Maternal and child health outcomes in rural South African mothers living with and without HIV

ABSTRACT

In the era of widespread antiretroviral therapy (ART), consequences of being HIV-exposed is unclear for children, especially in rural communities. A population sample of consecutive births (470/493) in the Eastern Cape of South Africa (SA) were recruited and reassessed at five points over the first 24 months. Maternal and child outcomes between mothers living with and without HIV were assessed using multiple linear and logistic regressions. At birth, 28% of the sample was mothers living with HIV and five additional mothers seroconverted. All mothers living with HIV reported taking ART. The rate of depressed mood and IPV was similar across serostatus. However, mothers living with HIV significantly decreased their alcohol use after learning about their pregnancy and were more likely to exclusively breastfeed when compared to mothers without HIV. Despite maternal HIV status, children had similar growth across the first 24 months of life. Future work is needed to assess if these developmental trajectories will persist.

KEYWORDS:

• HIV exposed children
• HIV
• rural
• South Africa
• exclusive breastfeeding

Disclosure statement

No potential conflict of interest was reported by the authors.

ORCID

Karl W. le Roux http://orcid.org/0000-0002-0554-2111

Joan Christodoulou http://orcid.org/0000-0001-6997-1567

Mark Tomlinson http://orcid.org/0000-0001-5846-3444

Mary Jane Rotheram-Borus http://orcid.org/0000-0001-6395-5187

Notes

1. Option A involved: for mothers with a CD4 of <350, full ART was offered for life. Mothers with a CD4 greater that 350 were given AZT twice daily until birth, with a dose of Truvada®, given at them time of going into labor. Infants were given NVP syrup until the cessation of breastfeeding.

Additional information

Funding

This study was funded by the National Institute of Mental Health (NIMH); [grant number R01MH111391], the Center for HIV Identification, Prevention and Treatment Services (CHIPTS); [grant number P30MH058107], the National Institute on Alcohol Abuse and Alcoholism (NIAAA); [grant numbers R01AA017104 and R24AA022919], the Postdoctoral HIV Research Training Program for HIV Combination Prevention [grant number T32MH109205], and the Elma Foundation. Mark Tomlinson is supported by the National Research Foundation, South Africa and is a Lead Investigator of the Centre of Excellence in Human Development, University Witwatersrand, South Africa.