Individual, partner, and couple predictors of HIV infection among pregnant women in Malawi: a case-control study

Abstract

We aimed to understand drivers of HIV-infection in pregnant women in Malawi. The study was conducted in antenatal and labor and delivery wards. HIV-infected women and their partners (cases) were frequency matched in a 1:2 ratio based on age and screening location to HIV-uninfected women and their partners (controls) in a prevalent case-control study. Characteristics associated with female HIV infection were assessed using logistic regression modeling. At screening, HIV-infected women were more likely to have partners outside Lilongwe than HIV-uninfected women (24% versus 0%, p<0.0001). Case females were more likely to have HIV-infected study partners than control females (75% versus 4%, p<0.0001). The odds of female HIV-infection were higher if either couple member reported >2 lifetime marriages (OR=9.0, CI=2.6-30.9) or >3 lifetime partners (OR=18.0, CI=3.1-103.6) and lower if either reported past couple HIV testing and counseling (OR=0.1, CI=0.04-0.3). Targeting women with migrating partners, promoting couple HIV testing and counseling, and limiting partners could slow HIV transmission

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ORCID for Nuala Mcgrath: orcid.org/0000-0002-1039-0159

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