Factors associated with abandonment of infants born to HIV-positive women

Results from a Ukrainian birth cohort

Bibliographic Data

ID19438645
AuthorsHeather Bailey (0000-0002-0953-3212, a MRC Centre of Epidemiology for Child Health, UCL Institute of Child Health , University College London , 30 Guilford Street, London , WC1N 1EH , UK), Igor Semenenko (0000-0003-1717-9281, b Perinatal Prevention of AIDS Initiative , Odessa , Ukraine), Tatyana Pilipenko (b Perinatal Prevention of AIDS Initiative , Odessa , Ukraine), Ruslan Malyuta (0000-0003-3831-8316, b Perinatal Prevention of AIDS Initiative , Odessa , Ukraine), Claire Thorne (0000-0003-0389-1956, a MRC Centre of Epidemiology for Child Health, UCL Institute of Child Health , University College London , 30 Guilford Street, London , WC1N 1EH , UK, corresponding author), the Ukraine European Collaborative the Ukraine European Collaborative, the Ukraine European Collaborative
Year2010
Volume22
Issue12
Pages1439-1448
Publication date2010-12-01
Peer ReviewedYes
Open AccessNo
TypeARTICLE
VenueAIDS Care (JOURNAL)
Journal identifiersISSN: 0954-0121 • E-ISSN: 1360-0451
PublisherInforma UK Limited (PUBLISHER • GB)
DOI10.1080/09540121.2010.482127
PMID20824547
PMCIDPMC3428901
OpenAlexW2165679125
LanguageEN
Citations received1
References cited18

Social marginalisation and other challenges facing HIV-positive pregnant women in Ukraine may put them at increased risk of relinquishing their infants to the state. We described rates of infant abandonment (exclusive non-parental care to most recent follow-up, censored at two years of age) and investigated associated factors using logistic regression models, in 4759 mother-infant pairs enrolled across six Ukrainian sites in the European Collaborative Study from 2000 to May 2009. Median maternal age was 26.0 years, 81.8% were married or cohabiting and 60.6% were nulliparous at enrolment. An injecting drug use (IDU) history was reported by 18.4%, 80.2% took antiretroviral therapy (ART) antenatally and most deliveries were vaginal. A small but significant proportion of infants had been cared for exclusively in institutions by their second birthday (2.1% overall), decreasing from 3.8% (15/393) in 2000-2002 to 1.6% (49/3136) in 2006-2009 (p<0.01), concurrent with prevention of mother-to-child transmission scale-up. A further 1% of infants spent some time in non-parental care. Antenatal ART was associated with an 88% reduced abandonment risk (adjusted odds ratio (AOR) 0.12), versus receipt of single dose nevirapine only, and this was reflected in HIV infection prevalence in the two groups (17.1% of abandoned infants versus 6.6% in parental care). Mothers without a cohabiting partner or husband were more likely to abandon (AOR 4.08), as were active IDUs (AOR 3.27) and those with ≥1 previous children (AOR 1.89 for second-born and AOR 2.56 for subsequent births). Women delivering by elective caesarean section were less likely to abandon (AOR 0.37 versus vaginal), as were those leaving full-time education later (AOR 0.61 for 17-18 years versus ≤16 years and AOR 0.23 for ≥19 years versus ≤16 years). Interventions to extend family planning and IDU harm reduction services along with non-stigmatising antenatal care to marginalised women are needed, and may reduce abandonment

Cohort · Logistic regression · Obstetrics · Odds ratio · Adolescent Sexual and Reproductive Health · Demography · HIV, Drug Use, Sexual Risk · HIV/AIDS Research and Interventions · Medicine · Pediatrics

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