article · BMC Pregnancy and Childbirth
Programmes aimed at preventing the vertical transmission of HIV seek to stop the virus passing from mothers to infants during pregnancy and breastfeeding. However, maintaining viral suppression remains difficult in resource-constrained environments. A study across 15 health centres in Bugesera District, Rwanda, reviewed records from 508 pregnant and breastfeeding women living with HIV enrolled in transmission prevention services in 2023. The analysis revealed that 8.5% of the women had an unsuppressed viral load, defined as at least 200 copies per millilitre. Higher risks of unsuppressed viral load were linked to mental health issues, attending fewer than four antenatal care visits, past interruptions in antiretroviral therapy, and being married or cohabiting. Addressing these specific challenges through enhanced psychosocial support and improved treatment retention is essential for maternal and child health outcomes.
Preventing mother-to-child HIV transmission depends on keeping maternal viral loads suppressed. Identifying the clinical and social factors that hinder viral control, such as poor mental health and interrupted clinic visits, allows public health programmes to focus resources on targeted support strategies. This helps protect vulnerable infants from infection and improves health outcomes for mothers in resource-constrained healthcare systems.
The abstract does not indicate a direct commercial application pathway, as it reports observational public health research. However, the identified risk factors could inform clinical decision-support tools, patient management software, or targeted psychosocial support interventions for maternal health clinics and health service providers. Such applications would require translation from epidemiological evidence into clinical or digital workflows, placing them at an early stage of operational readiness.
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Abstract Background Prevention of vertical transmission (PVT) of HIV programs are designed to prevent the transmission of HIV during pregnancy and breastfeeding. Nevertheless, attaining viral suppression among mothers living with HIV remains a major challenge, especially in resource-constrained settings like Bugesera District, Rwanda. This study aim to determine the prevalence and determinants of unsuppressed viral load (VL) among pregnant and breastfeeding women living with HIV enrolled in the PVT of HIV program as of 2023. Methods An analytical cross-sectional study using retrospective record review was carried out using secondary data from 508 pregnant and breastfeeding women living with HIV enrolled in the PVT of HIV services in 15 health centres in Bugesera District between January 2023 and December 2023, Data were extracted from patient records and analysed using descriptive statistics, bivariate analysis, and multivariate logistic regression to identify factors associated with an unsuppressed VL (≥ 200 copies/mL). Results Among the 508 pregnant and breastfeeding women living with HIV enrolled in the PVT of HIV services, the prevalence of unsuppressed VL was 8.5% (95% CI: 6.3–11.2). factors associated with unsuppressed VL were mental health problems (adjusted odds ratio [aOR] = 4.7, 95% CI: 2.3–9.5, p < 0.001), low attendance to antenatal care (ANC) (< 4 visits) (aOR = 2.2, 95% CI: 1.1–4.7, p = 0.025), a history of treatment interruption (aOR = 2.4, 95% CI: 1.1–4.9, p = 0.015) and being married or cohabiting (aOR = 2.0, 95% CI: 1.0–4.1, p = 0.035). Conclusion The unsuppression viral load rate among women living with HIV in Bugesera District was high. This study highlights the need of strengthening psychosocial support, increase attendance of antenatal care consultations and improve antiretroviral (ART) retention in the PVT of HIV program, particularly among women who are partnered.
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DOI: 10.1186/s12884-026-09822-7
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