ArticleJournal of the International AIDS Society2022
Cross-sectional trends in HIV prevalence among pregnant women in Botswana: an opportunity for PrEP?
Article in Journal of the International AIDS Society, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed, 12 citations in OpenAlex.
- Optimizing Identification and Care of Pregnant/Breastfeeding Women Living With HIV in Resource-Limited Settings.Journal of the International AIDS Society · 2026Article
- Uptake and retention in HIV care among pregnant and postpartum women living with HIV under different eras of vertical transmission prevention policies in sub-Saharan Africa: a systematic review and meta-analysis.medRxiv : the preprint server for health sciences · 2026Article
- Sociodemographic and obstetric determinants of HIV infection among pregnant women in Cameroon: a contribution toward the elimination of vertical transmission in low- and middle-income countries.BMC infectious diseases · 2026Article
- Epidemiological, clinical, and biological profiles of People Living With HIV in the PMTCT department of Panzi hospital: a retrospective cohort study in Eastern DR. Congo.AIDS research and therapy · 2025Article
- Alterations of the Upper Respiratory Microbiome Among Children Living With HIV Infection in Botswana.The Journal of infectious diseases · 2025Article
- Over a decade of HIV infection prevalence and incidence among Mozambican pregnant women: a secondary analysis of prospectively collected data.BMC public health · 2025Article
- Oral HIV pre-exposure prophylaxis use among pregnant and postpartum women: results from real-world implementation in Lesotho.Frontiers in reproductive health · 2023Article
- Association of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Infection With Maternal Mortality and Neonatal Birth Outcomes in Botswana by Human Immunodeficiency Virus Status.Obstetrics and gynecology · 2023Article
- Improving access to HIV testing for pregnant women in community birth centres in Nigeria: an evaluation of the Prevention of Mother-to-Child Transmission program.Therapeutic advances in infectious diseaseArticle
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Authors and funding
11 authors at 4 institutions in 3 countries.
Funding
Abstract
introductionYoung women in sub-Saharan Africa are at particularly high risk of HIV acquisition. Recent shifts towards "test and treat" strategies have potential to reduce transmission in this age group but have not been widely studied outside of clinical trials. Using data from nationwide surveillance among pregnant women in Botswana, where a "test and treat" program was implemented in 2016, we describe trends in HIV prevalence over time and highlight opportunities for targeted prevention.
methodsThe Tsepamo study abstracted data from obstetric records of all women delivering at eight government hospitals in Botswana between 2015 and 2019, accounting for 45% of all births in the country (n = 120,755). We used a stratified analysis to identify prevalence trends and evaluated decreases in HIV prevalence over time using the Cochrane-Armitage test for linear trend. A multivariable logistic regression analysis was also performed to identify factors associated with declines in HIV prevalence.
resultsOverall HIV prevalence was 24.1% among 120,755 women who delivered during the study period. Prevalence differed by site of delivery, ranging from 16.1% to 28.2%, and increased markedly with age. Lower educational attainment (adjusted odds ratio [aOR] = 3.28; 95% confidence interval [CI] 3.07-3.50) and being unmarried (aOR = 1.98; 95% CI 1.88-2.08) were associated with HIV infection. HIV prevalence was 10.0% with a first pregnancy, 21.0% with a second and 39.2% with a third or greater (aOR = 2.20; for any prior pregnancy; 95% CI 2.10-2.29). The same age-adjusted trends were seen when data were limited to women aged 15-24, with a two- to three-fold increase in HIV prevalence between a first and third pregnancy. Prevalence decreased linearly during the 5-year study period from 25.8% to 22.7% (p <0.001). Among age-specific strata, the greatest absolute decline occurred in those aged 35-39, with an 8.7% absolute decrease in HIV prevalence from 2015 to 2019. Minimal declines were seen in those 15-24, with a decrease of only 1.5% over the same period.
conclusionsWhile overall trends in Botswana show HIV prevalence declining among pregnant women, prevalence among the youngest age group has remained stagnant. Preventative interventions utilizing pre-exposure prophylaxis should be prioritized during the high-risk period surrounding a woman's first pregnancy.
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