{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T02:56:33Z","timestamp":1791428193407,"version":"4.3.3"},"reference-count":51,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2024,3,25]],"date-time":"2024-03-25T00:00:00Z","timestamp":1711324800000},"content-version":"vor","delay-in-days":24,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100010877","name":"ViiV Healthcare","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100010877","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000865","name":"Bill and Melinda Gates Foundation","doi-asserted-by":"publisher","award":["OPP1120138"],"award-info":[{"award-number":["OPP1120138"]}],"id":[{"id":"10.13039\/100000865","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["R01HD080465"],"award-info":[{"award-number":["R01HD080465"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["U01AI069924"],"award-info":[{"award-number":["U01AI069924"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Int AIDS Soc."],"published-print":{"date-parts":[[2024,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Monitoring mother\u2010infant pairs with HIV exposure is needed to assess the effectiveness of vertical transmission (VT) prevention programmes and progress towards VT elimination.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We used routinely collected data on infants with HIV exposure, born May 2018\u2013April 2021 in the Western Cape, South Africa, with follow\u2010up through mid\u20102022. We assessed the proportion of infants diagnosed with HIV at birth (\u22647 days), 10 weeks (&gt;1 to 14 weeks) and &gt;14 weeks as proxies for intrauterine, intrapartum\/early breastfeeding and late breastfeeding transmission, respectively. We used mixed\u2010effects Poisson regression to assess factors associated with VT in mothers known with HIV by delivery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>We included 50,461 infants born to mothers known with HIV by delivery. HIV was diagnosed in 894 (1.8%) infants. Among mothers, 51% started antiretroviral treatment (ART) before and 27% during pregnancy; 17% restarted during pregnancy after \u22656 months interruption; and 6% had no recorded ART during pregnancy. Most pregnancy ART regimens included non\u2010nucleoside reverse transcriptase inhibitors (83%). Of mothers with available results (90% with viral load [VL]; 70% with CD4), VL nearest delivery was &lt;100 copies\/ml in 78% and CD4 count \u2265350 cells\/\u03bcl in 62%. HIV\u2010PCR results were available for 86%, 67% and 48% of eligible infants at birth, 10 weeks and &gt;14 weeks. Among these infants, 0.9%, 0.4% and 1.5% were diagnosed positive at birth, 10 weeks and &gt;14 weeks, respectively. Among infants diagnosed with HIV, 43%, 16% and 41% were diagnosed at these respective time periods. Among mothers with VL&lt;100, 100\u2013999, 1000\u201399,000 and \u2265100,000 copies\/ml nearest delivery, infant HIV diagnosis incidence was 0.4%, 2.3%, 6.6% and 18.4%, respectively. Increased VT was strongly associated with recent elevated maternal VL with a seven\u2010fold increased rate with even modestly elevated VL (100\u2013999 vs. &lt;100 copies\/ml). VT was also associated with unknown\/low maternal CD4, maternal age &lt;20 years, no antenatal ART, later maternal ART start\/restart in pregnancy and ART gaps.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Despite high maternal ART coverage and routine postnatal prophylaxis, ongoing VT remains a concern. Timing of infant HIV diagnoses suggests intrapartum and\/or breastfeeding transmission in nearly 60%. Interventions to ensure retention on ART and sustained maternal viral suppression are needed to reduce VT.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jia2.26235","type":"journal-article","created":{"date-parts":[[2024,3,26]],"date-time":"2024-03-26T00:44:53Z","timestamp":1711413893000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Factors associated with vertical transmission of HIV in the Western Cape, South Africa: a retrospective cohort analysis"],"prefix":"10.1002","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2453-6219","authenticated-orcid":false,"given":"Kim","family":"Anderson","sequence":"first","affiliation":[{"name":"Centre for Infectious Disease Epidemiology and Research School of Public Health Faculty of Health Sciences University of Cape Town  Cape Town South 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Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7028-5772","authenticated-orcid":false,"given":"Nisha","family":"Jacob","sequence":"additional","affiliation":[{"name":"Division of Public Health Medicine School of Public Health Faculty of Health Sciences University of Cape Town  Cape Town South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Boulle","sequence":"additional","affiliation":[{"name":"Centre for Infectious Disease Epidemiology and Research School of Public Health Faculty of Health Sciences University of Cape Town  Cape Town South Africa"},{"name":"Health Intelligence, Western Cape Department of Health  Cape Town South Africa"},{"name":"Division of Public Health Medicine School of Public Health Faculty of Health Sciences University of Cape Town  Cape Town South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ushma","family":"Mehta","sequence":"additional","affiliation":[{"name":"Centre for Infectious Disease Epidemiology and Research School of Public Health Faculty of Health Sciences University of Cape Town  Cape Town South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1200-8726","authenticated-orcid":false,"given":"Reshma","family":"Kassanjee","sequence":"additional","affiliation":[{"name":"Centre for Infectious Disease Epidemiology and Research School of Public Health Faculty of Health Sciences University of Cape Town  Cape Town South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gayathri","family":"Sridhar","sequence":"additional","affiliation":[{"name":"ViiV Healthcare  Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leigh","family":"Ragone","sequence":"additional","affiliation":[{"name":"ViiV Healthcare  Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0157-9689","authenticated-orcid":false,"given":"Vani","family":"Vannappagari","sequence":"additional","affiliation":[{"name":"ViiV Healthcare  Durham North Carolina USA"},{"name":"Department of Epidemiology Gilling School of Public Health University of North Carolina  Chapel Hill North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8496-6475","authenticated-orcid":false,"given":"Mary\u2010Ann","family":"Davies","sequence":"additional","affiliation":[{"name":"Centre for Infectious Disease Epidemiology and Research School of Public Health Faculty of Health Sciences University of Cape Town  Cape Town South Africa"},{"name":"Health Intelligence, Western 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