Clinical and biological risk factors influencing Infant HIV Status in Uganda: A Case Study of Kisenyi Health Center IV, Kampala

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This study aimed at investigating how clinical and biological risk factors were associated with the transmission of HIV from mothers to children in Uganda. Methods: This study utilized secondary data extracted from patient charts of 200 HIV-positive mothers and their children who received services at Kisenyi Health Centre IV between 2017 and 2022. To model the relationship between the independent factors and the child’s HIV status, the Probit regression model was used. Results: Among the children, 22.5% were HIV positive. The type of antiretroviral (ARV) regimen administered to the mother significantly influenced the child’s HIV status. Specifically, the AZT/3TC/NVP regimen (Zidovudine, Lamivudine, Nevirapine) was associated with a statistically significant increase in the odds of HIV positivity in children (OR = 5.12; p = 0.016). Children whose mothers received the ABC/3TC/LPV regimen had 2.49 times higher odds of being HIV positive compared to those on regimen TDF/3TC/EFV (p = 0.017). Additionally, maternal HIV viral load was a significant biological determinant of the child’s HIV status. A viral load above 1000 copies/mL was associated with a fivefold increase in the odds of the child being HIV positive (OR = 5.06; p < 0.001). Conclusions: These findings highlight the importance of clinical decision-making, particularly the choice of ARV regimen, and the monitoring of maternal HIV viral load during pregnancy to optimize the likelihood of delivering an HIV-negative child. The study further recommends that future research and targeted interventions build on these results to improve HIV treatment outcomes in pediatric populations. Mother-to-child transmission HIV transmission Infant HIV status Pediatric HIV Antiretroviral Kampala-Uganda Background Human Immunodeficiency Virus (HIV) continues to pose a major global public health challenge, having claimed over 35.6 million lives to date [ 1 ]. Since the 1980s, HIV/AIDS has surged in developing countries, bringing significant demographic, economic, and societal consequences. According to UNICEF (2023), over 2 million children worldwide are affected by HIV/AIDS, with more than 80% residing in sub-Saharan Africa. Southern and Eastern Africa remain the continent’s most affected regions [ 2 ]. In Uganda, an estimated 95,000 children aged 0–14 live with HIV, with a prevalence rate of 0.5% [ 3 ]. Sub-Saharan Africa (SSA) accounts for over two-thirds of the world’s HIV infections [ 4 ], with women of reproductive age shouldering a disproportionate burden. Approximately 70% of global HIV infections occur in SSA, and women represent 60% of these cases [ 5 ]. Despite expanded prevention of mother-to-child transmission (PMTCT) programs, mother-to-child transmission (MTCT) rates remain high in the region, exacerbated by poverty and limited clinical care access for pregnant women and newborns. MTCT primarily occurs during pregnancy, childbirth, or breastfeeding [ 4 ]. Significant progress has been made through the use of antiretroviral (ARV) regimens during pregnancy, labor, and breastfeeding [ 6 ]. Measures such as comprehensive testing, ARV administration, elective cesarean delivery for high viral loads, and avoiding breastfeeding have considerably reduced MTCT rates, especially in high-resource settings [ 7 ]. Resource-limited areas have also seen progress with prenatal ARV programs and prophylaxis during breastfeeding. However, MTCT mechanisms remain complex and not fully understood [ 7 ], [ 8 ]. A report by UNICEF (2022) indicated that 160,000 new HIV infections among children under five in 2020 a 52% decline from 2010. In 35 priority countries, a 57% reduction in new childhood infections has been recorded [ 9 ]. Additionally, approximately 15.4 million children under 18 have lost one or both parents to AIDS-related causes, facing poverty, homelessness, discrimination, and limited opportunities. The “Global Plan towards the Elimination of New HIV Infections among Children and Keeping their Mothers Alive” [ 10 ] contributed to notable MTCT reductions through expanded PMTCT services and lifelong ARV access for pregnant women. However, progress fell short of 2020 targets, underscoring the need to accelerate treatment coverage [ 11 ]. In Uganda, the MTCT rate has dropped from over 20% in 2000 to 2.8% in 2021, though challenges persist. MTCT still accounts for 18% of new infections nationally [ 12 ], [ 13 ]. Existing studies have identified factors such as ARV regimens, viral load, delivery method, and infant feeding practices as key influencers of MTCT risk [ 6 ], [ 14 ], [ 15 ]. However, further local research is needed to inform tailored interventions suited to Uganda’s evolving context. It is against this background that this study investigated how clinical and biological risk factors are associated with the transmission of HIV from mothers to children in Uganda. Methods This study employed a retrospective cohort study design, utilizing secondary data extracted from patient charts and records of HIV-positive mothers who received antenatal care and delivery services at Kisenyi Health Centre IV. The review covered a five-year period from 2017 to 2022, during which records of 200 HIV-positive mothers who delivered at the facility were examined. Data were obtained from patient charts, which contained key variables relevant to the study. These included breastfeeding method, HIV viral load, marital status, age of the child, age of the mother, mode of delivery, CD4 count, type of antiretroviral (ARV) regimen, HIV status of the child, and other demographic information necessary for assessing mother-to-child transmission (MTCT) outcomes. Measures of outcome The study examined factors influencing pediatric HIV status, with the dependent variable being the child's HIV status, coded as 1 for HIV-positive and 0 for HIV-negative. Measures of explanatory variables The independent variables included maternal HIV viral load, categorized as < 1000 copies/mL and ≥ 1000 copies/mL. Breastfeeding practices were recorded as exclusive, complementary, mixed, and not breastfeeding. Additional maternal factors analyzed were residential area, categorized as Central, Rubaga, Makindye, Kawempe/Nakawa, and other; marital status, recorded as never married, married, and divorced/separated; and mode of delivery, categorized as vaginal and cesarean. The study also included antiretroviral regimen types, recorded as TDF/3TC/EFV, TDF/3TC/DTG, ABC/3TC/LPV, and AZT/3TC/NVP. Continuous variables included maternal age, duration on ARVs, CD4 count, and child’s age. This coding scheme facilitated quantitative analysis of potential risk factors for mother-to-child HIV transmission. Statistical analysis. The data were analyzed using STATA version 15.1 statistical software. Descriptive statistics were first generated to summarize the selected sociodemographic, clinical, and biological variables. These were presented in the form of frequencies and percentages. The Chi-square test was used to assess differences in the distribution of HIV status among children across categories of the explanatory variables. Pearson’s Chi-square test enabled the determination of whether there were statistically significant associations between HIV status and individual risk factors. To examine the relationship between clinical and biological risk factors and the HIV status of the child, a Probit regression model was adopted. This model was chosen because the outcome variable HIV status was binary (either HIV-positive or HIV-negative). Statistical significance was assessed at the 5% level. Missing data were assumed to be missing completely at random and were not expected to bias the results [ 16 ]. Results Table 1 shows the frequency distribution of factors influencing infant HIV status in Uganda by selected sociodemographic, clinical, and biological characteristics. The majority of HIV-positive mothers (75.0%) had undergone spontaneous vaginal delivery, commonly referred to as normal delivery. Regarding antiretroviral therapy, most of the mothers (45.0%) were on the TDF/3TC/DTG regimen a fixed-dose combination comprising dolutegravir, lamivudine, and tenofovir disoproxil, used as a first-line treatment for HIV/AIDS in adults. The findings further show that most mothers had a suppressed HIV viral load, defined as less than 1,000 copies/mL. With regard to breastfeeding practices, approximately 59.0% of HIV-positive mothers reported practicing exclusive breastfeeding providing breast milk only, without additional foods or liquids except for prescribed medications or supplements. The results also indicate that 69.5% of the children were aged between 1 and 5 months, and 54.0% were female. About 77.5% of the children born to HIV-positive mothers were HIV negative. Furthermore, Table 1 indicates significant associations between selected explanatory variables and the HIV status of the child, based on Pearson’s Chi-square test. Marital status showed a statistically significant relationship (p = 0.037), with a higher proportion of HIV-positive children observed among mothers who were divorced or separated (33%) compared to married (26%) and never-married mothers (13%). The type of ARV regimen also showed a significant association with infant HIV status (p = 0.006). Children whose mothers were on the AZT/3TC/NVP regimen had the highest HIV positivity rate (60%), while those on TDF/3TC/EFV had the lowest rate (14%). In addition, maternal HIV viral load was strongly associated with the child’s HIV status (p = 0.000); HIV positivity was higher among children born to mothers with viral loads above 1,000 copies/mL (51%) compared to those with suppressed viral loads (16%). Although a higher proportion of HIV-positive children was reported among caesarean deliveries (30%) compared to vaginal deliveries (20%), this difference was not statistically significant (p = 0.143). Table 1 Frequency distribution of the factors influencing Infant HIV Status in Uganda by selected Socio-demographic, Clinical and biological factors. Covariates N Percentage (%) HIV+ Percentage (%) HIV+ chi2 (χ2), p HIV Status of the Child HIV Negative 155 77.5 HIV Positive 45 22.5 Area of residence Central Region 29 14.5 3 10.3 Rubaga 56 28.0 13 23.3 Makindye 61 31.5 16 26.3 Kawempe/Nakawa 4 2.0 0 0.0 4.473 Others 50 25.0 13 26.0 (p = 0.346) Marital Status Married 89 44.5 23 25.8 Never married 75 37.5 10 13.3 6.607 Divorced/ Separated 36 18.0 12 33.3 (p = 0.037) Mode of delivery Spontaneous Vaginal delivery 150 75.0 30 20.0 2.151 Caesarean Section 50 25.0 15 30.0 (p = 0.143) Breast Feeding Practice Exclusive breast Feeding 118 59.0 26 22.1 Complementary Feeding 50 25.0 12 24.0 Mixed breastfeeding 29 14.5 7 24.1 0.995 No longer breastfeeding 3 1.5 0 0.0 (p = 0.803) Type of ARV regimen TDF/3TC/EFV (Tenofovir, Lamivudine, Efavirenz)- Atripla 84 42.0 12 14.3 TDF/3TC/DTG (Tenofovir, Lamivudine, Dolutegravir) 90 45.0 21 23.3 ABC/3TC/LPV (Abacavir, Lamivudine, Loprinavir) 21 10.5 9 42.9 12.309 AZT/3TC/NVP (Zidovudine, Lamivudine, Nevirapine) 5 2.5 3 60.0 (p = 0.006) Duration of ARV regimen treatment for mother (Years) 1–5 175 87.5 37 21.2 1.478 6–10 25 12.5 8 32.0 (p = 0.224) CD 4 Level (Cell/mm^3) 0-500 65 32.5 13 20.0 501–1000 78 39.0 20 25.7 0.743 1001–1500 57 28.5 78 21.1 (p = 0.690) Sex of the Child Male 92 46.0 22 23.9 0.195 Female 108 54.0 23 21.3 (p = 0.659) HIV Viral Loads 1000 copies/ml 37 18.5 19 51.4 (p = 0.000) Table 1 Frequency distribution of the factors influencing Infant HIV Status in Uganda by selected Socio-demographic, Clinical and biological factors. Factors influencing Infant HIV Status in Uganda Table 2 presents the results of the multivariate analysis using the Probit regression model, which included all clinical and biological risk factors. The model was selected based on the lowest Akaike Information Criterion (AIC = 194.68), indicating better fit compared to the Logit (AIC = 195.07) and Cloglog (AIC = 195.88) models. Among the variables included, only two were found to be statistically significant at the 5% level: maternal HIV viral load and type of ARV regimen. Specifically, the results in Table 3 show that the type of ARV regimen significantly influenced the likelihood of mother-to-child HIV transmission. The predicted probabilities of HIV positivity among children increased across the regimens, from 15% for TDF/3TC/EFV, to 24% for TDF/3TC/DTG, 37% for ABC/3TC/LPV, and 62% for AZT/3TC/NVP. These differences were statistically significant (p < 0.05), with AZT/3TC/NVP showing the highest associated risk. Table 2 Probit regression results for clinical and biological risk factors associated with mother-to-child transmission of HIV Covariate Odds Ratio P-Value 95% CI Area of residence Central region (Ref.) 1 - - Rubaga 2.367 0.157 0.727.91 Makindye 2.090 0.216 0.64, 7.04 Others 2.359 0.163 0.71, 7.98 Age of the mother 1.009 0.651 0.97, 1.05 Age of the child 1.090 0.100 0.98, 1.22 CD 4 Level 0.990 0.450 0.99, 1.00 Duration of the mother on ARV regimen treatment 1.143 0.147 0.95, 1.37 Sex of the child Male (Ref.) 1.000 - - Female 0.838 0.613 0.42, 1.54 Type of ARV regimen TDF/3TC/EFV (Tenofovir, Lamivudine, Efavirenz)- Atripla (Ref.) 1.000 - - TDF/3TC/DTG (Tenofovir, Lamivudine, Dolutegravir) 1.793 0.151 0.85, 4.00 ABC/3TC/LPV (Abacavir, Lamivudine, Loprinavir) 2.488 0.017 1.23, 6.35 AZT/3TC/NVP (Zidovudine, Lamivudine, Nevirapine) 5.129 0.016 1.58, 7.15 HIV Viral Loads 1000 copies/ml 5.057 0.000 2.44, 11.98 Mode of delivery Spontaneous Vaginal delivery (Ref.) 1.000 Caesarean Section 1.601 0.219 0.75, 3.56 Breast Feeding Practice Exclusive breast Feeding (Ref.) 1.000 - - Complementary Feeding 1.114 0.781 0.52, 2.39 Mixed breastfeeding 1.122 0.809 0.44. 2.85 (Ref.) = reference category; CI = confidence interval Table 2 further displays the estimated odds ratios for these regimens. Compared to the reference regimen (TDF/3TC/EFV), children born to mothers on TDF/3TC/DTG, ABC/3TC/LPV, and AZT/3TC/NVP had higher odds of being HIV positive (OR = 1.79, 2.49, and 5.13, respectively). While the result for TDF/3TC/DTG was not statistically significant (p = 0.15), both ABC/3TC/LPV (p = 0.017) and AZT/3TC/NVP (p = 0.016) showed statistically significant associations. An overall test of equality of margins also confirmed that the type of ARV regimen significantly affects the risk of HIV transmission (p < 0.05). Regarding biological factors, the viral load of the mother was a strong predictor of the child’s HIV status. The odds of HIV positivity were significantly higher by a factor of 5.06 (p = 0.000) among children whose mothers had a viral load greater than 1,000 copies/mL compared to those with suppressed viral loads, indicating that maternal viral load is a key factor of vertical HIV transmission. In contrast, mode of delivery did not show a statistically significant association with infant HIV status. Although children born via caesarean section had 1.6 times higher odds of being HIV positive compared to those delivered vaginally (OR = 1.60; p = 0.219), this result was not significant at the 5% level. This suggests that, within this sample, there is insufficient evidence to conclude that mode of delivery independently affects HIV transmission risk. Table 3 Margins to obtain the effect of ARV regimen on HIV status of the child Covariate Margin Delta method P-value 95% CI Type of ARV regimen TDF/3TC/EFV (Tenofovir, Lamivudine, Efavirenz)- Atripla (Ref.) 0.147 0.038 0.000 0.07, 0.22 TDF/3TC/DTG (Tenofovir, Lamivudine, Dolutegravir) 0.236 0.044 0.000 0.15, 0.34 ABC/3TC/LPV (Abacavir, Lamivudine, Loprinavir) 0.367 0.104 0.000 0.18, 0.56 AZT/3TC/NVP (Zidovudine, Lamivudine, Nevirapine) 0.624 0.104 0.003 0.21, 1.04 (Ref.) = reference category; CI = confidence interval Discussion The main objective of this study was to examine the clinical and biological risk factors influencing infant HIV status in Uganda, using a case study of Kisenyi Health Center IV in Kampala. The study identified key variables significantly associated with mother-to-child transmission (MTCT) of HIV, particularly the type of antiretroviral (ARV) regimen administered to the mother and the maternal HIV viral load were the associated factors identified. Among the four ARV regimens analyzed, AZT/3TC/NVP was associated with the highest risk of infant HIV positivity, while TDF/3TC/EFV showed the lowest. This is consistent with previous studies that have demonstrated that TDF-based regimens are generally more effective and safer than AZT-based regimens in preventing vertical transmission of HIV, particularly when initiated early in pregnancy [ 17 ]. This finding also aligns with the study by [ 18 ]which emphasized the importance of ARV regimens in preventing MTCT, implying that the ARV treatment given to a mother can influence the HIV status of the infant [ 19 ]. In addition, maternal HIV viral load was found to be a strong predictor of infant HIV status. Mothers with viral loads exceeding 1,000 copies/mL were significantly more likely to transmit HIV to their infants. This finding supports existing evidence that high maternal viral load is a major risk factor for MTCT, and that maintaining viral suppression during pregnancy is critical for the prevention of transmission [ 20 ]. The results of this study also align with previous research, such as the study by Hoffman et al. (2010), which emphasized the association between HIV-1 DNA viral load and mother-to-child transmission [ 21 ]. In summary, this study utilized secondary data from patient records of 200 HIV-positive mothers and their children at Kisenyi Health Center IV to investigate the clinical and biological risk factors influencing infant HIV status in Uganda. The findings revealed that the type of maternal antiretroviral (ARV) regimen and maternal HIV viral load were significantly associated with the risk of mother-to-child transmission (MTCT) of HIV. In particular, the AZT/3TC/NVP regimen was associated with the highest likelihood of infant HIV positivity, while the TDF/3TC/EFV regimen showed the lowest. Additionally, maternal viral load above 1,000 copies/mL was associated with a fivefold increase in the odds of the child being HIV positive. These results underscore the critical role of clinical decisions especially ARV regimen selection and viral load suppression in preventing vertical HIV transmission. There are several limitations that should be considered. First, the use of secondary data may introduce information bias due to incomplete records or inconsistent documentation practices. The retrospective nature of the study also limits the ability to control for confounders such as treatment adherence, timing of ARV initiation, or co-existing health conditions. Lastly, the observational design of the study does not allow for causal conclusions. Conclusion This study contributes valuable insights into the clinical and biological Factors associated with infant HIV status in Uganda. The results support existing evidence on the importance of selecting appropriate ARV regimens and ensuring viral suppression during pregnancy. Strengthening maternal HIV care through timely initiation of treatment, routine monitoring, and adherence support is essential for reducing the burden of MTCT in Uganda. Future research should aim to explore additional socio-behavioural and health system factors that may influence HIV transmission risk among mother-infant pairs. Abbreviations ABC/3TC/LPV Abacavir, lamivudine, Loprinavir AIC Akaike's information criterion ANC Antenatal care ARV Antiretroviral Therapy AZT/3TC/NVP Zidovudine, Lamivudine, Nevirapine BIC Bayesian information criterion cART Combined Antiretroviral Therapy COVID 19-coronavirus disease of 2019 eMTCT Elimination of Mother-to-child transmission of HIV HIV human immunodeficiency virus HIV/AIDS human immunodeficiency virus or acquired immunodeficiency syndrome HTS HIV testing services MOH Ministry of Health MTCT Mother-to-child transmission of HIV OR Odds Ratios PMTCT Prevention of Mother-to-child transmission of HIV SSA Sub-Saharan Africa TDF/3TC/EFV Tenofovir, lamivudine, Efavirenz TDF/3TC/DTG Tenofovir, Lamivudine, Dolutegravir UNAIDS The Joint United Nations Programme on HIV/AIDS UNICEF The United Nations Children's Fund UPHIA Uganda Population-Based HIV Impact Assessment WHO World Health Organization. Declarations Ethical approval and consent to participate The nature of this study did not involve direct participation of human subjects, as it relied on secondary data from existing patient records. However, ethical approval was obtained from Makerere University following the submission and review of the research proposal by the Graduate School. In addition, permission to access and use the data was sought and granted by the Ministry of Health, the Kampala Capital City Authority (KCCA) Directorate of Public Health and Environment, and the administration of Kisenyi Health Centre IV, in accordance with established research and ethics guidelines. Clinical Trial. Not applicable Consent for Publication. Not applicable Competing interests. The authors have no conflicts of interest to declare. Funding. This study received no specific grant from any funding agency, commercial entity or not-for-profit organization. It was self-funded by the author. Author Contribution [Francis Xavier Bagonza]: He is the main author of the manuscript implying that he conceived and designed the study, supervised data collection, performed literature review, curated data, conducted data analysis, contributed to interpretation of results, and participated in manuscript writing.[Dr John Bosco Asiimwe]: He provided academic guidance on this study and participated in proof reading the manuscript.[Dr Felix Wamono]: He provided academic guidance on this study and participated in proof reading the manuscript.[Dick Nsimbe]: Provided critical review of manuscript, edited and formatted it . Acknowledgements. The authors extend their sincere gratitude to Makerere University, Kisenyi health center IV and Kampala City Council authority for providing permissions to access patient records for this study. Data Availability The datasets used and/or analysed during the current study available from the corresponding author on reasonable request. 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Cite Share Download PDF Status: Published Journal Publication published 11 Feb, 2026 Read the published version in BMC Infectious Diseases → Version 1 posted Editorial decision: Revision requested 14 Oct, 2025 Reviews received at journal 09 Jul, 2025 Reviewers agreed at journal 30 Jun, 2025 Reviews received at journal 25 Jun, 2025 Reviewers agreed at journal 23 Jun, 2025 Reviewers agreed at journal 13 Jun, 2025 Reviewers invited by journal 13 Jun, 2025 Editor invited by journal 22 May, 2025 Editor assigned by journal 22 May, 2025 Submission checks completed at journal 22 May, 2025 First submitted to journal 19 May, 2025 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-6701744","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":472002642,"identity":"457dfda7-7e15-40ea-b362-6e6464ebf9a0","order_by":0,"name":"Francis Xavier Bagonza","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA2ElEQVRIiWNgGAWjYBACAxBRUcDAwA9iJBQQq+UMkJRsAGkxIEWLwQE4lwAwZz9+8cEBA7vEzedXJ354YMAgzy92AL8Wy56cYoMDBsnGZjfebpYAOsxw5uwEAg47kJMm/cGAWc7sxtkNIC0JBrcJaTn/Jk3igEE9j/GMs5t/EKflRvoxoJbDcgb8vduIs8VyxhtmoF+OG0vc4N1mkWAgQdgv5vzpDx8cqKhO7O8/u/nmjwobeX5pAloYGHigcSEBVilBSDkIsD+A0PwHiFE9CkbBKBgFIxEAABa5R5ivUPmQAAAAAElFTkSuQmCC","orcid":"","institution":"Makerere University","correspondingAuthor":true,"prefix":"","firstName":"Francis","middleName":"Xavier","lastName":"Bagonza","suffix":""},{"id":472002643,"identity":"05c541f4-b79c-4064-b730-ef583a266c68","order_by":1,"name":"John Bosco Asiimwe","email":"","orcid":"","institution":"Makerere University","correspondingAuthor":false,"prefix":"","firstName":"John","middleName":"Bosco","lastName":"Asiimwe","suffix":""},{"id":472002644,"identity":"886b10d3-ad51-4fef-aa0e-cbe94b96b931","order_by":2,"name":"Felix Wamono","email":"","orcid":"","institution":"Makerere University","correspondingAuthor":false,"prefix":"","firstName":"Felix","middleName":"","lastName":"Wamono","suffix":""},{"id":472002645,"identity":"d1e7fc0e-25fb-4c18-9368-9c878f8a8547","order_by":3,"name":"Dick Nsimbe","email":"","orcid":"","institution":"Makerere University","correspondingAuthor":false,"prefix":"","firstName":"Dick","middleName":"","lastName":"Nsimbe","suffix":""}],"badges":[],"createdAt":"2025-05-19 19:53:13","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-6701744/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-6701744/v1","draftVersion":[],"editorialEvents":[{"content":"https://doi.org/10.1186/s12879-026-12836-3","type":"published","date":"2026-02-11T15:58:15+00:00"}],"editorialNote":"","failedWorkflow":false,"files":[{"id":102785566,"identity":"deb17335-f890-44ef-b266-28270b9bfcfb","added_by":"auto","created_at":"2026-02-16 16:08:05","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":992929,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-6701744/v1/b47d1cc2-7f45-4959-93bb-429d84376df7.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Clinical and biological risk factors influencing Infant HIV Status in Uganda: A Case Study of Kisenyi Health Center IV, Kampala","fulltext":[{"header":"Background","content":"\u003cp\u003eHuman Immunodeficiency Virus (HIV) continues to pose a major global public health challenge, having claimed over 35.6\u0026nbsp;million lives to date [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. Since the 1980s, HIV/AIDS has surged in developing countries, bringing significant demographic, economic, and societal consequences. According to UNICEF (2023), over 2\u0026nbsp;million children worldwide are affected by HIV/AIDS, with more than 80% residing in sub-Saharan Africa. Southern and Eastern Africa remain the continent\u0026rsquo;s most affected regions [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. In Uganda, an estimated 95,000 children aged 0\u0026ndash;14 live with HIV, with a prevalence rate of 0.5% [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eSub-Saharan Africa (SSA) accounts for over two-thirds of the world\u0026rsquo;s HIV infections [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e], with women of reproductive age shouldering a disproportionate burden. Approximately 70% of global HIV infections occur in SSA, and women represent 60% of these cases [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]. Despite expanded prevention of mother-to-child transmission (PMTCT) programs, mother-to-child transmission (MTCT) rates remain high in the region, exacerbated by poverty and limited clinical care access for pregnant women and newborns.\u003c/p\u003e \u003cp\u003eMTCT primarily occurs during pregnancy, childbirth, or breastfeeding [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]. Significant progress has been made through the use of antiretroviral (ARV) regimens during pregnancy, labor, and breastfeeding [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]. Measures such as comprehensive testing, ARV administration, elective cesarean delivery for high viral loads, and avoiding breastfeeding have considerably reduced MTCT rates, especially in high-resource settings [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e]. Resource-limited areas have also seen progress with prenatal ARV programs and prophylaxis during breastfeeding. However, MTCT mechanisms remain complex and not fully understood [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e], [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]. A report by UNICEF (2022) indicated that 160,000 new HIV infections among children under five in 2020 a 52% decline from 2010. In 35 priority countries, a 57% reduction in new childhood infections has been recorded [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]. Additionally, approximately 15.4\u0026nbsp;million children under 18 have lost one or both parents to AIDS-related causes, facing poverty, homelessness, discrimination, and limited opportunities.\u003c/p\u003e \u003cp\u003eThe \u0026ldquo;Global Plan towards the Elimination of New HIV Infections among Children and Keeping their Mothers Alive\u0026rdquo; [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e] contributed to notable MTCT reductions through expanded PMTCT services and lifelong ARV access for pregnant women. However, progress fell short of 2020 targets, underscoring the need to accelerate treatment coverage [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e]. In Uganda, the MTCT rate has dropped from over 20% in 2000 to 2.8% in 2021, though challenges persist. MTCT still accounts for 18% of new infections nationally [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e], [\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e]. Existing studies have identified factors such as ARV regimens, viral load, delivery method, and infant feeding practices as key influencers of MTCT risk [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e], [\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e], [\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e]. However, further local research is needed to inform tailored interventions suited to Uganda\u0026rsquo;s evolving context. It is against this background that this study investigated how clinical and biological risk factors are associated with the transmission of HIV from mothers to children in Uganda.\u003c/p\u003e"},{"header":"Methods","content":"\u003cp\u003eThis study employed a retrospective cohort study design, utilizing secondary data extracted from patient charts and records of HIV-positive mothers who received antenatal care and delivery services at Kisenyi Health Centre IV. The review covered a five-year period from 2017 to 2022, during which records of 200 HIV-positive mothers who delivered at the facility were examined. Data were obtained from patient charts, which contained key variables relevant to the study. These included breastfeeding method, HIV viral load, marital status, age of the child, age of the mother, mode of delivery, CD4 count, type of antiretroviral (ARV) regimen, HIV status of the child, and other demographic information necessary for assessing mother-to-child transmission (MTCT) outcomes.\u003c/p\u003e \u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eMeasures of outcome\u003c/h2\u003e \u003cp\u003eThe study examined factors influencing pediatric HIV status, with the dependent variable being the child's HIV status, coded as 1 for HIV-positive and 0 for HIV-negative.\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eMeasures of explanatory variables\u003c/h3\u003e\n\u003cp\u003eThe independent variables included maternal HIV viral load, categorized as \u0026lt;\u0026thinsp;1000 copies/mL and \u0026ge;\u0026thinsp;1000 copies/mL. Breastfeeding practices were recorded as exclusive, complementary, mixed, and not breastfeeding. Additional maternal factors analyzed were residential area, categorized as Central, Rubaga, Makindye, Kawempe/Nakawa, and other; marital status, recorded as never married, married, and divorced/separated; and mode of delivery, categorized as vaginal and cesarean. The study also included antiretroviral regimen types, recorded as TDF/3TC/EFV, TDF/3TC/DTG, ABC/3TC/LPV, and AZT/3TC/NVP. Continuous variables included maternal age, duration on ARVs, CD4 count, and child\u0026rsquo;s age. This coding scheme facilitated quantitative analysis of potential risk factors for mother-to-child HIV transmission.\u003c/p\u003e \u003cdiv id=\"Sec5\" class=\"Section2\"\u003e \u003ch2\u003eStatistical analysis.\u003c/h2\u003e \u003cp\u003eThe data were analyzed using STATA version 15.1 statistical software. Descriptive statistics were first generated to summarize the selected sociodemographic, clinical, and biological variables. These were presented in the form of frequencies and percentages. The Chi-square test was used to assess differences in the distribution of HIV status among children across categories of the explanatory variables. Pearson\u0026rsquo;s Chi-square test enabled the determination of whether there were statistically significant associations between HIV status and individual risk factors. To examine the relationship between clinical and biological risk factors and the HIV status of the child, a Probit regression model was adopted. This model was chosen because the outcome variable HIV status was binary (either HIV-positive or HIV-negative). Statistical significance was assessed at the 5% level. Missing data were assumed to be missing completely at random and were not expected to bias the results [\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e].\u003c/p\u003e \u003c/div\u003e"},{"header":"Results","content":"\u003cp\u003e\u003cstrong\u003eTable 1\u003c/strong\u003e shows the frequency distribution of factors influencing infant HIV status in Uganda by selected sociodemographic, clinical, and biological characteristics. The majority of HIV-positive mothers (75.0%) had undergone spontaneous vaginal delivery, commonly referred to as normal delivery. Regarding antiretroviral therapy, most of the mothers (45.0%) were on the TDF/3TC/DTG regimen a fixed-dose combination comprising dolutegravir, lamivudine, and tenofovir disoproxil, used as a first-line treatment for HIV/AIDS in adults. The findings further show that most mothers had a suppressed HIV viral load, defined as less than 1,000 copies/mL. With regard to breastfeeding practices, approximately 59.0% of HIV-positive mothers reported practicing exclusive breastfeeding providing breast milk only, without additional foods or liquids except for prescribed medications or supplements. The results also indicate that 69.5% of the children were aged between 1 and 5 months, and 54.0% were female. About 77.5% of the children born to HIV-positive mothers were HIV negative.\u003c/p\u003e\n\u003cp\u003eFurthermore, Table 1 indicates significant associations between selected explanatory variables and the HIV status of the child, based on Pearson\u0026rsquo;s Chi-square test. Marital status showed a statistically significant relationship (p = 0.037), with a higher proportion of HIV-positive children observed among mothers who were divorced or separated (33%) compared to married (26%) and never-married mothers (13%). The type of ARV regimen also showed a significant association with infant HIV status (p = 0.006). Children whose mothers were on the AZT/3TC/NVP regimen had the highest HIV positivity rate (60%), while those on TDF/3TC/EFV had the lowest rate (14%). In addition, maternal HIV viral load was strongly associated with the child\u0026rsquo;s HIV status (p = 0.000); HIV positivity was higher among children born to mothers with viral loads above 1,000 copies/mL (51%) compared to those with suppressed viral loads (16%). Although a higher proportion of HIV-positive children was reported among caesarean deliveries (30%) compared to vaginal deliveries (20%), this difference was not statistically significant (p = 0.143).\u003c/p\u003e\n\u003cp\u003e\u003c/p\u003e\u0026nbsp;\u003ctable id=\"Tab1\" border=\"1\"\u003e\n \u003ccaption language=\"En\"\u003e\n \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e\n \u003cdiv class=\"CaptionContent\"\u003e\n \u003cp\u003eFrequency distribution of the factors influencing Infant HIV Status in Uganda by selected Socio-demographic, Clinical and biological factors.\u003c/p\u003e\n \u003c/div\u003e\n \u003c/caption\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eCovariates\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eN\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003ePercentage (%)\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eHIV+\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003ePercentage (%) HIV+\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003echi2 (\u0026chi;2), p\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eHIV Status of the Child\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eHIV Negative\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e155\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e77.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eHIV Positive\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e45\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e22.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eArea of residence\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eCentral Region\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e29\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e14.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e10.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eRubaga\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e56\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e28.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e23.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eMakindye\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e61\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e31.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e26.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eKawempe/Nakawa\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e2.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e4.473\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eOthers\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e50\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e25.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e26.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e(p\u0026thinsp;=\u0026thinsp;0.346)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eMarital Status\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eMarried\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e89\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e44.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e23\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e25.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNever married\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e75\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e37.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e13.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e6.607\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eDivorced/ Separated\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e36\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e18.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e33.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e(p\u0026thinsp;=\u0026thinsp;0.037)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eMode of delivery\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSpontaneous Vaginal delivery\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e150\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e75.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e20.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2.151\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eCaesarean Section\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e50\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e25.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e30.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e(p\u0026thinsp;=\u0026thinsp;0.143)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eBreast Feeding Practice\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eExclusive breast Feeding\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e118\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e59.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e26\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e22.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eComplementary Feeding\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e50\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e25.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e24.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eMixed breastfeeding\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e29\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e14.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e24.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.995\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNo longer breastfeeding\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e(p\u0026thinsp;=\u0026thinsp;0.803)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eType of ARV regimen\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eTDF/3TC/EFV (Tenofovir, Lamivudine, Efavirenz)- Atripla\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e84\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e42.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e14.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eTDF/3TC/DTG (Tenofovir, Lamivudine, Dolutegravir)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e90\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e45.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e21\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e23.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eABC/3TC/LPV (Abacavir, Lamivudine, Loprinavir)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e21\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e10.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e42.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e12.309\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eAZT/3TC/NVP (Zidovudine, Lamivudine, Nevirapine)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e2.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e60.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e(p\u0026thinsp;=\u0026thinsp;0.006)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eDuration of ARV regimen treatment for mother (Years)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1\u0026ndash;5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e175\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e87.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e37\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e21.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.478\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e6\u0026ndash;10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e12.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e32.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e(p\u0026thinsp;=\u0026thinsp;0.224)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eCD 4 Level (Cell/mm^3)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0-500\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e65\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e32.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e20.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e501\u0026ndash;1000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e78\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e39.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e25.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.743\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1001\u0026ndash;1500\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e57\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e28.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e78\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e21.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e(p\u0026thinsp;=\u0026thinsp;0.690)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eSex of the Child\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eMale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e92\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e46.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e22\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e23.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.195\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFemale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e108\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e54.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e23\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e21.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e(p\u0026thinsp;=\u0026thinsp;0.659)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eHIV Viral Loads\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026lt;\u0026thinsp;1000 copies/ml\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e163\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e81.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e26\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e16.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e21.672\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026gt;\u0026thinsp;1000 copies/ml\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e37\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e18.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e19\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e51.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e(p\u0026thinsp;=\u0026thinsp;0.000)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003c/p\u003e\n\u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable \u003cspan class=\"InternalRef\"\u003e1\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eFrequency distribution of the factors influencing Infant HIV Status in Uganda by selected Socio-demographic, Clinical and biological factors.\u003c/p\u003e\n\u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n\u003ch3\u003eFactors influencing Infant HIV Status in Uganda\u003c/h3\u003e\n\u003cp\u003eTable \u003cspan class=\"InternalRef\"\u003e2\u003c/span\u003e presents the results of the multivariate analysis using the Probit regression model, which included all clinical and biological risk factors. The model was selected based on the lowest Akaike Information Criterion (AIC\u0026thinsp;=\u0026thinsp;194.68), indicating better fit compared to the Logit (AIC\u0026thinsp;=\u0026thinsp;195.07) and Cloglog (AIC\u0026thinsp;=\u0026thinsp;195.88) models. Among the variables included, only two were found to be statistically significant at the 5% level: maternal HIV viral load and type of ARV regimen. Specifically, the results in Table \u003cspan class=\"InternalRef\"\u003e3\u003c/span\u003e show that the type of ARV regimen significantly influenced the likelihood of mother-to-child HIV transmission. The predicted probabilities of HIV positivity among children increased across the regimens, from 15% for TDF/3TC/EFV, to 24% for TDF/3TC/DTG, 37% for ABC/3TC/LPV, and 62% for AZT/3TC/NVP. These differences were statistically significant (p\u0026thinsp;\u0026lt;\u0026thinsp;0.05), with AZT/3TC/NVP showing the highest associated risk.\u003c/p\u003e\n\u003cdiv align=\"left\" class=\"colspec\"\u003e\u003cbr\u003e\u003c/div\u003e\u0026nbsp;\u0026nbsp;\u003ctable id=\"Tab2\" border=\"1\"\u003e\n \u003ccaption language=\"En\"\u003e\n \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e\n \u003cdiv class=\"CaptionContent\"\u003e\n \u003cp\u003eProbit regression results for clinical and biological risk factors associated with mother-to-child transmission of HIV\u003c/p\u003e\n \u003c/div\u003e\n \u003c/caption\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eCovariate\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eOdds Ratio\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eP-Value\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003e95% CI\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eArea of residence\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eCentral region (Ref.)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eRubaga\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2.367\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.157\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.727.91\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eMakindye\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2.090\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.216\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.64, 7.04\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eOthers\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2.359\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.163\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.71, 7.98\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eAge of the mother\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.009\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.651\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.97, 1.05\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eAge of the child\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.090\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.100\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.98, 1.22\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eCD 4 Level\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.990\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.450\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.99, 1.00\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eDuration of the mother on ARV regimen treatment\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.143\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.147\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.95, 1.37\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eSex of the child\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eMale (Ref.)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFemale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.838\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.613\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.42, 1.54\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eType of ARV regimen\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eTDF/3TC/EFV (Tenofovir, Lamivudine, Efavirenz)- Atripla (Ref.)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eTDF/3TC/DTG (Tenofovir, Lamivudine, Dolutegravir)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.793\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.151\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.85, 4.00\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eABC/3TC/LPV (Abacavir, Lamivudine, Loprinavir)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2.488\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.017\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.23, 6.35\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eAZT/3TC/NVP (Zidovudine, Lamivudine, Nevirapine)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e5.129\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.016\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.58, 7.15\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eHIV Viral Loads\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026lt;\u0026thinsp;1000 copies/ml (Ref.)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026gt;\u0026thinsp;1000 copies/ml\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e5.057\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.000\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2.44, 11.98\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eMode of delivery\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSpontaneous Vaginal delivery (Ref.)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eCaesarean Section\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.601\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.219\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.75, 3.56\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eBreast Feeding Practice\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eExclusive breast Feeding (Ref.)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eComplementary Feeding\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.114\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.781\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.52, 2.39\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eMixed breastfeeding\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.122\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.809\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.44. 2.85\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003c/p\u003e\n\u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n\u003cdiv id=\"Sec8\" class=\"Section2\"\u003e\n \u003ch2\u003e(Ref.)\u0026thinsp;=\u0026thinsp;reference category; CI\u0026thinsp;=\u0026thinsp;confidence interval\u003c/h2\u003e\n \u003cp\u003eTable \u003cspan class=\"InternalRef\"\u003e2\u003c/span\u003e further displays the estimated odds ratios for these regimens. Compared to the reference regimen (TDF/3TC/EFV), children born to mothers on TDF/3TC/DTG, ABC/3TC/LPV, and AZT/3TC/NVP had higher odds of being HIV positive (OR\u0026thinsp;=\u0026thinsp;1.79, 2.49, and 5.13, respectively). While the result for TDF/3TC/DTG was not statistically significant (p\u0026thinsp;=\u0026thinsp;0.15), both ABC/3TC/LPV (p\u0026thinsp;=\u0026thinsp;0.017) and AZT/3TC/NVP (p\u0026thinsp;=\u0026thinsp;0.016) showed statistically significant associations. An overall test of equality of margins also confirmed that the type of ARV regimen significantly affects the risk of HIV transmission (p\u0026thinsp;\u0026lt;\u0026thinsp;0.05). Regarding biological factors, the viral load of the mother was a strong predictor of the child\u0026rsquo;s HIV status. The odds of HIV positivity were significantly higher by a factor of 5.06 (p\u0026thinsp;=\u0026thinsp;0.000) among children whose mothers had a viral load greater than 1,000 copies/mL compared to those with suppressed viral loads, indicating that maternal viral load is a key factor of vertical HIV transmission. In contrast, mode of delivery did not show a statistically significant association with infant HIV status. Although children born via caesarean section had 1.6 times higher odds of being HIV positive compared to those delivered vaginally (OR\u0026thinsp;=\u0026thinsp;1.60; p\u0026thinsp;=\u0026thinsp;0.219), this result was not significant at the 5% level. This suggests that, within this sample, there is insufficient evidence to conclude that mode of delivery independently affects HIV transmission risk.\u003c/p\u003e\n \u003cdiv class=\"gridtable\"\u003e\u0026nbsp;\u003ctable id=\"Tab3\" border=\"1\"\u003e\n \u003ccaption language=\"En\"\u003e\n \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e\n \u003cdiv class=\"CaptionContent\"\u003e\n \u003cp\u003eMargins to obtain the effect of ARV regimen on HIV status of the child\u003c/p\u003e\n \u003c/div\u003e\n \u003c/caption\u003e\n \u003ccolgroup cols=\"5\"\u003e\u003c/colgroup\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eCovariate\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eMargin\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eDelta method\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eP-value\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003e95% CI\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eType of ARV regimen\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eTDF/3TC/EFV (Tenofovir, Lamivudine, Efavirenz)- Atripla (Ref.)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.147\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.038\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.07, 0.22\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eTDF/3TC/DTG (Tenofovir, Lamivudine, Dolutegravir)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.236\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.044\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.15, 0.34\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eABC/3TC/LPV (Abacavir, Lamivudine, Loprinavir)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.367\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.104\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.18, 0.56\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eAZT/3TC/NVP (Zidovudine, Lamivudine, Nevirapine)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.624\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.104\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.003\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.21, 1.04\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n \u003c/div\u003e\n\u003c/div\u003e\n\u003cp\u003e(Ref.)\u0026thinsp;=\u0026thinsp;reference category; CI\u0026thinsp;=\u0026thinsp;confidence interval\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eThe main objective of this study was to examine the clinical and biological risk factors influencing infant HIV status in Uganda, using a case study of Kisenyi Health Center IV in Kampala. The study identified key variables significantly associated with mother-to-child transmission (MTCT) of HIV, particularly the type of antiretroviral (ARV) regimen administered to the mother and the maternal HIV viral load were the associated factors identified. Among the four ARV regimens analyzed, AZT/3TC/NVP was associated with the highest risk of infant HIV positivity, while TDF/3TC/EFV showed the lowest. This is consistent with previous studies that have demonstrated that TDF-based regimens are generally more effective and safer than AZT-based regimens in preventing vertical transmission of HIV, particularly when initiated early in pregnancy [\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e]. This finding also aligns with the study by [\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e]which emphasized the importance of ARV regimens in preventing MTCT, implying that the ARV treatment given to a mother can influence the HIV status of the infant [\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eIn addition, maternal HIV viral load was found to be a strong predictor of infant HIV status. Mothers with viral loads exceeding 1,000 copies/mL were significantly more likely to transmit HIV to their infants. This finding supports existing evidence that high maternal viral load is a major risk factor for MTCT, and that maintaining viral suppression during pregnancy is critical for the prevention of transmission [\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e]. The results of this study also align with previous research, such as the study by Hoffman et al. (2010), which emphasized the association between HIV-1 DNA viral load and mother-to-child transmission [\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eIn summary, this study utilized secondary data from patient records of 200 HIV-positive mothers and their children at Kisenyi Health Center IV to investigate the clinical and biological risk factors influencing infant HIV status in Uganda. The findings revealed that the type of maternal antiretroviral (ARV) regimen and maternal HIV viral load were significantly associated with the risk of mother-to-child transmission (MTCT) of HIV. In particular, the AZT/3TC/NVP regimen was associated with the highest likelihood of infant HIV positivity, while the TDF/3TC/EFV regimen showed the lowest. Additionally, maternal viral load above 1,000 copies/mL was associated with a fivefold increase in the odds of the child being HIV positive. These results underscore the critical role of clinical decisions especially ARV regimen selection and viral load suppression in preventing vertical HIV transmission.\u003c/p\u003e \u003cp\u003eThere are several limitations that should be considered. First, the use of secondary data may introduce information bias due to incomplete records or inconsistent documentation practices. The retrospective nature of the study also limits the ability to control for confounders such as treatment adherence, timing of ARV initiation, or co-existing health conditions. Lastly, the observational design of the study does not allow for causal conclusions.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThis study contributes valuable insights into the clinical and biological Factors associated with infant HIV status in Uganda. The results support existing evidence on the importance of selecting appropriate ARV regimens and ensuring viral suppression during pregnancy. Strengthening maternal HIV care through timely initiation of treatment, routine monitoring, and adherence support is essential for reducing the burden of MTCT in Uganda. Future research should aim to explore additional socio-behavioural and health system factors that may influence HIV transmission risk among mother-infant pairs.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cdiv class=\"DefinitionList\"\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eABC/3TC/LPV\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eAbacavir, lamivudine, Loprinavir\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eAIC\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eAkaike's information criterion\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eANC\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eAntenatal care\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eARV\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eAntiretroviral Therapy\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eAZT/3TC/NVP\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eZidovudine, Lamivudine, Nevirapine\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eBIC\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eBayesian information criterion\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003ecART\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eCombined Antiretroviral Therapy\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eCOVID\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003e19-coronavirus disease of 2019\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eeMTCT\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eElimination of Mother-to-child transmission of HIV\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eHIV\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003ehuman immunodeficiency virus\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eHIV/AIDS\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003ehuman immunodeficiency virus or acquired immunodeficiency syndrome\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eHTS\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eHIV testing services\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eMOH\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eMinistry of Health\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eMTCT\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eMother-to-child transmission of HIV\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eOR\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eOdds Ratios\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003ePMTCT\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003ePrevention of Mother-to-child transmission of HIV\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eSSA\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eSub-Saharan Africa\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eTDF/3TC/EFV\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eTenofovir, lamivudine, Efavirenz\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eTDF/3TC/DTG\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eTenofovir, Lamivudine, Dolutegravir\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eUNAIDS\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eThe Joint United Nations Programme on HIV/AIDS\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eUNICEF\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eThe United Nations Children's Fund\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eUPHIA\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eUganda Population-Based HIV Impact Assessment\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eWHO\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eWorld Health Organization.\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003c/div\u003e"},{"header":"Declarations","content":"\u003ch2\u003e\u003cstrong\u003eEthical approval and consent to participate\u003c/strong\u003e\u003c/h2\u003e\n\u003cp\u003eThe nature of this study did not involve direct participation of human subjects, as it relied on secondary data from existing patient records. However, ethical approval was obtained from Makerere University following the submission and review of the research proposal by the Graduate School. In addition, permission to access and use the data was sought and granted by the Ministry of Health, the Kampala Capital City Authority (KCCA) Directorate of Public Health and Environment, and the administration of Kisenyi Health Centre IV, in accordance with established research and ethics guidelines.\u003c/p\u003e\n\u003ch2\u003eClinical Trial.\u003c/h2\u003e\n\u003cp\u003eNot applicable\u003c/p\u003e\n\u003ch2\u003eConsent for Publication.\u003c/h2\u003e\n\u003cp\u003eNot applicable\u003c/p\u003e\n\u003ch2\u003eCompeting interests.\u003c/h2\u003e\n\u003cp\u003eThe authors have no conflicts of interest to declare.\u003c/p\u003e\n\u003ch2\u003eFunding.\u003c/h2\u003e\n\u003cp\u003eThis study received no specific grant from any funding agency, commercial entity or not-for-profit organization. It was self-funded by the author.\u003c/p\u003e\n\u003ch2\u003eAuthor Contribution\u003c/h2\u003e\n\u003cp\u003e[Francis Xavier Bagonza]: He is the main author of the manuscript implying that he conceived and designed the study, supervised data collection, performed literature review, curated data, conducted data analysis, contributed to interpretation of results, and participated in manuscript writing.[Dr John Bosco Asiimwe]: He provided academic guidance on this study and participated in proof reading the manuscript.[Dr Felix Wamono]: He provided academic guidance on this study and participated in proof reading the manuscript.[Dick Nsimbe]: Provided critical review of manuscript, edited and formatted it .\u003c/p\u003e\n\u003ch2\u003eAcknowledgements.\u003c/h2\u003e\n\u003cp\u003eThe authors extend their sincere gratitude to Makerere University, Kisenyi health center IV and Kampala City Council authority for providing permissions to access patient records for this study.\u003c/p\u003e\n\u003ch2\u003eData Availability\u003c/h2\u003e\n\u003cp\u003eThe datasets used and/or analysed during the current study available from the corresponding author on reasonable request.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eMahy MI, Sabin KM, Feizzadeh A, Wanyeki I. Progress towards 2020 global HIV impact and treatment targets. J Int AIDS Soc. 2021;24:e25779.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eUNICEF, Children. and HIV and AIDS: Global snapshot 2023. United Nations Children\u0026rsquo;s Fund. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://www.unicef.org/reports/children-and-hiv-and-aids-global-snapshot-2023\u003c/span\u003e\u003cspan address=\"https://www.unicef.org/reports/children-and-hiv-and-aids-global-snapshot-2023\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e, 2023.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eHovis IW, et al. Decreased Prevalence of Rheumatic Heart Disease Confirmed Among HIVpositive Youth. Pediatr Infect Dis J. 2019;38(4):406\u0026ndash;9. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1097/INF.0000000000002161\u003c/span\u003e\u003cspan address=\"10.1097/INF.0000000000002161\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eYah CS, Tambo E. Why is mother to child transmission (MTCT) of HIV a continual threat to new-borns in sub-Saharan Africa (SSA). J Infect Public Health. 2019;12(2):213\u0026ndash;23. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1016/j.jiph.2018.10.008\u003c/span\u003e\u003cspan address=\"10.1016/j.jiph.2018.10.008\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eClarence E, Jeena PM. The unmet need for critical care at a quaternary paediatric intensive care unit in South Africa. South Afr Med J. 2022;112(11):871\u0026ndash;8.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eNational Institutes of Health (NIH) Office of AIDS Research. *NIH strategic plan for HIV and HIV-related research FY 2021\u0026ndash;2025: Implementation plan for 2023*. U.S. Department of Health and Human Services. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://www.oar.nih.gov/hiv-policy-and-research/strategic-plan\u003c/span\u003e\u003cspan address=\"https://www.oar.nih.gov/hiv-policy-and-research/strategic-plan\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e, 2023.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eEllington SR, Clarke KE, Kourtis AP. Cytomegalovirus infection in human immunodeficiency virus (HIV)\u0026ndash;exposed and HIV-infected infants: a systematic review. J Infect Dis. 2016;213(6):891\u0026ndash;900.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eEllington SR, King CC, Kourtis AP. Host factors that influence mother-to-child transmission of HIV-1: genetics, coinfections, behavior and nutrition. Future Virol. 2011;6(2):1451\u0026ndash;69. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.2217/fvl.11.119\u003c/span\u003e\u003cspan address=\"10.2217/fvl.11.119\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eUNICEF, Children HIV. and AIDS: Global and regional snapshots 2022. United Nations Children\u0026rsquo;s Fund (UNICEF). \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://data.unicef.org/resources/children-hiv-and-aids-global-snapshot-2022/\u003c/span\u003e\u003cspan address=\"https://data.unicef.org/resources/children-hiv-and-aids-global-snapshot-2022/\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e, 2022.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eUNAIDS. The gap report. Joint United Nations Programme on HIV/AIDS. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://www.unaids.org/en/resources/documents/2014/20140716_UNAIDS_gap_report\u003c/span\u003e\u003cspan address=\"https://www.unaids.org/en/resources/documents/2014/20140716_UNAIDS_gap_report\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e, 2014.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eChi BH, et al. 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Joint United Nations Programme on HIV/AIDS. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://www.unaids.org/en/resources/documents/2011/20111130_ua_report\u003c/span\u003e\u003cspan address=\"https://www.unaids.org/en/resources/documents/2011/20111130_ua_report\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e, 2011.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eUganda Ministry of Health \u0026amp; U.S. Centers for Disease Control and Prevention. *Uganda Population-based HIV Impact Assessment (UPHIA) 2020\u0026ndash;2021: Final report*. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://phia.icap.columbia.edu/wp-content/uploads/2022/07/UPHIA-2021-Summary-Sheet_English.pdf\u003c/span\u003e\u003cspan address=\"https://phia.icap.columbia.edu/wp-content/uploads/2022/07/UPHIA-2021-Summary-Sheet_English.pdf\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e, 2022.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eWorld Health Organization. Infant feeding for the prevention of mother-to-child transmission of HIV. Retrieved from \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://www.who.int/tools/elena/interventions/hiv-infant-feeding\u003c/span\u003e\u003cspan address=\"https://www.who.int/tools/elena/interventions/hiv-infant-feeding\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e, 2023.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003ePebody R. How likely is mother-to-child transmission of HIV? Retrieved from \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://www.aidsmap.com/about-hiv/how-likely-mother-child-transmission-hiv\u003c/span\u003e\u003cspan address=\"https://www.aidsmap.com/about-hiv/how-likely-mother-child-transmission-hiv\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e, 2022.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAbonazel MR, Ibrahim MG. On estimation methods for binary logistic regression model with missing values. Int J Math Comput Sci. 2018;4(3):79\u0026ndash;85.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eZash R, Jacobson DL, Diseko M, Mayondi G, Mmalane M, Shapiro RL. Comparative safety of antiretroviral treatment regimens in pregnancy. JAMA Pediatr. 2017;171(10):e172222\u0026ndash;172222.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eCiaranello AL, Seage GR, Freedberg KA, Weinstein MC, Lockman S, Walensky RP. Antiretroviral drugs for preventing mother-to-child transmission of HIV in sub-Saharan Africa: balancing efficacy and infant toxicity, \u003cem\u003eAIDS\u003c/em\u003e, vol. 22, no. 17, pp. 2359\u0026ndash;2369, Nov. 2008, \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1097/QAD.0b013e3283189bd7\u003c/span\u003e\u003cspan address=\"10.1097/QAD.0b013e3283189bd7\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eCiaranello AL, Seage GR III, Freedberg KA, Weinstein MC, Lockman S, Walensky RP. Antiretroviral drugs for preventing mother-to-child transmission of HIV in sub-Saharan Africa: balancing efficacy and infant toxicity. AIDS. 2008;22(17):2359.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eThea DM, Steketee RW, Pliner V, Bornschlegel T, Orloff S, Kalish ML. The effect of maternal viral load on the risk of perinatal transmission of HIV-1. Aids. 1997;11(4):437\u0026ndash;44.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eHoffman RM, et al. Effects of highly active antiretroviral therapy duration and regimen on risk for mother-to-child transmission of HIV in Johannesburg, South Africa. J Acquir Immune Defic Syndr (JAIDS). 2010;54(1):35\u0026ndash;41. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1097/QAI.0b013e3181cf9979**\u003c/span\u003e\u003cspan address=\"10.1097/QAI.0b013e3181cf9979**\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-infectious-diseases","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"infd","sideBox":"Learn more about [BMC Infectious Diseases](http://bmcinfectdis.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/infd","title":"BMC Infectious Diseases","twitterHandle":"#bmcinfectdis","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Mother-to-child transmission, HIV transmission, Infant HIV status, Pediatric HIV, Antiretroviral, Kampala-Uganda","lastPublishedDoi":"10.21203/rs.3.rs-6701744/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-6701744/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground\u003c/strong\u003e: Transmission of HIV from mother to child (MTCT) contributes to 18% of new HIV infections in Uganda. This study aimed at investigating how clinical and biological risk factors were associated with the transmission of HIV from mothers to children in Uganda.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods:\u003c/strong\u003e This study utilized secondary data extracted from patient charts of 200 HIV-positive mothers and their children who received services at Kisenyi Health Centre IV between 2017 and 2022. To model the relationship between the independent factors and the child’s HIV status, the Probit regression model was used.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults:\u003c/strong\u003e Among the children, 22.5% were HIV positive. The type of antiretroviral (ARV) regimen administered to the mother significantly influenced the child’s HIV status. Specifically, the AZT/3TC/NVP regimen (Zidovudine, Lamivudine, Nevirapine) was associated with a statistically significant increase in the odds of HIV positivity in children (OR = 5.12; p = 0.016). Children whose mothers received the ABC/3TC/LPV regimen had 2.49 times higher odds of being HIV positive compared to those on regimen TDF/3TC/EFV (p = 0.017). Additionally, maternal HIV viral load was a significant biological determinant of the child’s HIV status. A viral load above 1000 copies/mL was associated with a fivefold increase in the odds of the child being HIV positive (OR = 5.06; p \u0026lt; 0.001).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusions:\u003c/strong\u003e These findings highlight the importance of clinical decision-making, particularly the choice of ARV regimen, and the monitoring of maternal HIV viral load during pregnancy to optimize the likelihood of delivering an HIV-negative child. The study further recommends that future research and targeted interventions build on these results to improve HIV treatment outcomes in pediatric populations.\u003c/p\u003e","manuscriptTitle":"Clinical and biological risk factors influencing Infant HIV Status in Uganda: A Case Study of Kisenyi Health Center IV, Kampala","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-06-17 10:31:59","doi":"10.21203/rs.3.rs-6701744/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2025-10-14T14:57:11+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-07-09T22:08:46+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"159287436614205568621121682584657715431","date":"2025-06-30T14:08:01+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-06-25T12:13:02+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"237912117766356662851245407586609377388","date":"2025-06-23T08:00:52+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"55525966645701708501406110473710708899","date":"2025-06-13T12:08:28+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-06-13T11:05:48+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2025-05-22T16:17:56+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-05-22T11:36:02+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-05-22T11:32:40+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Infectious Diseases","date":"2025-05-19T19:48:20+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-infectious-diseases","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"infd","sideBox":"Learn more about [BMC Infectious Diseases](http://bmcinfectdis.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/infd","title":"BMC Infectious Diseases","twitterHandle":"#bmcinfectdis","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"f3839ee0-0fb0-4933-9f05-4e62f74ab8bd","owner":[],"postedDate":"June 17th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[],"tags":[],"updatedAt":"2026-02-16T16:05:15+00:00","versionOfRecord":{"articleIdentity":"rs-6701744","link":"https://doi.org/10.1186/s12879-026-12836-3","journal":{"identity":"bmc-infectious-diseases","isVorOnly":false,"title":"BMC Infectious Diseases"},"publishedOn":"2026-02-11 15:58:15","publishedOnDateReadable":"February 11th, 2026"},"versionCreatedAt":"2025-06-17 10:31:59","video":"","vorDoi":"10.1186/s12879-026-12836-3","vorDoiUrl":"https://doi.org/10.1186/s12879-026-12836-3","workflowStages":[]},"version":"v1","identity":"rs-6701744","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-6701744","identity":"rs-6701744","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}