Factors Associated with HIV Viral Load Testing Uptake among Pregnant and Lactating Women in Iringa Municipal, Tanzania


Authors : John Roman; Rose Mpembeni; Mucho Mizinduko

Volume/Issue : Volume 10 - 2025, Issue 3 - March


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DOI : https://doi.org/10.38124/ijisrt/25mar1074

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Abstract : Background: Vertical transmission of HIV in Tanzania and Iringa Municipal is still high with 11% HIV exposed infant born with HIV despite great effort done to reach elimination vertical transmission. This could be contributed by multiple factors; poor monitoring of HIV positive women is among the major contributing factor. There is currently a poor uptake of HIV viral load testing among pregnant and lactating women living with HIV compared to the general population getting HIV care and treatment despite efforts made by the World Health Organization (WHO).  Objectives: This study was aiming at determining the proportional and factors associated with HIV viral load testing among pregnant and lactating women living with HIV in Iringa Municipal.  Method and Materials: The Study design was facility based cross sectional in Iringa Municipal council. A total of 320 pregnant and lactating women who attended PMTCT services between 1st July and 31st July 2022 were interviewed. More information about client’s HIV viral load testing was extracted from clients’ cards and database. Descriptive statistic was done using frequency distributions, means/median, interquartile range while bivariable analysis was done by using logistic regression model to measure association of different variables with HIV viral load testing. All variables which had a p-value of less than 0.25 were subjected into multivariable analysis by using modified Poisson regression with robust standard error while adjusting for confounders.  Results: Out of 320 participants 163(50.9%) had HIV viral load tested within the past six months prior to the interview date. Pregnant and lactating women living with HIV who had understanding of when they are supposed to be tested for HIV viral load had 36% prevalence more to be tested for HIV viral load compared to those who do not understand. (aPR=1.358; p=0.015; 95%CI 1.065-1.737). Pregnant and lactating women living with HIV who receive PMTCT services from hospital and health center have 38% and 30% higher prevalence respectively for testing HIV viral load compared to those who receive at dispensary level. Hospital HVL testing (aPR=1.383; p=0.014; 95%CI=1.068 -1.79) and HVL testing at Health Center (aPR=1.299; p=0.047; 95%CI =1.004 -1.681).  Conclusion and Recommendation The proportional of HIV viral load testing among pregnant and lactating women (50.9%) found in this study is far below WHO recommendation. Predictive factor associated with low HIV viral load testing were clients understanding of when they are supposed to be testing for HIV viral load as well as level facilities. Tanzania Ministry of Health and Iringa Municipal council should consider identified factors to address low HIV viral load testing among HIV positive pregnant and breastfeeding women.

Keywords : HIV Viral Load Testing, Pregnant and Lactating Women Living with HIV, Uptake.

References :

  1. Office of AIDS Research (OAR) - HIVinfo N, Info C. GLOSSARY of HIV/AIDS-Related Terms 2021 • 9TH EDITION Offering information on HIV/AIDS treatment, prevention, and research. 2021;9th Editio:2,76.
  2. UNAIDS. Global AIDS Update 2018 Miles To Go: Closing Gaps Breaking Barriers Righting Injustices. Unaids [Internet]. 2018;pg 6:http://www.unaids.org/sites/default/files/media_as. Available from: http://www.unaids.org/sites/default/files/media_asset/miles-to-go_en.pdf
  3. UNICEF. Addressing the Global HIV Epidemic Among Pregnant Women , Mothers , Children and Adolescents. 2018;1–19.
  4. UNAIDS. On the to end AIDS. 2016; Available from: https://hlm2016aids.unaids.org/index.php/en/home/#:~:text=ON ENDING AIDS The 2016 High-Level Meeting on,aims to achieve ambitious targets by 2020%2C including%3A
  5. Yotebieng M, Mpody C, Ravelomanana NLR, Tabala M, Malongo F, Kawende B, et al. HIV viral suppression among pregnant and breastfeeding women in routine care in the Kinshasa province: a baseline evaluation of participants in CQI-PMTCT study. J Int AIDS Soc. 2019;22(9):1–12.
  6. Plan M. The United Republic of Tanzania, NATIONAL GUIDELINES FOR THE MANAGEMENT OF HIV AND AIDS 7th Edition. Development. 2019;7(5,371,780,231.09):2,274,923,575.00-29.08.
  7. Musanhu CCC, Takarinda KC, Shea J, Chitsike I, Eley B. Viral load testing among pregnant women living with HIV in Mutare district of Manicaland province, Zimbabwe. AIDS Res Ther [Internet]. 2022;19(1):1–11. Available from: https://doi.org/10.1186/s12981-022-00480-1
  8. Verlain E, Kafack F, Id JF, Nana TN, Saniotis A, Halle-ekane GE. Evaluation of plasma viral-load monitoring and the prevention of mother-to-child transmission of HIV-1 in three health facilities of the Littoral region of Cameroon. 2022;2019:1–12. Available from: http://dx.doi.org/10.1371/journal.pone.0277271
  9. Awungafac G, Amin ET, Fualefac A, Takah NF, Agyingi LA, Nwobegahay J, et al. Viral load testing and the use of test results for clinical decision making for hiv treatment in Cameroon: An insight into the clinic-laboratory interface. PLoS One. 2018;13(6):3–7.
  10. Myer L, Essajee S, Broyles LN, Watts DH, Lesosky M, El-Sadr WM, et al. Pregnant and breastfeeding women: A priority population for HIV viral load monitoring. PLoS Med. 2017;14(8):1–7.
  11. Sandbulte M, Brown M, Wexler C, Maloba M, Gautney B, Goggin K, et al. Maternal viral load monitoring: Coverage and clinical action at 4 Kenyan hospitals. PLoS One. 2020;15(5):1–12.
  12. Sha B, Tierney C, Cohn S, Sun X, Coombs R, Frenkel L, et al. Postpartum viral load rebound in HIV-1-infected women treated with highly active antiretroviral therapy: AIDS clinical trials group protocol A5150. HIV Clin Trials. 2011;12(1):9–23.
  13. Luoga E, Vanobberghen F, Bircher R, Nyuri A, Ntamatungiro AJ, Mnzava D, et al. Brief report: No HIV transmission from virally suppressed mothers during breastfeeding in rural Tanzania. J Acquir Immune Defic Syndr. 2018;79(1):E17–20.
  14. Onoya D, Nattey C, Jinga N, Mongwenyana C, Sherman G. Time of HIV diagnosis, CD4 count and viral load at antenatal care start and delivery in South Africa. PLoS One. 2020;15(2):1–14.
  15. Thinn KK, Thekkur P, Kyaw NTT, Aye NS, Zaw TM, Soan P, et al. Uptake of routine viral load testing among people living with HIV and its implementation challenges in Yangon region of Myanmar: A mixed-methods study. BMJ Open. 2019;9(12):1–10.
  16. Bispo S, Chikhungu L, Rollins N, Siegfried N, Newell ML. Postnatal HIV transmission in breastfed infants of HIV-infected women on ART: A systematic review and meta-analysis. J Int AIDS Soc. 2017;20(1):1–8.
  17. Moyo F, Mazanderani AH, Kufa T, Sherman GG. Maternal HIV viral load testing during pregnancy and postpartum care in Gauteng Province, South Africa. South African Med J. 2021;111(5):469–73.
  18. Humphrey JM, Songok J, Ofner S, Musick B, Alera M, Kipchumba B, et al. Retention in care and viral suppression in the PMTCT continuum at a large referral facility in western Kenya. 2022;3494–505.
  19. Melissa H. Watt1, Cody Cichowitz1, 2, Godfrey Kisigo1, 3, Linda Minja3, Brandon A. Knettel1, Elizabeth T. Knippler1, James Ngocho4, 5, Preeti Manavalan1, and Blandina T. Mmbaga1, 3, 4 5 1Duke. Predictors of postpartum HIV care engagement for women enrolled in prevention of mother-to-child transmission (PMTCT) programs in Tanzania. PMC 2020 June 01 Publ. 2020;31(6): 687(31(6): 687–698. doi:10.1080/09540121.2018.1550248. Predictors).
  20. Vrazo AC, Firth J, Amzel A, Sedillo R, Ryan J, Phelps BR. Interventions to significantly improve service uptake and retention of HIV-positive pregnant women and HIV-exposed infants along the prevention of mother-to-child transmission continuum of care: systematic review. Trop Med Int Heal. 2018;23(2):136–48.
  21. ML M, (Anova Health Institute, Johannesburg SA. Improving viral load uptake in primary healthcare facilities. :674.
  22. Lecher SL, Fonjungo P, Ellenberger D, Toure CA, Alemnji G, Bowen N. HIV Viral Load Monitoring Among Patients Receiving Antiretroviral Therapy — Eight Sub-Saharan Africa Countries , 2013 – 2018. 2021;70(21):775–8.
  23. Newman H, Hardie D. HIV-1 viral load testing in resource-limited settings: Challenges and solutions for specimen integrity. Rev Med Virol. 2021;31(2):1–6.
  24. Srivastava M, Sullivan D, Phelps BR, Modi S, Broyles LN. Boosting ART uptake and retention among HIV-infected pregnant and breastfeeding women and their infants: The promise of innovative service delivery models. J Int AIDS Soc. 2018;21(1):2016–9.
  25. Okonji JA, Zeh C, Weidle PJ, Williamson J, Akoth B, Masaba RO, et al. CD4, viral load response, and adherence among antiretroviral-naive breast-feeding women receiving triple antiretroviral prophylaxis for prevention of mother-to-child transmission of HIV in Kisumu, Kenya. J Acquir Immune Defic Syndr. 2012;61(2):249–57.
  26. Points KEY. Prevention of mother-to-child transmission ( PMTCT ) of HIV. 2018;
  27. Nakalega R, Mukiza N, Kiwanuka G, Makanga-Kakumba R, Menge R, Kataike H, et al. Non-uptake of viral load testing among people receiving HIV treatment in Gomba district, rural Uganda. BMC Infect Dis. 2020;20(1):4–9.
  28. Nyakura J, Shewade HD, Ade S, Mushavi A, Mukungunugwa SH, Chimwaza A, et al. Viral load testing among women on ‘option B+’ in Mazowe, Zimbabwe: How well are we doing? PLoS One. 2019;14(12):1–14.
  29. Atuhaire P, Matovu F, Nakalega R, Kataike H, Nabwana M, Lukyamuzi Z, et al. Time to first viral load testing among pregnant women living with HIV initiated on option B+ at 5 government clinics in Kampala city, Uganda: Retrospective cohort study. Int J Infect Dis [Internet]. 2021;104:526–31. Available from: https://doi.org/10.1016/j.ijid.2021.01.005

Background: Vertical transmission of HIV in Tanzania and Iringa Municipal is still high with 11% HIV exposed infant born with HIV despite great effort done to reach elimination vertical transmission. This could be contributed by multiple factors; poor monitoring of HIV positive women is among the major contributing factor. There is currently a poor uptake of HIV viral load testing among pregnant and lactating women living with HIV compared to the general population getting HIV care and treatment despite efforts made by the World Health Organization (WHO).  Objectives: This study was aiming at determining the proportional and factors associated with HIV viral load testing among pregnant and lactating women living with HIV in Iringa Municipal.  Method and Materials: The Study design was facility based cross sectional in Iringa Municipal council. A total of 320 pregnant and lactating women who attended PMTCT services between 1st July and 31st July 2022 were interviewed. More information about client’s HIV viral load testing was extracted from clients’ cards and database. Descriptive statistic was done using frequency distributions, means/median, interquartile range while bivariable analysis was done by using logistic regression model to measure association of different variables with HIV viral load testing. All variables which had a p-value of less than 0.25 were subjected into multivariable analysis by using modified Poisson regression with robust standard error while adjusting for confounders.  Results: Out of 320 participants 163(50.9%) had HIV viral load tested within the past six months prior to the interview date. Pregnant and lactating women living with HIV who had understanding of when they are supposed to be tested for HIV viral load had 36% prevalence more to be tested for HIV viral load compared to those who do not understand. (aPR=1.358; p=0.015; 95%CI 1.065-1.737). Pregnant and lactating women living with HIV who receive PMTCT services from hospital and health center have 38% and 30% higher prevalence respectively for testing HIV viral load compared to those who receive at dispensary level. Hospital HVL testing (aPR=1.383; p=0.014; 95%CI=1.068 -1.79) and HVL testing at Health Center (aPR=1.299; p=0.047; 95%CI =1.004 -1.681).  Conclusion and Recommendation The proportional of HIV viral load testing among pregnant and lactating women (50.9%) found in this study is far below WHO recommendation. Predictive factor associated with low HIV viral load testing were clients understanding of when they are supposed to be testing for HIV viral load as well as level facilities. Tanzania Ministry of Health and Iringa Municipal council should consider identified factors to address low HIV viral load testing among HIV positive pregnant and breastfeeding women.

Keywords : HIV Viral Load Testing, Pregnant and Lactating Women Living with HIV, Uptake.

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