Background: Mother-to-child transmission of HIV (MTCT) is when Human Immune deficiency Virus (HIV) of positive mother passes the virus to her baby. Without intervention transmission rate of HIV ranges from 15% to 45%, which can be reduced to below 5% with effective intervention. In Ethiopia, final mother-to-child transmission rate was 15% in 2016 which is much higher than target of the country to reduce transmission to lower than 5% by 2020. Aim of the study is to identify determinants of transmission of HIV from mother to child in West Shoa zone of Oromiya Region which has total population more than 2.1 million.
Methods: Mixed methods: unmatched case-control study among children tested HIV positive and negatives at the end of PMTC follow up; N=96(24 cases, 72 controls) and one-on-one questioner for mothers of positive infant conducted during June to August 2019; focusing on PCR done during the last two years (June 2017 to July 2019), in public hospitals. Variables of interest were collected using structured and semi-structured questioner and data abstraction forms from mothers of exposed infants, medical records of mothers and children.
Result: Majority among cases(70.8%) were not included in to option B+ program. Home delivery increases 6 times chance of HIV, AOR = 6.0; CI (1.5–29.2), none inclusion in to option B+ increase 18 chance of HIV transmission, AOR = 18.0; CI (5.0–68.1). Partner noninvolvement to HIV care increases chance of transmission by 7.3 times, AOR=7.3; CI(1.1–37.4). Mother-to- mother support program decrease chance of transmission by 86.5% with AOR = 0.13; CI (0.11–0.39). Poor ANC knowledge and practices among rural residents and unstable marriage in urban residents contributed to unaware MTCT of HIV.
Conclusion: ART clinics should focus on and strengthen mother-to-mother support program, should create space for partner involvement to HIV care and provide training for Health Extension Workers(HEW). Health education and awareness creation should be implemented by HEW to improve ANC practice, reduce home delivery and increase voluntary counseling and testing among residents.