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Introduction <p>Globally, about 2.1&#xa0;million children less than 15 years old get infected, and 110,000 die due to HIV/AIDS-related causes. Approximately 50% of HIV-exposed infants (HEI) are retained in Early Infants Diagnosis (EID) services for follow-up testing within the recommended timeframe of 18 months after birth. However, the retention of exposed infants who depend on the adults along their 18-month care cascade remains unknown. This study aimed to assess the retention in care of HEIs at the critical monitoring points of their care cascade and to establish factors associated with infant and maternal factors in order to improve the retention rates.</p> Methods <p>A retrospective cohort study utilizing quantitative methods of data collection was employed. The study examined 366 records of HIV-exposed infants born in 2021 in the Teso Sub-region. Retention rate was determined for 1st, 2nd, and 3rd PCR and rapid tests at 1.5, 9, 13.5, and 18 months, respectively. The Kaplan-Meier curve was used to estimate the retention rates at different time points of follow-up. The Cox proportional regression model was used to establish the factors associated with retention of HIV exposed infants in care.</p> Results <p>The study included 366 HIV-exposed infants (HEIs). The rate of retention was highest at 1.5 months (91.3%) but declined to (89.5%) at 9 months and 13 months (82%) before stabilizing back at 85.8% by 18 months. At multivariate analysis, factors that were significantly associated with retention in care of HIV-exposed infants included district of residence, with retention being higher in Kumi (aHR:1.50 :95%CI: 1.09–2.06) and Serere district compared to Bukedea district (aHR:1.54 :95%CI: 1.14–2.09). Timely EID registration (aHR:0.33 :95%CI: 0.12–0.71) and Timely initiation of Nevirapine prophylaxis (aHR:0.86:95%CI: 0.59–0.97) significantly reduced retention in care of HEIs.</p> Conclusion <p>Retention in care showed an early peak, followed by a gradual decline during mid-follow-up, and later stabilized toward the end of the observation period. The retention in care of HIV-exposed infants was significantly higher among infants residing in Kumi and Serere districts compared to Bukedea. Timely EID registration and timely initiation of Nevirapine prophylaxis significantly reduced retention in care. These findings underscore the importance of strengthening early infant diagnosis while addressing contextual barriers to enhance continuity of care with targeted support to lower-performing districts like Bukedea.</p>

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Retention in care of HIV-exposed infants and associated infant and maternal factors in Teso Sub Region, Eastern Uganda

  • 期刊论文

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  • 发表日期：

    2026年1月30日

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  • Barbara Shalah Logose,
  • Hussein Mukasa Kafeero,
  • Naziru Rashid,
  • Abdul Walusansa,
  • Aremu Abudulmujeeb Babatunde,
  • Kharim Mwebaza Muluya,
  • Agnes Auca,
  • Ziada Nankinga,
  • Pardon Akugizibwe,
  • Swaibu Zziwa

摘要

Introduction

Globally, about 2.1 million children less than 15 years old get infected, and 110,000 die due to HIV/AIDS-related causes. Approximately 50% of HIV-exposed infants (HEI) are retained in Early Infants Diagnosis (EID) services for follow-up testing within the recommended timeframe of 18 months after birth. However, the retention of exposed infants who depend on the adults along their 18-month care cascade remains unknown. This study aimed to assess the retention in care of HEIs at the critical monitoring points of their care cascade and to establish factors associated with infant and maternal factors in order to improve the retention rates.

Methods

A retrospective cohort study utilizing quantitative methods of data collection was employed. The study examined 366 records of HIV-exposed infants born in 2021 in the Teso Sub-region. Retention rate was determined for 1st, 2nd, and 3rd PCR and rapid tests at 1.5, 9, 13.5, and 18 months, respectively. The Kaplan-Meier curve was used to estimate the retention rates at different time points of follow-up. The Cox proportional regression model was used to establish the factors associated with retention of HIV exposed infants in care.

Results

The study included 366 HIV-exposed infants (HEIs). The rate of retention was highest at 1.5 months (91.3%) but declined to (89.5%) at 9 months and 13 months (82%) before stabilizing back at 85.8% by 18 months. At multivariate analysis, factors that were significantly associated with retention in care of HIV-exposed infants included district of residence, with retention being higher in Kumi (aHR:1.50 :95%CI: 1.09–2.06) and Serere district compared to Bukedea district (aHR:1.54 :95%CI: 1.14–2.09). Timely EID registration (aHR:0.33 :95%CI: 0.12–0.71) and Timely initiation of Nevirapine prophylaxis (aHR:0.86:95%CI: 0.59–0.97) significantly reduced retention in care of HEIs.

Conclusion

Retention in care showed an early peak, followed by a gradual decline during mid-follow-up, and later stabilized toward the end of the observation period. The retention in care of HIV-exposed infants was significantly higher among infants residing in Kumi and Serere districts compared to Bukedea. Timely EID registration and timely initiation of Nevirapine prophylaxis significantly reduced retention in care. These findings underscore the importance of strengthening early infant diagnosis while addressing contextual barriers to enhance continuity of care with targeted support to lower-performing districts like Bukedea.