Predictors of maternal HIV acquisition during pregnancy and lactation in sub-Saharan Africa: A systematic review and narrative synthesis.

Bibliographic Details
Title: Predictors of maternal HIV acquisition during pregnancy and lactation in sub-Saharan Africa: A systematic review and narrative synthesis.
Authors: Lauren A Graybill, Benjamin H Chi, Twaambo E Hamoonga, Margaret Kasaro, Jasmine N Hodges, Brian D Richardson, Jennifer S Bissram, Friday Saidi, Katie R Mollan, Kellie Freeborn, Nora E Rosenberg, Kimberly A Powers, Wilbroad Mutale
Source: PLoS ONE, Vol 19, Iss 12, p e0314747 (2024)
Publisher Information: Public Library of Science (PLoS), 2024.
Publication Year: 2024
Collection: LCC:Medicine
LCC:Science
Subject Terms: Medicine, Science
More Details: ObjectivesTo eliminate vertical transmission of HIV, global institutions recommend using a risk-guided approach for HIV prevention services in antenatal and postnatal settings. Identifying predictors of maternal HIV acquisition can inform the development of risk-guided approaches, but individual studies of predictors can have limited power and generalizability.MethodsWe conducted a systematic review and narrative synthesis to identify common predictors of maternal HIV acquisition in sub-Saharan Africa (SSA). We searched four databases for full-text articles that estimated associations between at least one predictor and risk of HIV acquisition among pregnant and/or lactating women (PLW) in SSA. We restricted our synthesis to predictors assessed in at least four study populations. For these predictors, we summarized how each predictor was defined and used vote counting and descriptive statistics to characterize overall trends.ResultsWe identified 26 eligible publications that summarized results from 24 unique studies. Studies were implemented in 12 countries between 1988 and 2021 and enrolled a total of 164,480 PLW at risk of acquiring HIV. Of the 66 predictors evaluated, 16 met our inclusion criteria. Estimated associations tended to be imprecise and variability in how predictors were measured precluded meta-analyses. We observed trends towards a higher risk of maternal HIV acquisition among young women and women who reported early coital debut, multiple partnerships, sexually transmitted infections, being unaware of partner HIV status, or having a partner living with HIV. In most studies, PLW in stable, monogamous relationships experienced a lower risk of acquiring HIV than those who were single, separated, or in a polygynous marriage. HIV risk perception, condom use, and vaginal drying were also commonly associated with HIV acquisition risk.ConclusionsIn our systematic review and narrative synthesis, we identified several easily measured characteristics that were associated with HIV acquisition among PLW in multiple study populations across SSA. Such findings can support the development and refinement of risk-guided approaches for HIV prevention in the region.
Document Type: article
File Description: electronic resource
Language: English
ISSN: 1932-6203
Relation: https://doaj.org/toc/1932-6203
DOI: 10.1371/journal.pone.0314747
Access URL: https://doaj.org/article/1b8103339d6049cb8782537a37433634
Accession Number: edsdoj.1b8103339d6049cb8782537a37433634
Database: Directory of Open Access Journals
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More Details
ISSN:19326203
DOI:10.1371/journal.pone.0314747
Published in:PLoS ONE
Language:English