Impact of Maternal Factors on Vertical HIV Transmission in Jigawa State, Nigeria: A Multilevel Analysis of Antenatal Care and Knowledge of HIV Status

Abstract

Human immunodeficiency virus (HIV) transmission from mother to child is responsible for over 90% of paediatric acquired immunodeficiency syndrome (AIDS), with Nigerian infants being the most susceptible in the global prevalence ladder. This is due to the prevalence of factors such as late enrolment to the follow-up clinic, rural residence, absence of maternal preventive measures for vertical transmission, and mixed infant feeding practices among HIV positive mothers. This study assessed the impact of mothers’ knowledge of their status, mode of infants feeding at birth, and their uptake of antenatal care (ANC) on Mother-to-child-Transmission (MTCT) of HIV; using data from five General hospitals and one specialist hospital in Jigawa State. A two-level hierarchical model is fitted and the intraclass correlation coefficient (ICC) computed for three (3) key predictor variables namely: Location, number of antenatal care visits, and mothers’ knowledge of their HIV/AIDS status so as to assess clustering structure. The study findings reveal that there exist a 63.4% correlation between the individual level factors and “Location”; ANC visits accounted for 25.9%, while Knowledge of HIV status returns an ICC of 73.8%. These findings show that the likelihood of a vertical transmission in the population is very much influenced by these clustering variables. Hence, proper understanding of MTCT should take into cognisance the impact of mothers’ knowledge of their statuses and other personal characteristics such as their place of residence and ANC uptake.