Progress Toward the Elimination of Vertical HIV Transmission in Nepal
A Retrospective Cohort Study
Bibliographic Data
| ID | 21426689 |
|---|---|
| Authors | Upendra Thapa Shrestha (0000-0001-7970-4972), Upendra Shrestha, Lok Raj Pandey, Man Bahadur KC, Ali Mirzazadeh (0000-0002-0478-3220, University of California, San Francisco), Keshab Deuba (0000-0002-9933-2210, Karolinska Institutet, corresponding author) |
| Year | 2025 |
| Volume | 50 |
| Issue | 6 |
| Pages | 1105-1114 |
| Publication date | 2025-12-01 |
| Peer Reviewed | Yes |
| Open Access | Yes |
| Type | ARTICLE |
| Venue | Journal of Community Health (JOURNAL) |
| Journal identifiers | ISSN: 0094-5145 • E-ISSN: 1573-3610 |
| Publisher | Springer Science and Business Media LLC (PUBLISHER) |
| DOI | 10.1007/s10900-025-01474-6 |
| PMID | 40593364 |
| OpenAlex | W4411849717 |
| Language | EN |
| References cited | 18 |
Despite global advancements, pregnant women living with HIV in Nepal remain at risk for vertical transmission. This study examined demographic and clinical characteristics, antiretroviral therapy (ART) retention, and transmission outcomes among this population. A retrospective cohort analysis was conducted using data from Nepal’s national electronic HIV register, including 322 women who became pregnant between 2020 and 2023. We analyzed sociodemographic profiles, clinical status at diagnosis, ART initiation timing, retention rates at 6, 12, and 24 months, and infant HIV status. The mean age was 26.9 years; over half (56.2%) were aged 25–39 years. Nearly 40% were illiterate, 87.6% unemployed, and 66.8% reported unsafe sexual behavior as the mode of HIV transmission. Over half (58.1%) were diagnosed prior to pregnancy, and 75.5% were in WHO Stage 1. ART began on the same day in 34.8% and within a week in 40.1%, with 56.8% already on ART during pregnancy. Retention was high: 96.9% at 6 months, 94.8% at 12 months, and 96.0% at 24 months. Vertical transmission occurred in 4.3% of pregnancies. Higher transmission rates were observed among younger mothers (6.9%), Dalit women (11.5%), those in advanced HIV stages (11.1%), with delayed ART initiation (8.6%), high viral loads (13.3%), and home deliveries (17.6%). In Nepal, approximately 1 in 23 infants born to women living with HIV still acquire the infection. Strengthening early diagnosis, improving ART uptake, and addressing disparities in care especially among high-risk groups are essential to eliminating vertical transmission and improving maternal and child health outcomes
Antiretroviral therapy · Cohort · Cohort study · Environmental health · Family medicine · Human immunodeficiency virus (HIV) · Obstetrics · Population · Pregnancy · Retrospective cohort study · Transmission (telecommunications) · Viral load · Adolescent Sexual and Reproductive Health · Demography · HIV, Drug Use, Sexual Risk · HIV/AIDS Research and Interventions · Internal Medicine · Medicine · Pediatrics
Incidence, prevalence and associated factors of mother-to-child transmission of HIV, among children exposed to maternal HIV, in Belgaum district, Karnataka, India
Retention in care and viral suppression in the PMTCT continuum at a large referral facility in western Kenya
No time, no money, no luck
Dalit’s livelihoods in Nepal
| Citation velocity | historical |
|---|---|
| Highly cited | No |