Predictors of HIV Testing Positive Result Among Pregnant Women Attending Prenatal Clinics in the Democratic Republic of Congo

Abstract

Since it began in 2003, HIV/AIDS surveillance in Democratic Republic of the Congo has been mainly carried out among pregnant women attending antenatal clinics. In addition to screening for syphilis and HIV, some demographic, behavioral, and obstetrical data are also collected. This work aimed to identify the factors associated with a positive HIV test result from the demographic and medico-obstetrical data collected at the time of surveillance-based HIV testing among pregnant women attending sentinel sites in DRC. The HIV surveillance database among pregnant women was obtained from the National AIDS Control Program of DRC. The association between the HIV test result and the factors studied was assessed by the adjusted Odds Ratio (AOR), through a logistic regression of HIV serology on these potential factors. From 2003 to 2013, 109,553 pregnant women were screened for HIV in the DRC surveillance sites. The regression of the HIV test result on the possible factors showed among others that: (i) primary or secondary education was associated with a higher odd of test positivity (AOR: 1.51, 95% CI: 1.13 - 2.03 and 1.41, 95% CI 1.05 - 1.89 respectively) compared to the higher/university level of education; (ii) the sexual debut before age 15 (AOR: 1.33, 95% CI: 1.21 - 1.46) or between 15 and 17 years of age (AOR: 1.18, 95% CI: 1.09 - 1.28) was associated with a positive test result in comparison to age 18 and older; and (iii) the presence of an active syphilis infection was associated with a twofold increase in HIV positive test result odd (AOR: 2.01, 95% CI: 1, 77-2.29). Primary prevention efforts against HIV infection in DRC should include delaying sexual debut, encouraging complete formal education of women, and preventing and adequately managing sexually transmissible infections.