Magnitude of HIV and associated factors among antenatal care pregnant women at public hospitals of eastern zone Tigray Ethiopia, 2025 G.C

Magnitude of HIV and associated factors among antenatal care pregnant women at public hospitals of eastern zone Tigray Ethiopia, 2025 G.C | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Magnitude of HIV and associated factors among antenatal care pregnant women at public hospitals of eastern zone Tigray Ethiopia, 2025 G.C Asgele Gebrekrstos This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-8455195/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background: HIV infection is mainly transmitted via sexual contact and mother to child during pregnancy, delivery and breast feeding and among avertable infection; it is significantly contributor to adverse birth outcomes of pregnancy worldwide particularly in low and middle income countries. Sub-Saharan African countries including Ethiopia are among affected areas with HIV infection. Ethiopia is currently providing and demonstrating strategies aimed to ending AIDS death, to eliminate new infection of HIV and elimination of MTCT of HIV particularly in pregnant women by 2030, as part of Sustainable Development goals. Hence, this study aimed to assess the magnitudes of HIV infection and associated factors among pregnant women attending antenatal care at public hospitals of eastern zone, Tigray, Ethiopia during the period 2024/25. Methods - Institutional-based cross-sectional study was conducted at public hospitals of eastern zone, Tigray, Ethiopia. Initially hospitals were selected via simple random sampling then pregnant women were selected using a systematic random sampling technique. Interviewer questionnaire and chart reviews were used to collect data. Data was collected using kobo collect tool, cleaned using Excel and analyzed in SPSSV23.0. Descriptive statistics was used to assess the magnitude of HIV and binary logistic regression was used to determine associated factors. Variables with p-value less than 0.25 were transferred to multivariable analysis. Variables with P-value<0.05 were used to declare statistical significance. Result :-The magnitude of HIV infection among pregnant women was 11.4 % with (95% CI,8.4-14.4). This study showed 64% of the pregnant women who reported history of sexually forced or raped were found to be living with HIV infection. Significant associated factors for HIV prevalence were history of sexually Forced /raped within five years, women with STI history within one year, number of sexual partners in her life and women had Sign and symptoms of STI. Conclusion: The present study found significant high rate of HIV infection among pregnant women and history of sexually Forced /raped within last five years were also among significant influential associated factors to this high prevalence. Infectious Diseases HIV magnitude pregnant women eastern zone Tigray Background Sexual transmitted infections(STI) can be bacteria, viruses, fungi or parasites that mainly transmitted via sexual contact including vaginal, anal and oral sex as well as from mother to child during pregnancy, childbirth and breast feeding [1] . Human immunodeficiency virus (HIV) infection is among prevalent Sexual transmitted infections and is the most serious public health problem that leads to adverse birth outcomes of pregnancy worldwide particularly Africa region including Ethiopia[ 2] . Human immunodeficiency virus (HIV) is a viral infection that causes acquired immunodeficiency syndrome (AIDS) and predominantly transmitted through sexual contact. Human immunodeficiency virus (HIV) can also be spread via blood contact, breast milk and during pregnancy and delivery to the child, but cannot transmitted through ordinary day-to-day contact such as kissing, hugging, shaking hands, or sharing personal objects, food or water [3]. HIV is a viral infection that can affect all age groups of the population; however the most vulnerable groups are Women and girls, young people, people who inject drugs, sex workers, people who live in low socioeconomic conditions and prisoners. This virus is transmitted through certain body fluids and weakens the immune system by destroying cells that fight disease and it can also spread from a mother to her baby [4] . There were an estimated 39.9 million [36.1–44.6 million) people living with HIV in 2023, among whom 53% were women and girls. Despite ongoing transmission in all countries globally and there were also 1.3 million new HIV infections globally which decline 40% from 2010 [5] . In Africa an estimated 25.6 million people living with HIV, 760,000 newly infected with HIV and about 380,000 people died from AIDS related illness in 2022 [6] . HIV infection is still among the most serious health problems of the world, particularly in low-income countries. HIV infection during pregnancy has been associated with numerous adverse pregnancy outcomes. The maternal infection can lead to spontaneous abortion, preterm labor, fetal death, fetal-growth restriction, or fetal infection. [7] .In 2023, around 1.2 million pregnant women were living with HIV and the rate of mother-to-child HIV transmission including perinatal and postnatal infections were 10%. Over all, Sub-Saharan Africa countries are covers to above 80% of children living with HIV aged 0–19 years[8]. In 2023, there were 120,000 new HIV infections among children under five which was dramatic declining from 300,000 in 2010.There is progress in reducing mother-to-child transmission of HIV due to increased access to PMTCT-related services and increased number of pregnant women living with HIV being initiated on lifelong antiretroviral medicines. But progress is slow and not enough to meet the 2025 targets[9]. HIV incidence and HIV-related deaths are slowly declining and numerous countries reported increases in adult cases. However, the risk of HIV infection is increasing with key populations as compared to the general population and it requires further fast intervention in HIV prevention. In Africa the prevalence of HIV among pregnant women is higher than other continents and it is as high as 44.3%[10] . Currently in Ethiopia around 610,000 people are living with HIV and an estimated 100,000 people living with HIV (PLHIV) are not aware of their status. In 2021 G.C the annual report of new HIV infection was 12,000 people which decreased by 54% since 2010. Around 12,000 people died in Ethiopia due to AIDS, a 56% reduction from 27,000 in 2010.The prevalence of HIV infection trend demonstrated a downward from 1.4% in 2010 to 0.8% in 2021 and 0.77% in 2022 [11] . Based on the data EPHI 2019 estimate, Ethiopia had 18,677 mothers who need ART for PMTCT across the nation, of whom 17,164 received ART which is a 91.9% performance. In Ethiopia the prevalence of HIV is higher in urban areas than in rural areas and it also varies from region to region. In 2016, the rural prevalence was 0.4%, which was seven times less than the urban prevalence 2.9% and based on this national report of Ethiopia in diverse geographic areas, HIV prevalence varies by location, ranging from less than 0.15% in Ethiopia Somali to 3.99% in Gambella regions in 2019/20 [2] . However, many studies in Ethiopia showed that the prevalence of HIV infection among pregnant women is higher than the national reports, the prevalence of HIV among pregnant women rose to 11.2% and the prevalence of adverse birth out-come among HIV-positive mothers was also high, which showed 21%[12, 13]. Currently new HIV infection in key populations continues to face increases from time to time particularly low-income countries like Ethiopia, though the core objective of Ethiopia and different international organizations are focused on ending AIDS death, eliminating new HIV infections and eliminating mother to child transmission of HIV. Although the international organizations including Ethiopia did not achieve the targets of 2025, Still these organizations are continuing promote synergies across the disease areas under a universal health coverage framework and promote implementation focused on achieving the goals of ending AIDS death related, eliminating new HIV infections, and eliminating MTCT of HIV by 2030, as part of efforts towards achieving the 2030 Agenda for Sustainable Development. Despite Ethiopia having launched and demonstrated strategies to achieving the 2030 Agenda for Sustainable development goals and to ensure no child is born infected with HIV, ending AIDS death and eliminating new HIV infections, Still HIV infection is continues to be a major global public health concern. Although there are some studies done in other regions of Ethiopia regarding HIV infection in pregnancy, but there is no clear study in Tigray region concerning magnitudes of HIV infection in pregnancy as far as our knowledge, likely due to Covid19 & war zone. Thus, this study was designed to assess magnitude of HIV infection and associated factors among antenatal care pregnant women at public hospitals of eastern zone, Tigray, Ethiopia. Methods and materials Study Area and Period The study was conducted at public hospitals of Eastern zone, Tigray, Ethiopia. It is one of the seven zones in Tigray regional state. Adigrat town is the zonal town which is located 116.7 Kms north of Mekelle city and 1035.3Kms north of Addis Abeba. Based on a 2007 census, this zone has a total population of 755,343. According to the 2019 Tigray regional health bureau data, there are 2 general hospitals,5 primary hospitals, 40 health centers and 132 health posts in Eastern zone Tigray, all of which are governmental. List of the hospitals are Adigrat Hospital, Wukro Hospital, Dr.Tsegay Hospital, Freweyni Hospital, Dewuhan Hospital, Fresemetat Hospital and Mulu Assefa Hospital and Five of these hospitals were included in the study. The Study was conducted from March to May 2025. Study Design The purpose of this study was to assess magnitude of HIV infection among pregnant women attending antenatal care and associated factors at public hospitals of eastern zone Tigray Ethiopia, during the 2025 G.C. The appropriate method for this study was an institutional- based analytical cross-sectional study, as this design was suitable or important for collecting or gathering data at single point of time and was appropriate for showing magnitude and associated factors of HIV infection among antenatal care pregnant women. Population Source of population All pregnant women who came to antenatal care at public hospitals of Eastern zone. Study population All pregnant women who came to antenatal care at selected public hospitals Eastern zone during the study period. Inclusion and Exclusion criteria Inclusion criteria All pregnant women who came to antenatal care in selected public hospitals Eastern zone during the study period. Exclusion criteria Pregnant women who were seriously ill and those who were mentally ill during data collection time were excluded. Sample Size Determination The sample size was calculated using a single proportion formula considering the following assumptions. n= the required sample size Z= is the standard normal deviation usually set at 1.96 d= the degree of accuracy desired usually set as 0.03 P= it was taken from study done in Referral Hospitals of the Amhara Regional State, Ethiopia which is 10.4% [14]. n= Z 2 p(1-p)/d2 n=(1.96) 2 0.104(1-.104)/(.03) 2 = 398 with 10% non-response rate 438 Sampling Procedures Simple random sampling was used to select hospitals. Initially, hospitals were selected, followed by a selection of study participants using systematic sampling methods. Five hospitals were included via simple random sampling methods out of seven hospitals of eastern zone Tigray,Ethiopia. The selected hospitals were Adigrat Hospitals, Wukro Hospital, Dr.Tsegay Hospital, Freweyni Hospital and Dewuhan Hospital. The sample was allocated to hospitals via proportionally, based on their average monthly antenatal care client flow from previous months. Over the last three months, the average number of pregnant women who visited at specific hospitals were 480 Adigrat Hospital, 420 Wukro Hospital, 360 Freweyni Hospital,320 Dr.Tsegay Hospital and 170 Dewuhan Hospital. The sampling interval (K) value was calculated as 1750/438=4. All pregnant women who came to antenatal care in selected public hospitals of the Eastern zone during the study period and those who fulfilled the criteria were included. Study variables Independent variables Socio-demographic variables (age, education level(status), marital status, occupational status, and educational status ) Obstetrics, reproductive and medical history (ANC follow-up, blood transfusion, gravidity, previous history of abortion, stillbirth, the presence or History of STIs ,Husband’s history of STI, and syphilis status) Sexual and Behavior-related variables (number of life time sexual partners, new sexual partner, sexual violence ,alcohol and condom use) Dependent variable Magnitude of HIV infection among pregnant women Operational Definitions Sexual Violence -Pregnant women who have any history of the act of forcing or attempting to force through physical body harm or any means to engage in sexual behavior against their will. Alcohol use : It was assessed with the question “Have you been drinking alcohol during your current pregnancy?” If the answer will “yes” and took any unit of alcohol during the current pregnancy, then the mother was considered to have alcohol exposure while pregnant. Data collection instrument and procedure In this Study, the data were gathered using primary sources and chart review. The primary data were obtained using structured questionnaire administered through face to face interviews with pregnant women and via chart review. The questionnaire was developed following a review of different literatures [10, 13-25] and it included socio-demographic characteristics, obstetrics history, reproductive health and medical history, Sexual and behavioral factors. The questionnaire was prepared in English, translated into the local language Tigrigna, then back-translated to English to check its consistency. A Pre-test was carried out outside study area at Fresemaetat hospital and necessary modifications were made. Ten degree holder midwives participated to collect the data; and two master midwives and four general practitioners (GP) participated as supervisors. Data quality and management We gave Training for data collectors and supervisors for two days on how to collect the data, how to handle the participants and how to follow the data collectors. A Pretest was conducted on 5% of the total sample and based on the pre-test modification was made on the questionnaire. The data compilation system and data completeness were checked and strictly controlled by the principal investigator and supervisors. Data were collected using kobo-collect, cleaned in Microsoft excel and exported to SPSS version 23 software package. Double data entry and random checks were made to ensure the validity of the study. Confidentiality and privacy were given special emphasis during the training session and data collection time. Data processing and analysis Data was checked and screened each questionnaire and codes were carefully written at each margin of the questionnaire after the data collection period was complete. After data was collected using kobo-collect and cleaned using Microsoft Excel then exported to SPSS (Statistical Package for the Social science) version 23 for analysis. Data cleaning was performed for each variable to check its accuracy, identify inconsistencies and address missing values of the data. Descriptive statistics like mean, frequency and percentage was explored using tables and figures to display the values of the variables in the study. Bivariate and multivariable analysis was also conducted to see the association and to measure the strength of the relationship between dependent and independent variables. Variables with p-value of less than 0.25 were transferred to multivariable analysis and Variable with P-value<0.05 was used to declare statistical significance. The association between dependent and independent variables was determined using Adjusted Odds Ratio (AOR) with a 95% confidence Interval (CI). Results Socio-demographic characters Total of 438 participants were interviewed and their charts were reviewed, making 100 % response rate. The socio- demographic data mainly focused on the distribution of age, residence, marital status, maternal education, maternal occupation, and gravidity. The largest age group was from 25-34 years, accounting for nearly half of the sample (48.6%, n=213). A significant number of the participants lived in urban areas accounting for 72.1% (n=316). Of the participants,84.5%(n=370) of the pregnant women were married and most mothers had completed some level of schooling, with Elementary and high school accounting for 325(74.2%).The majority of participants,296(67.6%) of the pregnant women were housewives and around 384(87.7%) were also Orthodox religion. Among respondents more than half 55.7% had an income less than 5000 ETB and most of the pregnant women were multigravida 330 (75.3%)( Table-1 ). Table-1:- Socio-demographic characters Variables Frequency Percent Age in years 18-24 124 28.3 25-34 213 48.6 35-55 101 23.1 Residence Frequency Percent Urban 316 72.1 Rural 122 27.9 Marital status Frequency Percent Married 370 84.5 Not Married 68 15.5 Educational level of the mother Frequency Percent Illiterate 52 11.9 Elementary and high school 325 74.2 Deploma and above 61 13.9 Occupation of the mother Frequency Percent Housewife 296 67.6 Merchant 20 4.6 Government employed 41 9.4 Private employed 59 13.5 Others 22 5 Gravidity Frequency Percent Primgravida 108 24.7 Multigravida 330 75.3 Income Frequency Percent 50-5000 244 55.7 5001-10000 109 24.9 10001-20000 82 18.7 20001-50000 3 .7 Religion Frequency Percent Orthodox 384 87.7 Catholic 33 7.5 Muslim 20 4.6 Protestant 1 .2 Maternal, reproductive and sexual health related factors The table or data focused on the descriptive analysis of reproductive history, gestational age at time data collection, sexual health, relationship dynamics, sexual history/risk behaviors, and current infection status for Syphilis and HIV of the pregnant women. Of the total respondents, 108 (24.7%) of the pregnant women had a history of abortion. Majority 268(61.2%) of the respondents were in third trimester whereas 128(29.2%) were second trimester and only 42(9.6%) were in the first trimester. Regarding current and history of sexually transmitted infections, around 72(16.4%) of the pregnant women reported having had STI within the past one year and 45(10.3%) of the respondents were also reported having signs and symptoms of sexual transmitted infections (STI). Among the total respondents, the majority 296(67.6%) were currently living with their husband and 89(20.3%) of the total participants suspected their regular partner was having a sexual relationship with someone else. 337(76.9%) of the pregnant women reported having only one lifetime sexual partner, while 101(23.1%) reported more than one sexual partner. Of all respondents, around 25(5.7%) of the pregnant women reported a history of sexually forced/rape or had sex against their will within the last five years and 64% of those women were found to be living with HIV. Nearly 63(14.4%) of all participants had multiple sexual partners in the last one year, while a small group 21(4.8%) were receiving money or goods for sex. Prevalence of current HIV infection of pregnant women Of the total 438 respondents, 50(11.4%)(95%CI:8.4%-14.4%) of the pregnant women were HIV seropositive. In addition to this, 20(4.6%)95%CI:2.5%-6.6%) of the participants were also syphilis seropositive and 8(1.8%) of the women had HIV-Syphilis co-infection (Table-2). Table-2- Maternal, reproductive and sexual health related factors Variables Category Frequency (%) History of abortion Yes 108(24.7%) No 330(74.3%) Gestational age at time of data collection First trimester 42(9.6%) Second trimester 128(29.2%) Third trimester 268((61.2%) History of STI in last one year Yes 72(16.4%) No 366(83.6%) Do you currently live with your husband/ partner Yes 296(67.6%) No 142(32.4%) Do you suspecting your regular partner is having a sexual relationship with some Yes 89(20.3%) No 349(79.7%) Received money or goods for sex Yes 21(4.8%) No 417(95.2%) In your lifetime, have you ever had sex with a casual partner who was 10 or more than10 years Yes 12(2.7%) No 426(97.3%) Did you have Multiple sexual partner in the past 1 year Yes 63(14.4%) NO 375(85.6%) In your lifetime, have you ever received money or goods for sex Yes 21(4.8%) No 417(95.2%) How many sexual partner did you have in your lifetime One partner 337(76.9%) Two or More partner 101(23.1%) Have ever had sex with some body forced/raped or Against your will with in the last five year? Yes 25(5.7%) No 413(94.3%) Sign and symptoms of STI Yes 45(10.3%) No 393(89.7%) Family history of HIV Yes 27(6.2%) No 411(93.8%) Current Syphilis condition Yes 20(4.6%)95%,2.5-6.6) No 418(95.4%) Current HIV status Yes 50(11.4%)(95%,8.4-14.4) No 388(88.6%) HIV-Syphilis Co-infection Yes 8(1.8%) No 430(98.2%) Factors associated with HIV among pregnant women In the bivariate logistic regression analysis, the factors associated with HIV infection of Sero-prevalence included nine variables such as Age , Women with STI history with in one year, Husband suspecting another sexual partners, multiple sexual partners within 1 year, Number of sexual partner in her life , history of Sexually Forced /rape within five years, Sign and symptoms of STI, history of Sex for money or good and Syphilis condition/status were considered as candidate to further analysis to multivariable logistic regression with p-value was less than 0.25. Of the total 438 respondents, 50(11.4%)(95%,) of the pregnant women were HIV seropositive. In multivariate logistic regression analysis, after controlling possible confounders, variables or factors were considered significantly associated with Sero-prevalence of HIV infection at p-value less than 0.05 were: history of Sexually Forced /rape within five years, Women with STI history within one year, Number of sexual partners in her life and women had Sign and symptoms of STI. This study indicated that pregnant women who reported STI history in the past year had 3.7 times more likely to have HIV positive compared to those who did not with (AOR=3.7,95%CI(1.5-8.9). In this study pregnant women who experienced sexually Forced /rape against her will within five years had 5.4 times being HIV positive compared to those who did not with (AOR=5.4,95%,CI(1.76-16.67). The study finding showed that mothers who had more than one sexual partners in their life time had 4.8 times more likely to have HIV positive than who had one sexual partners in their life time (AOR=4.8,95% CI(1.8-12.77). Participants who reported signs and symptoms of an STI had nearly 6.6 times having HIV positive compared to those who did not reported with (AOR= 6.6,95%,CI(2.3-18.7) (Table-3 ). Table-3- Factors associated with HIV among pregnant women at public hospitals of Tigray,Ethiopia. Variables Category HIV COR (95%CI) AOR (95%CI) P-Value Positive Negative Age 15-24 8(16%) 116(29.9%) .25(.105-.584) .396(.12-1.26) .118 25-34 20(40%) 193(49.7%) .37(.19-.7) .73(.28-1.9) .518 35-55 22(44%) 79(20.4%) 1 1 Women with STI history with in one year Yes 31(62%) 41(10.6%) 13.8(7.2-26.6) 3.7(1.5-8.9) .004 No 19(38%) 347(89.4%) 1 1 Husband had another sexual partner Yes 36(72%) 53(13.7%) 16.3(8.2-32.2) 2.44(.95-6.3) .063 No 14(28%) 335(86.3%) 1 1 Women had multiple sexual partner with in 1 year Yes 29(58%) 34(8.8%) 14.38(7.4-27.9) 1.5(.53-4) .46 No 21(42%) 354(91.2%) 1 1 Number of sexual partner in her life 1 12(24%) 325(83.8%) 1 1 2 and above 38(76%) 63(16.2%) 16.3(8.09-32.99) 4.8(1.8-12.77) .002 Sexually Forced /rape within five years Yes 16(32%) 9(2.3%) 19.8(8.15-48.2) 5.4(1.76-16.67) 0.003 No 34(68%) 379(97.7%) 1 1 Sign and symptoms of STI Yes 26(52%) 19(4.9%) 21(10.3-43.3) 6.6(2.3-18.7) .000 No 24(48%) 369(95.1%) 1 1 Sex for money or good Yes 13(26%) 8(2.1%) 16.7(6.5-42.9) .98(.25-3.8) .98 No 37(74%) 38(97.9%) 1 Syphilis condition Yes 8(16%) 12(3.1%) 5.97(2.3-15.4) 3.65(.9-14.6) .067 No 42(84%) 376(96.9%) 1 1 COR=crude odds ratio, AOR=adjusted odds ratio Discussion This study focused on the investigation of HIV prevalence and associated factors among pregnant women in Eastern zone, Tigray, Ethiopia and the results provided us update finding about current HIV prevalence among pregnant women in Tigray. In addition to HIV prevalence this study also investigated the prevalence of syphilis in pregnancy and HIV/Syphilis co-infection. According to current study done in Tigray, Ethiopia, the prevalence of HIV among pregnant women was 50(11.4%)(95%,8.4-14.4) and this high prevalence is alarming for the region and nation. This study is comparable with the study done in Felege Hiwot Comprehensive Specialized Hospital, Amhara region, Ethiopia which was 10.4% [8] and study conducted in yirgalem hospital ,southern Ethiopia(10.1%) [23].Our result was also familiar with study Carried out in Democratic Republic of Congo(11%) [26] and study done in Mozambique(11.48%)[27],Cameroon (9.3%)[28]. Based on the present study conducted in Tigray, Ethiopia, the prevalence of HIV during pregnancy is 11.4%,which is higher than study conducted in Amhara regional state, northern Ethiopia(7.6%) [24], Atat Hospital, Southern Ethiopia(2.7%)[29], in Mizan Tepi University Teaching Hospital, Southwest Ethiopia(5%)[19], in Debre Berhan ,Ethiopia(7.2%)[25].This difference might be due to,Tigray was at war zone for the last three years and it was impacted population, particularly due to sexual violence and destruction of the health system. The current study done in Tigray, Ethiopia HIV prevalence among pregnant women were also higher than as compare to study conducted in Tanzania(2.4%)[18], in Kabarole District, Uganda(2.9%)[16], in Nigeria(7.22%)[21], in rural Gabon (3.9%)[30],in Cameroon(6.8%)[31], in a Tertiary Care Hospital in Islamabad,Pakistan(1.5%)[32], a systematic review and meta-analysis in china(2.9%)[22]. This discrepancy might be due to study time, study area and socio-demographic characteristics of the population. Studies carried out in South Africa, in Luanda (Angola) and a Tertiary Hospital in Ibadan, Nigeria, in Lusaka Province, Zambia and in Cameroon revealed HIV prevalence among pregnant was 44.3%,13.4%, 26.4% , 26% and 13.1% respectively[17, 20, 33-35], which were slightly higher as compared to the current study. The possible reason for this difference might be due to inadequacy and poorly targeted intervention activities and antenatal follow up. This study also identified factors associated with HIV prevalence among pregnant women like history of Sexually Forced /rape within five years, Women with STI history within one year, Number of sexual partners in her life and women had Sign and symptoms of STI. The current study carried out in Tigray showed that pregnant women who experienced history of sexually violence / Forced or rape against her will within five years had 5.4 times being HIV positive compared to those who did not with(AOR=5.4,95%,CI(1.76-16.67).This finding was consistent with cross-sectional study done in Kobo Town, Ehtiopia [15]. The reason might be due to both area were affected by war/conflict. In this study the Pregnant women who had history of STI 3.7 times more likely have HIV infection when we compared to their counterparts with (AOR=3.7,95%CI(1.5-8.9). This finding has agreement with study conducted in Amhara region, northern Ethiopia[24] and in Kobo Town, Ehtiopia[15].This might be due to there is high risk HIV infection transmission increases with who have Sexually transmitted infection. The probability of acquiring HIV infection was 4.8 times higher among Mothers who had more than one sexual partners in their life time had than who had one sexual partners in their life time (AOR=4.8,95% CI(1.8-12.77). The finding in line with study carried-out in Kabarole District,Uganda[16] in Lusaka, Zambia[36].The reason is logically the risk of acquiring any sexually transmitted infection specifically HIV infection increases with increasing number of sexual partner. Pregnant women who reported signs and symptoms of an STI had nearly 6.6(AOR= 6.6,95%,CI(2.3-18.7) times significantly increases HIV infection compared to those who did not reported. This is similar with study done in South Africa[37]. The possible reason might be due to the presence of genital ulcer and inflammation may increase susceptible to HIV infection. Limitation of the study The current study was done at specific zone of Tigray region, which has been affected region with war and post war crisis ,so it might not generalized to the other areas of the country. Conclusion and Recommendations Based on this study the magnitude of HIV infection among pregnant women was significantly high which gave alarming for the region and as whole nation. This result indicated that it needs tremendous intervention on the institutions and community as whole to resolve the problem. According to this study the factors significantly associated to the increment of HIV infection among pregnant women were sexually forced /rape within five years, women with STI history within one year, number of sexual partners in her life and women had Sign and symptoms of STI. Therefore the finding indicated that the region still on the post war impact or post war health crisis, so the regional and national government more expected to do on prevention and intervention to eliminate new infection among pregnant women and eliminate maternal to child transmission. Abbreviations AIDS -Acquired Immunodeficiency Syndrome , ANC -Antenatal Care, AOR -Adjusted Odds Ratio, ART -Antiretroviral treatment, CI -Confidence Interval , COR -Crude Odds Ratio, Covid19 –Coronavirus diseases 2019, Dr. -Doctor ,ETB- Ethiopian birr , G.C - Gregorian calendar, HIV -Human immunodeficiency virus, MTCT -Mother to child Transmission , PMTCT -Prevention of mother-to-child transmission, SD -Standard deviation , SPSS -Statistical package for the social science , STI -Sexual transmitted infections. Declarations Ethical Consideration The ethical approval and permission was obtained from Adigrat University College of Medicine and health sciences, Institutional Review Board. Permission was also obtained from study areas before the data collection was started. Additionally, data collectors were informed to the staff and Permission were requested to the responsible body at the beginning of data collection. Data collectors were accompanied by an official letter from Adigrat University College of Medicine and health sciences and Tigray regional health bureau. In accordance with the Declaration of Helsinki, behaviors of the study were clearly explained to the participants and data were collected after getting informed verbal consent from the respondents and maximum effort was invested to keep their privacy. Respondents were informed in advance about the purpose of the study as well as privacy and confidentiality of the participants was also protected. Consent for publication Not applicable Data availability The datasets used and/or analyzed during this study are available from the corresponding author on reasonable request. Competing interests The authors declare no competing interests Funding Adigrat University was source of funding to carry out for this research. The funding organization has no role in the design of the study and collection, analysis, and interpretation of data and in writing of the manuscript. Author Contributions AG, GM,TH, MG and GT contributed to the conception and design of the study, collected, entered, analyzed, interpreted the data and prepared the manuscript .HH,DG,HT,MK,NL and LT contributed to data analysis, interpretation and drafted the manuscript. All authors read and approved the final manuscript. Acknowledgments Our special gratitude goes to ANC staff, respondents for the priceless support during collection of the data for this project. We are also grateful to thank to public hospitals of eastern zone, Tigray for their assistance and cooperation in the data collection process. References WHO. 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Health and HIV Unit. 2024 Global HIV Estimates on children, adolescents and pregnant women . 2024 [cited 2024 2/11/2024]; Available from: https://www.childrenandaids.org/sites/default/files/2024-09/2024%20HIV%20Estimates%20Learning%20Lab%20-%20Final%20slides%20-%20September%202024%20pdf.pdf. women, U.D.M.t.s.o.c.a. Elimination of mother-to-child transmission . 2024 [cited 2024 2/11/2024]; Available from: https://data.unicef.org/topic/hivaids/emtct/. Hoque, M., et al., Prevalence, incidence and seroconversion of hiv and syphilis infections among pregnant women of south africa. Southern African journal of infectious diseases, 2021. 36 (1). fund, T.G. Global fund grants in the federal democratic republic of Ethiopia 2023 [cited 2023 2/11/24]; Available from: https://stage-globalfund-v8.euwest01.umbraco.io/media/13718/oig_gf-oig-24-006_report_en.pdf. 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Schumann, H., et al., The incidence of HIV and associated risk factors among pregnant women in Kabarole District, Uganda. PLoS One, 2020. 15 (6): p. e0234174. Fouedjio, J.H., et al., Prevalence and associated factors of HIV infection among pregnant women attending antenatal care at the Yaoundé central hospital. International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 2017. 6 (7): p. 2698. Magwe, E.A., Prevalence and Determinants of HIV Infections among Pregnant Women Attending Antenatal Clinics in Iringa Municipality, Tanzania. Afro-Egyptian Journal of Infectious and Endemic Diseases, 2025. 15 (2): p. 169-178. Asres, A.W., M.M. Endalew, and S.Y. Mengistu, Prevalence and trends of sexually transmitted infections among pregnant women in Mizan Tepi University Teaching Hospital, Southwest Ethiopia: a cross-sectional study. Pan African Medical Journal, 2022. 42 (1). Okonko, I.O., et al., Prevalence of HIV in a cohort of pregnant women attending a tertiary hospital in Ibadan, Nigeria. Immunol Infect Dis, 2019. 7 (1): p. 7-12. Ozim, C.O., et al., Prevalence of human immunodeficiency virus (HIV) among pregnant women in Nigeria: a systematic review and meta-analysis. BMJ open, 2023. 13 (3): p. e050164. Wu, S., et al., Prevalence of human immunodeficiency virus, syphilis, and hepatitis B and C virus infections in pregnant women: a systematic review and meta-analysis. Clinical microbiology and infection, 2023. 29 (8): p. 1000-1007. Amsalu, A., et al., Prevalence, Infectivity, and Associated Risk Factors of Hepatitis B Virus among Pregnant Women in Yirgalem Hospital, Ethiopia: Implication of Screening to Control Mother ‐to ‐Child Transmission. Journal of pregnancy, 2018. 2018 (1): p. 8435910. 24. Anteneh, D.E., et al., Seroprevalence of HIV, HBV, and syphilis co-infections and associated factors among pregnant women attending antenatal care in Amhara regional state, northern Ethiopia: A hospital-based cross-sectional study. Plos one, 2024. 19 (8): p. e0308634. 25. Zinabie, S., et al., Sero-prevalence of syphilis and HIV and associated factors in pregnant women attending antenatal care clinics in Debre Berhan Public Health Institutions, Ethiopia. Am J Biomed Life Sci, 2018. 6 (3): p. 56-62. 26. Pour, M., et al., Increased HIV in greater Kinshasa urban health zones: Democratic Republic of Congo (2017–2018). AIDS Research and Therapy, 2020. 17 (1): p. 67. 27. Mendes-Muxlhanga, A., et al., Over a decade of HIV infection prevalence and incidence among Mozambican pregnant women: a secondary analysis of prospectively collected data. BMC Public Health, 2025. 25 (1): p. 251. 28. Ebogo-Belobo, J.T., et al., Systematic review and meta-analysis of seroprevalence of human immunodeficiency virus serological markers among pregnant women in Africa, 1984-2020. World Journal of Critical Care Medicine, 2023. 12 (5): p. 264. 29. Bafa, T.A. and A.D. Egata, Seroepidemiological patterns and predictors of hepatitis B, C and HIV viruses among pregnant women attending antenatal care clinic of Atat Hospital, Southern Ethiopia. SAGE Open Medicine, 2020. 8 : p. 2050312119900870. 30. Davi, S.D., et al., Epidemiology of co-infections in pregnant women living with human immunodeficiency virus 1 in rural Gabon: a cross-sectional study. Infectious Diseases of Poverty, 2023. 12 (04): p. 83-92. 31. Egbe, T.O., et al., Estimating HIV incidence during pregnancy and knowledge of prevention of mother ‐to ‐child transmission with an ad hoc analysis of potential cofactors. Journal of Pregnancy, 2016. 2016 (1): p. 7397695. 32. Mishal, M., et al., Frequency of HIV Infection Among Pregnant Women in a Tertiary Care Hospital in Islamabad, Pakistan. Cureus, 2025. 17 (3). 33. Vueba, A.N., et al., Prevalence of HIV and hepatitis B virus among pregnant women in Luanda (Angola): geospatial distribution and its association with socio-demographic and clinical-obstetric determinants. Virology journal, 2021. 18 (1): p. 239. 34. Hoque, M., et al., Prevalence, incidence and seroconversion of HIV and Syphilis infections among pregnant women of South Africa. South Afr J Infect Dis. 2021; 36 (1): a296 . 35. Kasonde, G., M. Masaka, and C. Michelo, Trends in HIV Prevalence among Pregnant Women in Lusaka Province, Zambia 1994-2008. Journal of Transmitted Diseases and Immunity, 2018. 2 (1): p. 1-9. 36. Hamoonga, T.E., et al., HIV risk perception and associated factors among pregnant and breastfeeding women in Zambia: implications for PrEP uptake in antenatal and postnatal settings. Frontiers in Reproductive Health, 2025. 7 : p. 1540248. 37. Nyemba, D.C., et al., Prevalence, incidence and associated risk factors of STIs during pregnancy in South Africa. Sexually transmitted infections, 2021. 97 (5): p. 375-381. Additional Declarations The authors declare no competing interests. Cite Share Download PDF Status: Posted Version 1 posted 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. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. 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Human immunodeficiency virus (HIV) infection is among prevalent Sexual transmitted infections and is the most serious public health problem that leads to adverse birth outcomes of pregnancy worldwide particularly Africa region including Ethiopia[\u003cb\u003e2]\u003c/b\u003e. Human immunodeficiency virus (HIV) is a viral infection that causes acquired immunodeficiency syndrome (AIDS) and predominantly transmitted through sexual contact. Human immunodeficiency virus (HIV) can also be spread via blood contact, breast milk and during pregnancy and delivery to the child, but cannot transmitted through ordinary day-to-day contact such as kissing, hugging, shaking hands, or sharing personal objects, food or water\u003cb\u003e[3].\u003c/b\u003e\u003c/p\u003e \u003cp\u003eHIV is a viral infection that can affect all age groups of the population; however the most vulnerable groups are Women and girls, young people, people who inject drugs, sex workers, people who live in low socioeconomic conditions and prisoners. This virus is transmitted through certain body fluids and weakens the immune system by destroying cells that fight disease and it can also spread from a mother to her baby\u003cb\u003e[4]\u003c/b\u003e. There were an estimated 39.9\u0026nbsp;million [36.1\u0026ndash;44.6\u0026nbsp;million) people living with HIV in 2023, among whom 53% were women and girls. Despite ongoing transmission in all countries globally and there were also 1.3\u0026nbsp;million new HIV infections globally which decline 40% from 2010\u003cb\u003e[5]\u003c/b\u003e. In Africa an estimated 25.6\u0026nbsp;million people living with HIV, 760,000 newly infected with HIV and about 380,000 people died from AIDS related illness in 2022 \u003cb\u003e[6]\u003c/b\u003e .\u003c/p\u003e \u003cp\u003eHIV infection is still among the most serious health problems of the world, particularly in low-income countries. HIV infection during pregnancy has been associated with numerous adverse pregnancy outcomes. The maternal infection can lead to spontaneous abortion, preterm labor, fetal death, fetal-growth restriction, or fetal infection. \u003cb\u003e[7]\u003c/b\u003e.In 2023, around 1.2\u0026nbsp;million pregnant women were living with HIV and the rate of mother-to-child HIV transmission including perinatal and postnatal infections were 10%. Over all, Sub-Saharan Africa countries are covers to above 80% of children living with HIV aged 0\u0026ndash;19 years[8]. In 2023, there were 120,000 new HIV infections among children under five which was dramatic declining from 300,000 in 2010.There is progress in reducing mother-to-child transmission of HIV due to increased access to PMTCT-related services and increased number of pregnant women living with HIV being initiated on lifelong antiretroviral medicines. But progress is slow and not enough to meet the 2025 targets[9]. HIV incidence and HIV-related deaths are slowly declining and numerous countries reported increases in adult cases. However, the risk of HIV infection is increasing with key populations as compared to the general population and it requires further fast intervention in HIV prevention. In Africa the prevalence of HIV among pregnant women is higher than other continents and it is as high as 44.3%[10] .\u003c/p\u003e \u003cp\u003eCurrently in Ethiopia around 610,000 people are living with HIV and an estimated 100,000 people living with HIV (PLHIV) are not aware of their status. In 2021 G.C the annual report of new HIV infection was 12,000 people which decreased by 54% since 2010. Around 12,000 people died in Ethiopia due to AIDS, a 56% reduction from 27,000 in 2010.The prevalence of HIV infection trend demonstrated a downward from 1.4% in 2010 to 0.8% in 2021 and 0.77% in 2022 \u003cb\u003e[11]\u003c/b\u003e. Based on the data EPHI 2019 estimate, Ethiopia had 18,677 mothers who need ART for PMTCT across the nation, of whom 17,164 received ART which is a 91.9% performance. In Ethiopia the prevalence of HIV is higher in urban areas than in rural areas and it also varies from region to region. In 2016, the rural prevalence was 0.4%, which was seven times less than the urban prevalence 2.9% and based on this national report of Ethiopia in diverse geographic areas, HIV prevalence varies by location, ranging from less than 0.15% in Ethiopia Somali to 3.99% in Gambella regions in 2019/20 \u003cb\u003e[2]\u003c/b\u003e. However, many studies in Ethiopia showed that the prevalence of HIV infection among pregnant women is higher than the national reports, the prevalence of HIV among pregnant women rose to 11.2% and the prevalence of adverse birth out-come among HIV-positive mothers was also high, which showed 21%[12, 13].\u003c/p\u003e \u003cp\u003eCurrently new HIV infection in key populations continues to face increases from time to time particularly low-income countries like Ethiopia, though the core objective of Ethiopia and different international organizations are focused on ending AIDS death, eliminating new HIV infections and eliminating mother to child transmission of HIV. Although the international organizations including Ethiopia did not achieve the targets of 2025, Still these organizations are continuing promote synergies across the disease areas under a universal health coverage framework and promote implementation focused on achieving the goals of ending AIDS death related, eliminating new HIV infections, and eliminating MTCT of HIV by 2030, as part of efforts towards achieving the 2030 Agenda for Sustainable Development. Despite Ethiopia having launched and demonstrated strategies to achieving the 2030 Agenda for Sustainable development goals and to ensure no child is born infected with HIV, ending AIDS death and eliminating new HIV infections, Still HIV infection is continues to be a major global public health concern. Although there are some studies done in other regions of Ethiopia regarding HIV infection in pregnancy, but there is no clear study in Tigray region concerning magnitudes of HIV infection in pregnancy as far as our knowledge, likely due to Covid19 \u0026amp; war zone. Thus, this study was designed to assess magnitude of HIV infection and associated factors among antenatal care pregnant women at public hospitals of eastern zone, Tigray, Ethiopia.\u003c/p\u003e"},{"header":"Methods and materials","content":"\u003cp\u003e\u003cstrong\u003eStudy Area and Period \u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;The study was conducted at public hospitals of Eastern zone, Tigray, Ethiopia. It is one of the seven zones in Tigray regional state. Adigrat town is the zonal town which is located 116.7 Kms north of Mekelle city and 1035.3Kms north of Addis Abeba. Based on a 2007 census, this zone has a total population of 755,343. According to the 2019 Tigray regional health bureau data, there are 2 general hospitals,5 primary hospitals, 40 health centers and 132 health posts in Eastern zone Tigray, all of \u0026nbsp;which are governmental. List of the hospitals are Adigrat Hospital, Wukro Hospital, Dr.Tsegay Hospital, Freweyni Hospital, Dewuhan Hospital, Fresemetat Hospital and Mulu Assefa Hospital and Five of these hospitals were included in the study. The Study was conducted from March to May 2025.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u0026nbsp;Study Design\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe purpose of this study was to assess magnitude of HIV infection among pregnant women attending antenatal care and associated factors at public hospitals of eastern zone Tigray Ethiopia, during the 2025 G.C. The appropriate method for this study was an institutional- based\u0026nbsp;analytical\u0026nbsp;cross-sectional study, as this design was suitable or important for collecting or gathering data at single point of time and was appropriate for showing magnitude and associated factors of HIV infection among antenatal care pregnant women.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003ePopulation\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u0026nbsp;Source of population \u0026nbsp; \u0026nbsp;\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cul\u003e\n \u003cli\u003eAll pregnant women who came to antenatal care at public hospitals of Eastern zone.\u0026nbsp;\u003c/li\u003e\n\u003c/ul\u003e\n\u003cp\u003e\u003cstrong\u003eStudy population\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cul\u003e\n \u003cli\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003eAll\u0026nbsp;pregnant women who came to antenatal care at selected public hospitals Eastern zone during the study period.\u003cstrong\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u0026nbsp;\u003c/strong\u003e\u003c/li\u003e\n\u003c/ul\u003e\n\u003cp\u003e\u003cstrong\u003eInclusion and Exclusion criteria \u0026nbsp; \u0026nbsp; \u0026nbsp;\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u0026nbsp;Inclusion criteria \u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cul\u003e\n \u003cli\u003eAll pregnant women who came to antenatal care in selected public hospitals Eastern zone during the study period.\u0026nbsp;\u003c/li\u003e\n\u003c/ul\u003e\n\u003cp\u003e\u003cstrong\u003eExclusion criteria \u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cul\u003e\n \u003cli\u003ePregnant women who were seriously ill and those who were mentally ill during data collection time were excluded.\u003c/li\u003e\n\u003c/ul\u003e\n\u003cp\u003e\u003cstrong\u003eSample Size Determination \u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe sample size was calculated using a single proportion formula considering the following assumptions. \u0026nbsp;\u003c/p\u003e\n\u003cp\u003en= the required sample size \u0026nbsp;\u003c/p\u003e\n\u003cp\u003eZ= is the standard normal deviation usually set at 1.96 \u0026nbsp;\u0026nbsp;\u003c/p\u003e\n\u003cp\u003ed= the degree of accuracy desired usually set as 0.03\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eP= it was taken from study done in Referral Hospitals of the Amhara Regional State, Ethiopia which is 10.4% [14].\u003c/p\u003e\n\u003cp\u003en= \u0026nbsp; Z\u003csup\u003e2\u003c/sup\u003ep(1-p)/d2\u0026nbsp;\u003c/p\u003e\n\u003cp\u003en=(1.96)\u003csup\u003e2\u003c/sup\u003e 0.104(1-.104)/(.03)\u003csup\u003e2\u003c/sup\u003e =\u003cstrong\u003e398\u003c/strong\u003e with 10% non-response rate \u003cstrong\u003e438\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eSampling Procedures\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;Simple random sampling was used to select hospitals.\u0026nbsp;Initially, hospitals were selected, followed by a selection of study participants using systematic sampling methods. Five hospitals were included via simple random sampling methods out of seven hospitals of eastern zone Tigray,Ethiopia. The selected hospitals were Adigrat Hospitals, Wukro Hospital, Dr.Tsegay Hospital, Freweyni Hospital and Dewuhan Hospital. The sample was allocated to hospitals via proportionally, based on their average monthly antenatal care client flow from previous months. Over the last three months, the average number of pregnant women who visited at specific hospitals were 480 Adigrat Hospital, 420 Wukro Hospital, 360 Freweyni Hospital,320 Dr.Tsegay Hospital and 170 Dewuhan Hospital. The sampling interval (K) value was calculated as \u003cstrong\u003e1750/438=4.\u0026nbsp;\u003c/strong\u003eAll pregnant women who came to antenatal care in selected public hospitals of the Eastern zone during the study period and those who fulfilled the criteria were included.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003eStudy variables\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003eIndependent variables\u003c/strong\u003e\u003c/p\u003e\n\u003cul\u003e\n \u003cli\u003eSocio-demographic variables (age, education level(status), marital status, occupational status, and educational status )\u003c/li\u003e\n \u003cli\u003eObstetrics, reproductive and medical history (ANC follow-up, blood transfusion, gravidity, previous history of abortion, stillbirth,\u0026nbsp;the presence or History of STIs ,Husband\u0026rsquo;s history of STI, and syphilis status)\u003c/li\u003e\n \u003cli\u003eSexual and Behavior-related variables (number of life time sexual partners, new sexual partner, sexual violence ,alcohol and condom use)\u003c/li\u003e\n\u003c/ul\u003e\n\u003cp\u003e\u003cstrong\u003eDependent variable\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;Magnitude of HIV infection among pregnant women \u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eOperational Definitions\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eSexual Violence\u003c/strong\u003e-Pregnant women who have any history of the act of forcing or attempting to force through physical body harm or any means to engage in sexual behavior against their will.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAlcohol use\u003c/strong\u003e: It was assessed with the question \u0026ldquo;Have you been drinking alcohol during your current pregnancy?\u0026rdquo; If the answer will \u0026ldquo;yes\u0026rdquo; and took any unit of alcohol during the current pregnancy, then the mother was considered to have alcohol exposure while pregnant.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u0026nbsp;Data collection instrument and procedure\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eIn this Study, the data were gathered using primary sources and chart review. The primary data were obtained using structured questionnaire administered through face to face interviews with pregnant women and via chart review.\u0026nbsp;The questionnaire was developed following a review of different literatures [10, 13-25]\u0026nbsp;and it included socio-demographic characteristics, obstetrics history, reproductive health and medical history, Sexual and behavioral factors. The questionnaire was prepared in English, translated into the local language Tigrigna, then back-translated to English to check its consistency. A Pre-test was carried out outside study area at Fresemaetat hospital and necessary modifications were made. Ten degree holder midwives participated to collect the data; and two master midwives and four general practitioners (GP) participated as supervisors.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u0026nbsp;Data quality and management\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWe gave\u0026nbsp;Training for data collectors and supervisors for two days on how to collect the data, how to handle the participants and how to follow the data collectors. A Pretest was conducted on 5% of the total sample and based on the pre-test modification was made on the questionnaire. The data compilation system and data completeness were checked and strictly controlled by the principal investigator and supervisors. Data were collected using kobo-collect, cleaned in Microsoft excel and exported to SPSS version 23 software package. Double data entry and random checks were made to ensure the validity of the study. Confidentiality and privacy were given special emphasis during the training session and data collection time. \u0026nbsp;\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003eData processing and analysis\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eData was checked and screened each questionnaire and codes were carefully written at each margin of the questionnaire after the data collection period was complete. After data was collected using kobo-collect and cleaned using Microsoft Excel then exported to SPSS (Statistical Package for the Social science) version 23 for analysis. Data cleaning was performed for each variable to check its accuracy, identify inconsistencies and address missing values of the data. Descriptive statistics like mean, frequency and percentage was explored using tables and figures to display the values of the variables in the study. Bivariate and multivariable analysis was also conducted to see the association and to measure the strength of the relationship between dependent and independent variables. Variables with p-value of less than 0.25 were transferred to multivariable analysis and Variable with P-value\u0026lt;0.05 was used to declare statistical significance. The association between dependent and independent variables was determined using Adjusted Odds Ratio (AOR) with a 95% confidence Interval (CI).\u0026nbsp;\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003e\u003cstrong\u003eSocio-demographic characters \u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eTotal of 438 participants were interviewed and their charts were reviewed, making 100 % response rate. The socio- demographic data mainly focused on the distribution of age, residence, marital status, maternal education, maternal occupation, and gravidity. \u0026nbsp;The largest age group was from 25-34 years, accounting for nearly half of the sample (48.6%, n=213). A significant number of the participants lived in urban areas accounting for 72.1% (n=316). Of the participants,84.5%(n=370) of the pregnant women were married \u0026nbsp;and most mothers had completed some level of schooling, with Elementary and high school accounting for 325(74.2%).The majority of participants,296(67.6%) of the pregnant women \u0026nbsp;were \u0026nbsp;housewives and around 384(87.7%) \u0026nbsp;were also Orthodox religion. Among respondents more than half 55.7% had an income less than 5000 ETB and most of the pregnant women were multigravida 330 (75.3%)(\u003cstrong\u003eTable-1\u003c/strong\u003e).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable-1:- Socio-demographic characters\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 50.6542%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;Variables\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 28.785%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFrequency\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.5607%;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePercent\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 50.6542%;\"\u003e\n \u003cp\u003eAge in years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 28.785%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.5607%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 50.6542%;\"\u003e\n \u003cp\u003e\u0026nbsp;18-24 \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 28.785%;\"\u003e\n \u003cp\u003e124\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.5607%;\"\u003e\n \u003cp\u003e28.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 50.6542%;\"\u003e\n \u003cp\u003e\u0026nbsp;25-34\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 28.785%;\"\u003e\n \u003cp\u003e213\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.5607%;\"\u003e\n \u003cp\u003e48.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 50.6542%;\"\u003e\n \u003cp\u003e\u0026nbsp;35-55\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 28.785%;\"\u003e\n \u003cp\u003e101\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.5607%;\"\u003e\n \u003cp\u003e23.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 50.6542%;\"\u003e\n \u003cp\u003e\u0026nbsp;Residence\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 28.785%;\"\u003e\n \u003cp\u003eFrequency\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.5607%;\"\u003e\n \u003cp\u003ePercent\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 50.6542%;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;Urban\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 28.785%;\"\u003e\n \u003cp\u003e316\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.5607%;\"\u003e\n \u003cp\u003e72.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 50.6542%;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;Rural\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 28.785%;\"\u003e\n \u003cp\u003e122\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.5607%;\"\u003e\n \u003cp\u003e27.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 50.6542%;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;Marital status\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 28.785%;\"\u003e\n \u003cp\u003eFrequency\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.5607%;\"\u003e\n \u003cp\u003ePercent\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 50.6542%;\"\u003e\n \u003cp\u003eMarried\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 28.785%;\"\u003e\n \u003cp\u003e370\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.5607%;\"\u003e\n \u003cp\u003e84.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 50.6542%;\"\u003e\n \u003cp\u003eNot Married\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 28.785%;\"\u003e\n \u003cp\u003e68\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.5607%;\"\u003e\n \u003cp\u003e15.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 50.6542%;\"\u003e\n \u003cp\u003e\u0026nbsp;Educational level of the mother\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 28.785%;\"\u003e\n \u003cp\u003eFrequency\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.5607%;\"\u003e\n \u003cp\u003ePercent\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 50.6542%;\"\u003e\n \u003cp\u003eIlliterate\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 28.785%;\"\u003e\n \u003cp\u003e52\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.5607%;\"\u003e\n \u003cp\u003e11.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 50.6542%;\"\u003e\n \u003cp\u003eElementary and high school\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 28.785%;\"\u003e\n \u003cp\u003e325\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.5607%;\"\u003e\n \u003cp\u003e74.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 50.6542%;\"\u003e\n \u003cp\u003eDeploma and above\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 28.785%;\"\u003e\n \u003cp\u003e61\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.5607%;\"\u003e\n \u003cp\u003e13.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 50.6542%;\"\u003e\n \u003cp\u003e\u0026nbsp;Occupation of the mother\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 28.785%;\"\u003e\n \u003cp\u003eFrequency\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.5607%;\"\u003e\n \u003cp\u003ePercent\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 50.6542%;\"\u003e\n \u003cp\u003e\u0026nbsp;Housewife\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 28.785%;\"\u003e\n \u003cp\u003e296\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.5607%;\"\u003e\n \u003cp\u003e67.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 50.6542%;\"\u003e\n \u003cp\u003e\u0026nbsp;Merchant\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 28.785%;\"\u003e\n \u003cp\u003e20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.5607%;\"\u003e\n \u003cp\u003e4.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 50.6542%;\"\u003e\n \u003cp\u003e\u0026nbsp;Government employed\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 28.785%;\"\u003e\n \u003cp\u003e41\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.5607%;\"\u003e\n \u003cp\u003e9.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 50.6542%;\"\u003e\n \u003cp\u003e\u0026nbsp;Private employed\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 28.785%;\"\u003e\n \u003cp\u003e59\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.5607%;\"\u003e\n \u003cp\u003e13.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 50.6542%;\"\u003e\n \u003cp\u003e\u0026nbsp; Others\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 28.785%;\"\u003e\n \u003cp\u003e22\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.5607%;\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 50.6542%;\"\u003e\n \u003cp\u003eGravidity\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 28.785%;\"\u003e\n \u003cp\u003eFrequency\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.5607%;\"\u003e\n \u003cp\u003ePercent\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 50.6542%;\"\u003e\n \u003cp\u003e\u0026nbsp;Primgravida\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 28.785%;\"\u003e\n \u003cp\u003e108\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.5607%;\"\u003e\n \u003cp\u003e24.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 50.6542%;\"\u003e\n \u003cp\u003e\u0026nbsp;Multigravida\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 28.785%;\"\u003e\n \u003cp\u003e330\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.5607%;\"\u003e\n \u003cp\u003e75.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 50.6542%;\"\u003e\n \u003cp\u003e\u0026nbsp; Income\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 28.785%;\"\u003e\n \u003cp\u003e\u0026nbsp;Frequency\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.5607%;\"\u003e\n \u003cp\u003ePercent\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 50.6542%;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; 50-5000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 28.785%;\"\u003e\n \u003cp\u003e244\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.5607%;\"\u003e\n \u003cp\u003e55.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 50.6542%;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; 5001-10000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 28.785%;\"\u003e\n \u003cp\u003e109\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.5607%;\"\u003e\n \u003cp\u003e24.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 50.6542%;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; 10001-20000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 28.785%;\"\u003e\n \u003cp\u003e82\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.5607%;\"\u003e\n \u003cp\u003e18.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 50.6542%;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;20001-50000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 28.785%;\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.5607%;\"\u003e\n \u003cp\u003e.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 50.6542%;\"\u003e\n \u003cp\u003e\u0026nbsp;Religion\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 28.785%;\"\u003e\n \u003cp\u003eFrequency\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.5607%;\"\u003e\n \u003cp\u003ePercent\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 50.6542%;\"\u003e\n \u003cp\u003eOrthodox\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 28.785%;\"\u003e\n \u003cp\u003e384\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.5607%;\"\u003e\n \u003cp\u003e87.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 50.6542%;\"\u003e\n \u003cp\u003eCatholic\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 28.785%;\"\u003e\n \u003cp\u003e33\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.5607%;\"\u003e\n \u003cp\u003e7.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 50.6542%;\"\u003e\n \u003cp\u003eMuslim\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 28.785%;\"\u003e\n \u003cp\u003e20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.5607%;\"\u003e\n \u003cp\u003e4.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 50.6542%;\"\u003e\n \u003cp\u003eProtestant\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 28.785%;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.5607%;\"\u003e\n \u003cp\u003e.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cstrong\u003eMaternal, reproductive and sexual health related factors\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe table or data focused on the descriptive analysis of reproductive history, gestational age at time data collection, sexual health, relationship dynamics, sexual history/risk behaviors, and current infection status for Syphilis and HIV of the pregnant women. Of the total respondents, 108 (24.7%) of the pregnant women had a history of abortion. Majority 268(61.2%) of the respondents were in third trimester whereas 128(29.2%) were second trimester and only 42(9.6%)\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003ewere in the first trimester. Regarding current and history of sexually transmitted infections, around 72(16.4%) of the pregnant women reported having had STI within the past one year and 45(10.3%) of the respondents were also reported having signs and symptoms of sexual transmitted infections (STI).\u003c/p\u003e\n\u003cp\u003eAmong the total respondents, the majority 296(67.6%) were currently living with their husband and 89(20.3%) of the total participants suspected their regular partner was having a sexual relationship with someone else. 337(76.9%) of the pregnant women reported having only one lifetime sexual partner, while 101(23.1%) reported more than one sexual partner. Of all respondents, around 25(5.7%) of the pregnant women reported a history of sexually forced/rape or had sex against their will within the last five years and 64% of those women were found to be living with HIV. Nearly 63(14.4%) of all participants had multiple sexual partners in the last one year, while a small group 21(4.8%) were receiving money or goods for sex.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u0026nbsp;Prevalence of current HIV infection of pregnant women\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eOf the total 438 respondents, 50(11.4%)(95%CI:8.4%-14.4%) \u0026nbsp;of the pregnant women were HIV seropositive. In addition to this, 20(4.6%)95%CI:2.5%-6.6%) of the participants were also syphilis seropositive and 8(1.8%) of the women had HIV-Syphilis co-infection (Table-2).\u003c/p\u003e\n\u003cp\u003eTable-2- Maternal, reproductive and sexual health related factors \u0026nbsp; \u0026nbsp; \u0026nbsp;\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" align=\"\" width=\"720\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 408px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eVariables\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCategory\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 174px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFrequency (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 408px;\"\u003e\n \u003cp\u003e\u0026nbsp;History of abortion\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 174px;\"\u003e\n \u003cp\u003e108(24.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 174px;\"\u003e\n \u003cp\u003e330(74.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"3\" valign=\"top\" style=\"width: 408px;\"\u003e\n \u003cp\u003eGestational age at time of data collection \u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003eFirst trimester\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 174px;\"\u003e\n \u003cp\u003e42(9.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003eSecond trimester\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 174px;\"\u003e\n \u003cp\u003e128(29.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003eThird trimester\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 174px;\"\u003e\n \u003cp\u003e268((61.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 408px;\"\u003e\n \u003cp\u003eHistory of STI \u0026nbsp;in last one year\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 174px;\"\u003e\n \u003cp\u003e72(16.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 174px;\"\u003e\n \u003cp\u003e366(83.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 408px;\"\u003e\n \u003cp\u003eDo you currently live with your husband/ partner\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 174px;\"\u003e\n \u003cp\u003e296(67.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 174px;\"\u003e\n \u003cp\u003e142(32.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 408px;\"\u003e\n \u003cp\u003eDo you suspecting your regular partner is having a sexual relationship with some\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 174px;\"\u003e\n \u003cp\u003e89(20.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 174px;\"\u003e\n \u003cp\u003e349(79.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 408px;\"\u003e\n \u003cp\u003eReceived money or goods for sex\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 174px;\"\u003e\n \u003cp\u003e21(4.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 174px;\"\u003e\n \u003cp\u003e417(95.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 408px;\"\u003e\n \u003cp\u003eIn your lifetime, have you ever had sex with a casual partner who was 10 or more than10 \u0026nbsp;years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 174px;\"\u003e\n \u003cp\u003e12(2.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 174px;\"\u003e\n \u003cp\u003e426(97.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 408px;\"\u003e\n \u003cp\u003eDid you have Multiple sexual \u0026nbsp;partner in the past 1 year\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 174px;\"\u003e\n \u003cp\u003e63(14.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003eNO\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 174px;\"\u003e\n \u003cp\u003e375(85.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 408px;\"\u003e\n \u003cp\u003eIn your lifetime, have you ever received money or goods for sex\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 174px;\"\u003e\n \u003cp\u003e21(4.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 174px;\"\u003e\n \u003cp\u003e417(95.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 408px;\"\u003e\n \u003cp\u003eHow many sexual partner did you have \u0026nbsp;in \u0026nbsp;your lifetime\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003eOne partner\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 174px;\"\u003e\n \u003cp\u003e337(76.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003eTwo or More \u0026nbsp;partner\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 174px;\"\u003e\n \u003cp\u003e101(23.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 408px;\"\u003e\n \u003cp\u003eHave ever had sex with some body forced/raped or Against your will with in the last five year?\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 174px;\"\u003e\n \u003cp\u003e25(5.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 174px;\"\u003e\n \u003cp\u003e413(94.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 408px;\"\u003e\n \u003cp\u003eSign and symptoms of STI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003eYes\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 174px;\"\u003e\n \u003cp\u003e45(10.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003eNo\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 174px;\"\u003e\n \u003cp\u003e393(89.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 408px;\"\u003e\n \u003cp\u003eFamily history of HIV\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003eYes\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 174px;\"\u003e\n \u003cp\u003e27(6.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003eNo\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 174px;\"\u003e\n \u003cp\u003e411(93.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 408px;\"\u003e\n \u003cp\u003eCurrent Syphilis condition\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003eYes\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 174px;\"\u003e\n \u003cp\u003e20(4.6%)95%,2.5-6.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003eNo\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 174px;\"\u003e\n \u003cp\u003e418(95.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 408px;\"\u003e\n \u003cp\u003eCurrent HIV status\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003eYes\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 174px;\"\u003e\n \u003cp\u003e50(11.4%)(95%,8.4-14.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003eNo\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 174px;\"\u003e\n \u003cp\u003e388(88.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 408px;\"\u003e\n \u003cp\u003eHIV-Syphilis Co-infection\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003eYes\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 174px;\"\u003e\n \u003cp\u003e8(1.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003eNo\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 174px;\"\u003e\n \u003cp\u003e430(98.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cstrong\u003eFactors associated with HIV among pregnant women\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eIn the bivariate logistic regression analysis, the factors associated with HIV infection of Sero-prevalence included nine variables such as Age , Women \u0026nbsp;with STI history with in one year, Husband suspecting another sexual partners, multiple sexual partners within 1 year, Number of sexual partner \u0026nbsp;in her life , history of Sexually Forced /rape within five years, Sign and symptoms of STI, history of Sex for money or good and Syphilis condition/status were considered as candidate to further analysis to multivariable logistic regression with p-value was less than 0.25.\u003c/p\u003e\n\u003cp\u003eOf the total 438 respondents, 50(11.4%)(95%,) of the \u0026nbsp;pregnant women were HIV seropositive. In multivariate logistic regression analysis, after controlling possible confounders, variables or factors were considered significantly associated with Sero-prevalence of HIV infection at p-value less than 0.05 were: history of Sexually Forced /rape within five years, Women with STI history within one year,\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003eNumber of sexual partners in her life and women had Sign and symptoms of STI.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThis study indicated that pregnant women who reported STI history in the past year had 3.7 times more likely to have HIV positive compared to those who did not with (AOR=3.7,95%CI(1.5-8.9). In this study pregnant women who experienced sexually Forced /rape against her will within five years had 5.4 times being HIV positive compared to those who did not with (AOR=5.4,95%,CI(1.76-16.67). \u0026nbsp; The study finding showed that mothers who had more than one sexual partners in their \u0026nbsp;life time had 4.8 times more likely to have HIV positive than who had one sexual partners in their \u0026nbsp;life time (AOR=4.8,95% CI(1.8-12.77). Participants who reported \u0026nbsp; signs and symptoms of an STI had nearly 6.6 times having \u0026nbsp;HIV positive compared to those who did not reported with (AOR= 6.6,95%,CI(2.3-18.7) \u003cstrong\u003e(Table-3\u003c/strong\u003e).\u003c/p\u003e\n\u003cp\u003eTable-3- Factors associated with HIV among pregnant women at public hospitals of Tigray,Ethiopia.\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"762\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 204px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eVariables\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;Category\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 186px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; HIV\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCOR\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e(95%CI)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAOR\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e(95%CI)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eP-Value\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePositive\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp; Negative\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"3\" valign=\"top\" style=\"width: 204px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;Age\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e\u0026nbsp; 15-24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e8(16%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003e116(29.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e.25(.105-.584)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e.396(.12-1.26)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e.118\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e\u0026nbsp; 25-34\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e20(40%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003e193(49.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e.37(.19-.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e.73(.28-1.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e.518\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e\u0026nbsp; 35-55\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e22(44%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003e79(20.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 204px;\"\u003e\n \u003cp\u003eWomen \u0026nbsp;with STI history with in one year\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e31(62%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003e41(10.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e13.8(7.2-26.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e3.7(1.5-8.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e.004\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e19(38%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003e347(89.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 204px;\"\u003e\n \u003cp\u003eHusband had another sexual partner\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003eYes\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e36(72%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003e53(13.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e16.3(8.2-32.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e2.44(.95-6.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e.063\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003eNo\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e14(28%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003e335(86.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 204px;\"\u003e\n \u003cp\u003eWomen had multiple sexual partner with in 1 year\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003eYes\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e29(58%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003e34(8.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e14.38(7.4-27.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e1.5(.53-4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e.46\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003eNo\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e21(42%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003e354(91.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 204px;\"\u003e\n \u003cp\u003eNumber of sexual partner \u0026nbsp;in her life \u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e12(24%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003e325(83.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e2 and above\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e38(76%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003e\u0026nbsp;63(16.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e16.3(8.09-32.99)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e4.8(1.8-12.77)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e.002\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 204px;\"\u003e\n \u003cp\u003eSexually Forced /rape within five years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003eYes\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e16(32%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003e\u0026nbsp;9(2.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e19.8(8.15-48.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e5.4(1.76-16.67)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e0.003\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003eNo\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e34(68%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003e\u0026nbsp;379(97.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 204px;\"\u003e\n \u003cp\u003eSign and symptoms of STI\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003eYes\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e26(52%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003e19(4.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e21(10.3-43.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e6.6(2.3-18.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003eNo\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e24(48%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003e369(95.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 204px;\"\u003e\n \u003cp\u003eSex for money or good\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003eYes\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e13(26%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003e8(2.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e16.7(6.5-42.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e.98(.25-3.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e.98\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003eNo\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e37(74%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003e38(97.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 204px;\"\u003e\n \u003cp\u003eSyphilis condition \u0026nbsp;\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003eYes\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e8(16%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003e12(3.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e5.97(2.3-15.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e3.65(.9-14.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e.067\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003eNo\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e42(84%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003e376(96.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;COR=crude odds ratio, AOR=adjusted odds ratio\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eThis study focused on the investigation of HIV prevalence and associated factors among pregnant women in Eastern zone, Tigray, Ethiopia and the results provided us update finding about current HIV prevalence among pregnant women in Tigray. In addition to HIV prevalence this study also investigated the prevalence of syphilis in pregnancy and HIV/Syphilis co-infection. According to current study done in Tigray, Ethiopia, the prevalence of HIV among pregnant women was 50(11.4%)(95%,8.4-14.4) and this high prevalence is alarming for the region and nation. This study is comparable with the study done in Felege Hiwot Comprehensive Specialized Hospital, Amhara region, Ethiopia which was 10.4% [8] and study conducted in yirgalem hospital ,southern Ethiopia(10.1%) [23].Our result was also familiar with study Carried out \u0026nbsp; in Democratic Republic of Congo(11%) [26] and study done in \u0026nbsp;Mozambique(11.48%)[27],Cameroon (9.3%)[28].\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eBased on the present study conducted in Tigray, Ethiopia, the prevalence of HIV during pregnancy is 11.4%,which is higher than study conducted in Amhara regional state, northern Ethiopia(7.6%) [24], Atat Hospital, Southern Ethiopia(2.7%)[29], in \u0026nbsp;Mizan \u0026nbsp; Tepi University \u0026nbsp;Teaching \u0026nbsp;Hospital, \u0026nbsp; Southwest \u0026nbsp;Ethiopia(5%)[19], in Debre Berhan ,Ethiopia(7.2%)[25].This difference might be due to,Tigray was at war zone for the last three years and it was impacted population, particularly due to sexual violence and destruction of the health system.\u003c/p\u003e\n\u003cp\u003eThe current study done in Tigray, Ethiopia HIV prevalence among pregnant women were also higher than as compare to study conducted in Tanzania(2.4%)[18], in Kabarole District, Uganda(2.9%)[16], in Nigeria(7.22%)[21], in rural Gabon (3.9%)[30],in \u0026nbsp; Cameroon(6.8%)[31], in a Tertiary Care Hospital in Islamabad,Pakistan(1.5%)[32], a systematic review and meta-analysis in china(2.9%)[22]. This discrepancy might be due to study time, study area and socio-demographic characteristics of the population.\u0026nbsp;Studies carried out in South Africa,\u0026nbsp;in Luanda (Angola) and a Tertiary Hospital in Ibadan, Nigeria, in Lusaka Province, Zambia \u0026nbsp;and in Cameroon revealed HIV prevalence among pregnant was 44.3%,13.4%, 26.4% , 26% and 13.1% respectively[17, 20, 33-35],\u0026nbsp;which were slightly higher as compared to \u0026nbsp;the current study. The possible reason for this difference might be due to inadequacy and poorly targeted intervention activities and antenatal follow up.\u003c/p\u003e\n\u003cp\u003eThis study also identified factors associated with HIV prevalence among pregnant women like history of Sexually Forced /rape within five years, Women with STI history within one year,\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003eNumber of sexual partners in her life and women had Sign and symptoms of STI. The current study carried out in Tigray showed that \u0026nbsp; pregnant women who experienced history of sexually violence / Forced or rape against her will within five years had 5.4 times being HIV positive compared to those who did not with(AOR=5.4,95%,CI(1.76-16.67).This finding was consistent with cross-sectional study done in Kobo Town, Ehtiopia [15]. The reason might be due to both area were affected by war/conflict.\u003c/p\u003e\n\u003cp\u003eIn this study the Pregnant women who had history of STI 3.7 times more likely have HIV infection when we compared to their counterparts with \u0026nbsp;(AOR=3.7,95%CI(1.5-8.9). This finding has agreement with study conducted in Amhara region, northern Ethiopia[24] and in Kobo Town, Ehtiopia[15].This might be due to there is high risk HIV infection transmission increases with who have Sexually transmitted infection.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe probability of acquiring HIV infection was 4.8 times higher among Mothers who had more than one sexual partners in their life time had than who had one sexual partners in their life time (AOR=4.8,95% CI(1.8-12.77). The finding in line with study carried-out in Kabarole \u0026nbsp; District,Uganda[16] in Lusaka, Zambia[36].The reason is logically the risk of \u0026nbsp;acquiring any sexually transmitted infection specifically HIV infection increases with increasing number of sexual partner. Pregnant women who reported signs and symptoms of an STI had nearly 6.6(AOR= 6.6,95%,CI(2.3-18.7) times significantly increases \u0026nbsp; HIV infection \u0026nbsp; compared to those who did not reported.\u0026nbsp;This is similar with study done\u0026nbsp;in South Africa[37]. The possible reason might be due to the presence of genital ulcer and inflammation may increase\u0026nbsp;susceptible to HIV infection.\u003c/p\u003e\n\u003cp id=\"_Toc28910312\"\u003e\u003cstrong\u003eLimitation of the study\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe current study was done at specific zone of Tigray region, which has been \u0026nbsp;affected region with war and post war crisis ,so it might not generalized to the other areas of the country.\u0026nbsp;\u003c/p\u003e"},{"header":"Conclusion and Recommendations","content":"\u003cp\u003eBased on\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003ethis study the magnitude of HIV infection among pregnant women was significantly high which gave alarming for the region and as whole nation. This result indicated that it needs tremendous intervention on the institutions and community as whole to resolve the problem. According to this study the factors significantly associated to the increment of HIV infection among pregnant women were sexually forced /rape within five years, women with STI history within one year,\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003enumber of sexual partners in her life and women had Sign and symptoms of STI. Therefore the finding indicated that the region still on the post war impact or post war health crisis, so the regional and national government more expected to do on prevention and intervention to eliminate new infection among pregnant women and eliminate maternal to child transmission.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cp\u003e\u003cstrong\u003eAIDS\u003c/strong\u003e-Acquired Immunodeficiency Syndrome ,\u0026nbsp;\u003cstrong\u003eANC\u003c/strong\u003e -Antenatal Care,\u0026nbsp;\u003cstrong\u003eAOR\u003c/strong\u003e -Adjusted Odds Ratio, \u003cstrong\u003eART\u003c/strong\u003e-Antiretroviral treatment,\u0026nbsp;\u003cstrong\u003eCI\u003c/strong\u003e-Confidence Interval ,\u003cstrong\u003eCOR\u003c/strong\u003e -Crude Odds Ratio,\u003cstrong\u003eCovid19\u003c/strong\u003e \u0026ndash;Coronavirus diseases 2019,\u003cstrong\u003eDr.\u003c/strong\u003e -Doctor \u0026nbsp;,ETB- Ethiopian birr \u0026nbsp; ,\u003cstrong\u003eG.C\u003c/strong\u003e - Gregorian calendar, \u003cstrong\u003eHIV\u003c/strong\u003e-Human immunodeficiency virus, \u003cstrong\u003eMTCT\u003c/strong\u003e -Mother to child Transmission ,\u003cstrong\u003ePMTCT\u003c/strong\u003e -Prevention of mother-to-child transmission,\u0026nbsp;\u003cstrong\u003eSD\u003c/strong\u003e -Standard deviation\u0026nbsp;,\u003cstrong\u003eSPSS\u003c/strong\u003e-Statistical package for the social science\u0026nbsp;,\u0026nbsp;\u003cstrong\u003eSTI\u003c/strong\u003e -Sexual transmitted infections.\u003c/p\u003e\n\u003cp\u003e\u003cbr\u003e\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthical Consideration\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe ethical approval and permission was obtained from Adigrat University College of Medicine and health sciences, Institutional Review Board. Permission was also obtained from study areas before the data collection was started. Additionally, data collectors were informed to the staff and Permission were requested to the responsible body at the beginning of data collection. Data collectors were accompanied by an official letter from Adigrat University College of Medicine and health sciences and Tigray regional health bureau.\u0026nbsp;In accordance with the Declaration of Helsinki, behaviors of the study were clearly explained to the participants and data were collected after getting informed verbal consent from the respondents and maximum effort was invested to keep their privacy. Respondents were informed in advance about the purpose of the study as well as privacy and confidentiality of the participants was also protected.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData availability\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe datasets used and/or analyzed during this study are available from the corresponding author on reasonable request.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare no competing interests\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAdigrat University was source of funding to carry out for this research. The funding organization has no role in the design of the study and collection, analysis, and interpretation of data and in writing of the manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthor Contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAG, GM,TH, MG and GT contributed to the conception and design of the study, collected, entered, analyzed, interpreted the data and prepared the manuscript .HH,DG,HT,MK,NL and LT \u0026nbsp;contributed to data analysis, interpretation and drafted the manuscript. All authors read and approved the final manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgments\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eOur special gratitude goes to ANC staff, respondents for the priceless support during collection \u0026nbsp; of the data for this project. We are also grateful to thank to public hospitals of eastern zone, Tigray for their assistance and cooperation in the data collection process.\u0026nbsp;\u003cstrong\u003e\u0026nbsp; \u0026nbsp;\u003c/strong\u003e\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n \u003cli\u003eWHO. \u003cem\u003eSexually transmitted infections (STIs)\u003c/em\u003e. 2024 10/21/2024]; Available from: https://www.who.int/news-room/fact-sheets/detail/sexually-transmitted-infections-(stis).\u003c/li\u003e\n \u003cli\u003eEthiopia, M.o.H.o., \u003cem\u003e\u0026lt;National-Guideline-for-Prevention-of-Mother-to-child-Transmission-of-HIV-Syphilis-and-Hepatitis-B-Virus-2021.pdf\u0026gt;\u003c/em\u003e. 2021.\u003c/li\u003e\n \u003cli\u003eWHO. \u003cem\u003eHIV and AIDS\u003c/em\u003e. 2024 [cited 2024 2/11/2024]; Available from: https://www.who.int/news-room/fact-sheets/detail/hiv-aids.\u003c/li\u003e\n \u003cli\u003ePolicy, G.H. \u003cem\u003eThe Global HIV/AIDS Epidemic\u003c/em\u003e. 2024 [cited 2024 2/11/2024]; Available from: https://www.kff.org/global-health-policy/fact-sheet/the-global-hiv-aids-epidemic/.\u003c/li\u003e\n \u003cli\u003e2024, U.G.A.U. \u003cem\u003ePeople living with HIV \u0026mdash; Thematic briefing note \u0026mdash; 2024 global AIDS update The Urgency of Now: AIDS at a Crossroads\u003c/em\u003e. 2024 [cited 2024 2/11/2024]; Available from: https://www.unaids.org/en/resources/documents/2024/2024-unaids-global-aids-update-living-with-hiv.\u003c/li\u003e\n \u003cli\u003eAfrica, W.R.O.f. \u003cem\u003eHIV/AIDS\u003c/em\u003e. 2023 [cited 2023 3/11/2024]; Available from: https://www.afro.who.int/health-topics/hivaids.\u003c/li\u003e\n \u003cli\u003eCunningham, F.G., et al., \u003cem\u003eWilliams Obstetrics 26th edition\u003c/em\u003e. 2022. 1180-1180.\u003c/li\u003e\n \u003cli\u003eLwamba, C., S. 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Endalew, and S.Y. Mengistu, \u003cem\u003ePrevalence and trends of sexually transmitted infections among pregnant women in Mizan Tepi University Teaching Hospital, Southwest Ethiopia: a cross-sectional study.\u003c/em\u003e Pan African Medical Journal, 2022. \u003cstrong\u003e42\u003c/strong\u003e(1).\u003c/li\u003e\n \u003cli\u003eOkonko, I.O., et al., \u003cem\u003ePrevalence of HIV in a cohort of pregnant women attending a tertiary hospital in Ibadan, Nigeria.\u003c/em\u003e Immunol Infect Dis, 2019. \u003cstrong\u003e7\u003c/strong\u003e(1): p. 7-12.\u003c/li\u003e\n \u003cli\u003eOzim, C.O., et al., \u003cem\u003ePrevalence of human immunodeficiency virus (HIV) among pregnant women in Nigeria: a systematic review and meta-analysis.\u003c/em\u003e BMJ open, 2023. \u003cstrong\u003e13\u003c/strong\u003e(3): p. e050164.\u003c/li\u003e\n \u003cli\u003eWu, S., et al., \u003cem\u003ePrevalence of human immunodeficiency virus, syphilis, and hepatitis B and C virus infections in pregnant women: a systematic review and meta-analysis.\u003c/em\u003e Clinical microbiology and infection, 2023. \u003cstrong\u003e29\u003c/strong\u003e(8): p. 1000-1007.\u003c/li\u003e\n \u003cli\u003eAmsalu, A., et al., \u003cem\u003ePrevalence, Infectivity, and Associated Risk Factors of Hepatitis B Virus among Pregnant Women in Yirgalem Hospital, Ethiopia: Implication of Screening to Control Mother\u003c/em\u003e\u003cem\u003e‐to\u003c/em\u003e\u003cem\u003e‐Child Transmission.\u003c/em\u003e Journal of pregnancy, 2018. \u003cstrong\u003e2018\u003c/strong\u003e(1): p. 8435910.\u003c/li\u003e\n \u003cli\u003e24. 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Mendes-Muxlhanga, A., et al., \u003cem\u003eOver a decade of HIV infection prevalence and incidence among Mozambican pregnant women: a secondary analysis of prospectively collected data.\u003c/em\u003e BMC Public Health, 2025. \u003cstrong\u003e25\u003c/strong\u003e(1): p. 251.\u003c/li\u003e\n \u003cli\u003e28. Ebogo-Belobo, J.T., et al., \u003cem\u003eSystematic review and meta-analysis of seroprevalence of human immunodeficiency virus serological markers among pregnant women in Africa, 1984-2020.\u003c/em\u003e World Journal of Critical Care Medicine, 2023. \u003cstrong\u003e12\u003c/strong\u003e(5): p. 264.\u003c/li\u003e\n \u003cli\u003e29. Bafa, T.A. and A.D. Egata, \u003cem\u003eSeroepidemiological patterns and predictors of hepatitis B, C and HIV viruses among pregnant women attending antenatal care clinic of Atat Hospital, Southern Ethiopia.\u003c/em\u003e SAGE Open Medicine, 2020. \u003cstrong\u003e8\u003c/strong\u003e: p. 2050312119900870.\u003c/li\u003e\n \u003cli\u003e30. Davi, S.D., et al., \u003cem\u003eEpidemiology of co-infections in pregnant women living with human immunodeficiency virus 1 in rural Gabon: a cross-sectional study.\u003c/em\u003e Infectious Diseases of Poverty, 2023. \u003cstrong\u003e12\u003c/strong\u003e(04): p. 83-92.\u003c/li\u003e\n \u003cli\u003e31. Egbe, T.O., et al., \u003cem\u003eEstimating HIV incidence during pregnancy and knowledge of prevention of mother\u003c/em\u003e\u003cem\u003e‐to\u003c/em\u003e\u003cem\u003e‐child transmission with an ad hoc analysis of potential cofactors.\u003c/em\u003e Journal of Pregnancy, 2016. \u003cstrong\u003e2016\u003c/strong\u003e(1): p. 7397695.\u003c/li\u003e\n \u003cli\u003e32. Mishal, M., et al., \u003cem\u003eFrequency of HIV Infection Among Pregnant Women in a Tertiary Care Hospital in Islamabad, Pakistan.\u003c/em\u003e Cureus, 2025. \u003cstrong\u003e17\u003c/strong\u003e(3).\u003c/li\u003e\n \u003cli\u003e33. Vueba, A.N., et al., \u003cem\u003ePrevalence of HIV and hepatitis B virus among pregnant women in Luanda (Angola): geospatial distribution and its association with socio-demographic and clinical-obstetric determinants.\u003c/em\u003e Virology journal, 2021. \u003cstrong\u003e18\u003c/strong\u003e(1): p. 239.\u003c/li\u003e\n \u003cli\u003e34. Hoque, M., et al., \u003cem\u003ePrevalence, incidence and seroconversion of HIV and Syphilis infections among pregnant women of South Africa. South Afr J Infect Dis. 2021; 36 (1): a296\u003c/em\u003e.\u003c/li\u003e\n \u003cli\u003e35. Kasonde, G., M. Masaka, and C. Michelo, \u003cem\u003eTrends in HIV Prevalence among Pregnant Women in Lusaka Province, Zambia 1994-2008.\u003c/em\u003e Journal of Transmitted Diseases and Immunity, 2018. \u003cstrong\u003e2\u003c/strong\u003e(1): p. 1-9.\u003c/li\u003e\n \u003cli\u003e36. Hamoonga, T.E., et al., \u003cem\u003eHIV risk perception and associated factors among pregnant and breastfeeding women in Zambia: implications for PrEP uptake in antenatal and postnatal settings.\u003c/em\u003e Frontiers in Reproductive Health, 2025. \u003cstrong\u003e7\u003c/strong\u003e: p. 1540248.\u003c/li\u003e\n \u003cli\u003e37. Nyemba, D.C., et al., \u003cem\u003ePrevalence, incidence and associated risk factors of STIs during pregnancy in South Africa.\u003c/em\u003e Sexually transmitted infections, 2021. \u003cstrong\u003e97\u003c/strong\u003e(5): p. 375-381.\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"HIV, magnitude, pregnant women, eastern zone Tigray","lastPublishedDoi":"10.21203/rs.3.rs-8455195/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-8455195/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground: \u003c/strong\u003eHIV infection is mainly transmitted via sexual contact and mother to child during pregnancy, delivery and breast feeding and among avertable infection; it is significantly contributor to adverse birth outcomes of pregnancy worldwide particularly in low and middle income countries. Sub-Saharan African countries including Ethiopia are among affected areas with HIV infection. Ethiopia is currently providing and demonstrating strategies aimed to ending AIDS death, to eliminate new infection of HIV and elimination of MTCT of HIV particularly in pregnant women by 2030, as part of Sustainable Development goals. Hence, this study aimed to assess the magnitudes of HIV infection and associated factors among pregnant women attending antenatal care at public hospitals of eastern zone, Tigray, Ethiopia during the period 2024/25. \u003cstrong\u003e\u0026nbsp;Methods\u003c/strong\u003e- Institutional-based cross-sectional study was conducted at public hospitals of eastern zone, Tigray, Ethiopia. Initially hospitals were selected via simple random sampling then pregnant women were selected using a systematic random sampling technique. Interviewer questionnaire and chart reviews were used to collect data. Data was collected using kobo collect tool, cleaned using Excel and analyzed in SPSSV23.0. Descriptive statistics was used to assess the magnitude of HIV and binary logistic regression was used to determine associated factors. Variables with p-value less than 0.25 were transferred to multivariable analysis. Variables with P-value\u0026lt;0.05 were used to declare statistical significance.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResult\u003c/strong\u003e:-The magnitude of HIV infection among pregnant women was 11.4 % with (95% CI,8.4-14.4). This study showed 64% of the pregnant women who reported history of sexually forced or raped were found to be living with HIV infection. Significant associated factors for HIV prevalence were history of sexually Forced /raped within five years, women with STI history within one year,\u003cstrong\u003e \u003c/strong\u003enumber of sexual partners in her life and women had Sign and symptoms of STI.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion: \u003c/strong\u003eThe present study found significant high rate of HIV infection among pregnant women and history of sexually Forced /raped within last five years were also among significant influential associated factors to this high prevalence.\u003c/p\u003e","manuscriptTitle":"Magnitude of HIV and associated factors among antenatal care pregnant women at public hospitals of eastern zone Tigray Ethiopia, 2025 G.C","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-01-06 06:09:08","doi":"10.21203/rs.3.rs-8455195/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"1856a1a8-f709-41d1-9643-9a0c626ec840","owner":[],"postedDate":"January 6th, 2026","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[{"id":60242875,"name":"Infectious Diseases"}],"tags":[],"updatedAt":"2026-01-06T06:09:08+00:00","versionOfRecord":[],"versionCreatedAt":"2026-01-06 06:09:08","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-8455195","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-8455195","identity":"rs-8455195","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}