Assessing the impact of optimized prevention strategies for mother-to-child HIV transmission dynamics in Kenya: a mathematical modeling study
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HIV can be transmitted from a HIV infected mother to her child during pregnancy, delivery, or breastfeeding. According to NSDCC 2023, Kenya has estimated PMTCT coverage of 89.56% and PMTCT transmission rate of 8.6%. Even though there has been strides to address PMTCT, there is need to gear up approaches in addressing MTCT in order to significantly advance elimination. This research formulates a mathematical model to represent the dynamics of MTCT. Equilibrium points of the model are computed and the stability of HIV-free point is investigated. The numerical results show that a 50% decrease in maternal HIV transmission lowers infant infection rates by about 17.7%, whereas the same reduction in infant transmission decreases infections by nearly 39%, highlighting the greater sensitivity of infant transmission rates to direct interventions. While combination of strategies achieves the highest HIV minimization rates of up to 99.89% on infants, ART adherence alone significantly reduces transmission, particularly on infants (91.42%) while use of post-exposure prophylaxis (PEP) shows limited effectiveness when used alone(39.65%), suggesting that it should be complemented with other strategies for optimal impact. These findings emphasize the critical need for integrated interventions, where combining multiple prevention methods yields the best outcomes in reducing HIV infections on infants and moving closer to the elimination of pediatric HIV. These findings align with global recommendations from World Health Organization (WHO). This research can be used by the ministry of health to inform policy as well as recreated for other maternal infections.
Author summary
HIV can be transmitted from a mother to her child during pregnancy, delivery, or breastfeeding. In Kenya, despite efforts to prevent mother-to-child transmission (PMTCT), HIV transmission rates remain a concern. In this study, we developed a mathematical model to understand how HIV spreads from mothers to infants and to evaluate the effectiveness of different prevention strategies. Our findings highlight that reducing HIV transmission in mothers lowers infant infection rates, but direct interventions for infants, such as early antiretroviral therapy (ART) and post-exposure prophylaxis (PEP), have an even greater impact. A combination of strategies—ensuring mothers adhere to ART, providing PEP for infants, and promoting safe breastfeeding practices—was found to reduce HIV infections in infants by up to 99.89%. These results support the need for integrated approaches to HIV prevention. Policymakers and healthcare providers can use this research to refine HIV prevention programs, ensuring better maternal and infant health outcomes. Our model can also be adapted for other maternal infections, contributing to broader public health efforts in disease prevention.
