initiated Prep, and 2,027 had the status of their partner captured of which 79 per cent of the women were living with partners living with HIV while 3,165 women with partners of unknown HIV status, and 11 per cent living with HIV-negative partners.

Out of those who initiated Prep, 786 continued to use Prep after the first month, with 68 per cent of women who had a partner living with HIV continuing use.

Women and girls older than 15 years seeking maternal and child health services who tested HIV negative at that visit or within a month and were willing to receive Prep counselling were interviewed to assess for HIV behavioural risk factors and offered Prep. Correlates of Prep initiation and continuation were assessed.

Women who initiated Prep were followed up one month, three months, and six months after initiation.

“Having a partner living with HIV was the only predictor of Prep continuation at one month. Frequent reasons for discontinuation were side effects and low HIV risk perception. From the findings, no incident HIV infection was reported among women on Prep,” said the study.

The primary outcomes were maternal HIV incidence and appropriate Prep use, defined as the proportion of high-risk participants accepting Prep and low-risk participants declining it.

“Many women attending maternal and child health clinics had risk factors for HIV and elected to use Prep, indicating that routinely accessed maternal and child health clinics can be an effective platform for Prep delivery for young women. As Prep awareness rises, Prep provision in routine clinical settings such as maternal and child health facilities might contribute to decreased HIV incidence among young women,” said the study.