Kheth’Impilo: Adolescent and Young Pregnant Women at Increased Risk of Mother-to- Child Transmission of HIV and Poor Maternal and Infant Health Outcomes: a Cohort Study from, South Africa # MOPDB0103 IAS Melbourne 2014 July Geoff Fatti, Najma Shaikh, Eula Mothibi, Bonaventure Egbujie, Brian Eley, Debra Jackson, Ashraf Grimwood

 South Africa has the highest burden of childhood HIV infection globally, and has high rates of adolescent & youth pregnancy.  To explore risks associated with pregnancy in young HIV- infected women, we compared mother-to-child HIV transmission and maternal & infant health outcomes according to maternal age categories.  A cohort of HIV-positive pregnant women and their infants were followed at three sentinel surveillance facilities in the Nelson Mandela Bay Metropolitan district of South Africa.

 Facilities were supported by Kheth’Impilo, a non-profit organisation that provides HSS initiatives and TA to NDOH  All HIV-positive pregnant women and their infants who attended facilities between Jan 2009 and March 2012 were included.  Routine, individual-level clinical data were captured electronically.  Young women were defined as ≤24 years old and adolescents as ≤19 years.  Multivariable log-binomial and Cox regression were used to compare outcomes between maternal age categories.

956 mother-infant pairs were included, of whom 312 (32.6%) were young women. Of these, 65 (20.8%) were adolescents. The proportion of young pregnant women increased by 23% between 2009/10 and 2011/12. Time till ART initiation after booking

young women (≤ 24 yrs) adolescents (≤ 19 yrs) IncreaseDecrease

 An increasing proportion of pregnant HIV- positive women were young.  Young women had increased MTCT and poorer maternal and infant outcomes.  Interventions targeting young women are increasingly needed to reduce pregnancy, HIV acquisition, MTCT and improve maternal and infant outcomes if South Africa is to attain its millennium development goals.  ISHP has to be more pro-active in increasing access to HCT,FP and barrier methods

This presentation and the data contained herein is made possible by the support of the American People through the United States Agency for International Development (USAID). The contents of this presentation are the sole responsibility of Kheth’Impilo and do not necessarily reflect the views of USAID or the United States Government.