PMTCT Service Uptake among Adolescents and Adult Women Attending Antenatal Care in Selected Health Facilities in Zimbabwe
To understand the uptake of HIV services by adolescent women, the authors conducted a retrospective analysis of patient-level data (2011–2013) on services for antenatal care (ANC) and prevention of mother-to-child transmission (PMTCT) in 36 facilities in 5 districts in Zimbabwe. Zimbabwe's Option A policy encourages pregnant women to attend ANC before 14 weeks gestation and to begin antiretroviral therapy (ART) if eligible. The authors compared service uptake by 22,215 adolescent (19 years). Adolescents (22.5% of the total) were 34 percent more likely to present to ANC before 14 weeks gestational age than older women; just over one-third of both adolescents and adults completed the four recommended visits. Acceptance of HIV testing was high in both groups (>95%). HIV prevalence was 5.5 percent in adolescents versus 20.1 percent in adults. While the majority of both HIV-positive groups received antiretrovirals for PMTCT (84%), fewer eligible adolescents than adults were initiated on ART (44% versus 51.3%), though the difference was not statistically significant. Pregnant adolescents must be a priority for primary HIV prevention services and expanded HIV treatment services among pregnant women to achieve an AIDS-free generation in Zimbabwe and similar high-HIV burden countries.