ArticleThe Journal of antimicrobial chemotherapy2022
HIV stigma limits the effectiveness of PMTCT in Guinea: the ANRS 12344-DIAVINA study.
Article in The Journal of antimicrobial chemotherapy, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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4 citing papers in PubMed, 6 citations in OpenAlex.
- Streamlining Stigma Measurement: Validation and Abridgment of the HIV Stigma Scale for Pregnant Women Living with HIV in South Africa.AIDS and behavior · 2026Article
- Pediatric human immunodeficiency virus infection in the modern era: A systematic review of recent advances and their implications.Pediatric investigation · 2025Review
- Facilitators and barriers to community-based HIV testing in Guinea: a CFIR-based implementation analysis.Frontiers in public health · 2025Article
- The impact of stigma and socioeconomic barriers on HIV treatment adherence in Conakry, Republic of Guinea: a gender perspective.The Pan African medical journal · 2025Article
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Authors and funding
14 authors at 11 institutions in 2 countries.
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Abstract
backgroundNearly half of HIV-infected children worldwide are born in West and Central African countries where access to prevention of mother-to-child transmission of HIV (PMTCT) programmes is still limited. WHO recommends reinforced antiretroviral prophylaxis for infants at high risk of mother-to-child transmission of HIV (MTCT) but its implementation needs further investigation in the field.
methodsThe prospective ANRS 12344-DIAVINA study evaluated the feasibility of a strategy combining early infant diagnosis (EID) and reinforced antiretroviral prophylaxis in high-risk infants as identified by interviews with mothers at Ignace Deen Hospital, Conakry, Guinea.
results6493 women were admitted for delivery, 6141 (94.6%) accepted HIV testing and 114 (1.9%) were HIV positive. Among these, 51 high-risk women and their 56 infants were included. At birth, a blood sample was collected for infant EID and reinforced antiretroviral prophylaxis was initiated in 48/56 infants (86%, 95% CI 77%-95%). Iron supplementation was given to 35% of infants for non-severe anaemia. Retrospective measurement of maternal plasma viral load (pVL) at delivery revealed that 52% of women had pVL < 400 copies/mL attributable to undisclosed HIV status and/or antiretroviral intake. Undisclosed HIV status was associated with self-stigmatization (85% versus 44%, P = 0.02). Based on the results of maternal pVL at delivery, 'real' high-risk infants were more frequently lost to follow-up (44% versus 8%, P < 0.01) in comparison with low-risk infants, and this was associated with mothers' stigmatization (69% versus 31%, P < 0.01).
conclusionsReinforced antiretroviral prophylaxis and EID at birth are widely feasible. However, mothers' self-disclosure of HIV status and antiretroviral intake do not allow adequate evaluation of MTCT risk, which argues for maternal pVL measurement near delivery. Furthermore, actions against stigmatization are crucial to improve PMTCT.
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