Descriptive Evaluation of Prevention of Mother-to-Child Transmission of HIV Outcomes and Associated Factors in HIV-Exposed Infants at a Tertiary Teaching and Referral Hospital in Kenya

Abstract

Despite substantial scale-up of prevention of mother-to-child transmission (PMTCT) services, vertical HIV transmission remains a public health concern in sub-Saharan Africa. Facility-level evaluations are essential to assess progress toward elimination targets and identify gaps in care. This study evaluated PMTCT outcomes and associated factors among HIV-exposed infants at Nakuru County Teaching and Referral Hospital, Kenya. A retrospective review of records for 141 HIV-exposed infants was conducted, analyzing demographic characteristics, maternal antiretroviral therapy (ART) status, infant prophylaxis, feeding practices, and HIV testing outcomes at 6 weeks, 6 months, 12 months, and 24 months. The mean infant age at enrollment was 6.36 weeks (SD ±1.69), with 51% being female. Maternal ART coverage during PMTCT was 95.8%. All infants underwent HIV testing at 6 weeks, with an HIV positivity rate of 5.0%, while the overall prevalence from 6 to 24 months was 4.3%. Dual infant prophylaxis using nevirapine and zidovudine was administered to 96.5% of infants at 6 weeks, and exclusive breastfeeding was practiced among 97.2% of infants. The findings indicate that HIV prevalence among HIV-exposed infants was below the WHO elimination threshold, reflecting strong PMTCT implementation. However, retention gaps and continued seroconversion highlight the need for strengthened follow-up systems, sustained ART adherence, and reinforced infant feeding counseling to further advance the elimination of pediatric HIV