Knowledge of HIV status among mothers accompanying their infants for immunization in Machakos, Kenya, 2014.

Background: Elimination of mother-to-child transmission of HIV is achievable through prevention of mother-to-child transmission (PMTCT) interventions. For HIV-positive mothers to access PMTCT services, they must be identified through HIV testing and counseling. We sought to measure the proportion of mothers with unknown HIV status and to determine associated factors. Methods: We recruited into a cross-sectional study 400 mothers accompanying their infants for routine immunization at mother-child health clinic (MCH) at Machakos Hospital, Kenya, collected information on HIV testing from their antenatal records, and offered opt-out HIV testing to those with unknown HIV status. Results: Overall, 304 (76.0%) mothers had unknown status at MCH, of whom 25 (8.6%) tested HIV-positive. HIV positivity was three times higher among mothers who never tested during pregnancy/delivery versus those whose last negative HIV test was >3 months prior to study enrolment (18% versus 6%). Women living more than three kilometers away from the health facility had 2.7-fold greater odds of having unknown status compared to those who lived less than three kilometers (adjusted odds ratio [AOR] 2.7, 95% CI 1.3-5.6). Married women had 3.2-fold greater odds of having unknown status as compared to those who were single (AOR 3.2, 95% CI 1.4-7.0). Those with education had a tenfold reduction in odds of having unknown status compared to those with none (AOR 0.1, 95% CI 0.0-0.2). Conclusion: Interventions are needed to improve women's ANC attendance, uptake of HIV testing, and disclosure of HIV status during pregnancy to achieve the elimination of MTCT.