Progress Towards the 95-95-95 Cascade Among Pregnant Women Living with HIV in Sub-Saharan Africa Open Access

Abstract

Objective: To examine progress toward the UNAIDS 95-95-95 targets for pregnant women living with HIV (PWLH) in Sub-Saharan Africa (SSA) and identify factors associated with meeting these targets.  

Background: Despite attempts to put an end to the HIV epidemic, SSA is disproportionately affected, with PWLH at high risk of vertical transmission. Achieving the UNAIDS 95-95-95 targets by 2030 is critical to eliminating the HIV epidemic, but progress among PWLH in SSA is understudied.

Methods: Data from Population-based HIV Impact Assessment (PHIA) surveys conducted between 2015-2019 in 13 SSA countries were analyzed. PWLH aged 15-44 years were included. Descriptive and multivariable analyses were conducted to assess progress towards the 95-95-95 targets and identify demographic and regional factors associated with achievement.  

Results: Among 693 PWLH, 70.6% were aware of their HIV status, 91.4% were on treatment, and 87.6% achieved viral load suppression. Significant regional disparities were observed, with Southern Africa demonstrating higher achievement than Western and Eastern Africa. Younger PWLH exhibited lower awareness levels. Factors associated with lower awareness, treatment, and viral suppression included younger age and geographic region. Despite high antenatal care attendance, a notable proportion of PWLH were not offered HIV testing during pregnancy. 

Conclusions: Achieving the ambitious UNAIDS 95-95-95 targets by 2030 would require targeted interventions that address regional differences, stigma, and healthcare professional training. Integrating HIV treatment into antenatal services is critical for increasing PWLH awareness and testing rates in SSA, ultimately leading to the elimination of vertical transmission and better mother and child health outcomes. Longitudinal studies with higher sample sizes are required to guide evidence-based interventions and monitor progress over time.

Table of Contents

Introduction - 1

Methods - 4

Results - 8

Discussion - 11

Tables and Figures - 16

References - 25

About this Master's Thesis

Rights statement

• Permission granted by the author to include this thesis or dissertation in this repository. All rights reserved by the author. Please contact the author for information regarding the reproduction and use of this thesis or dissertation.

School	Rollins School of Public Health
Department	Epidemiology
Subfield / Discipline	Epidemiology - MPH & MSPH
Degree	M.P.H.
Submission	Master's Thesis
Language	English
Research Field	Sub Saharan Africa Studies Health Sciences, Epidemiology Women's Studies
Keyword	HIV Antenatal Care Sub-Saharan Africa Pregnant Women
Committee Chair / Thesis Advisor	Bengtson, Angela, Emory University
Committee Members	Laws, Rebecca, CDC

Last modified

Primary PDF

Thumbnail	Title	Date Uploaded	Actions
	Progress Towards the 95-95-95 Cascade Among Pregnant Women Living with HIV in Sub-Saharan Africa ()	2024-04-25 16:09:49 -0400	Press to Select an action Download

Supplemental Files

Thumbnail	Title	Date Uploaded	Actions