Why did they get infected? Audit of MTCT risk factors among HIV-positive Infants attending Faith Based Health facilities in Uganda

Background This study investigated the risk factors for MTCT among HIV positive infants in 29 faith-based health facilities in Uganda. Scope Despite major investments in PMTCT, Uganda continues to record pediatric HIV infections, especially in rural areas where faith based facilities are key providers. The study aimed to identify factors such as maternal ART adherence, healthcare access, and socio cultural influences to guide targeted Ministry of Health interventions. Methodology: A cross-sectional, retrospective design reviewed records of 117 HIV positive mother infant pairs from purposively selected facilities. Data were collected using a Ministry of Health-adapted PMTCT/EID audit tool, capturing socio-demographic, clinical, and service delivery factors. Analysis was conducted in IBM SPSS Version 20 using descriptive statistics and logistic regression. Results Most mothers were 19–24 years (52%), adolescent girls and young women (56%), single (52%), and unemployed (58%). ART initiation occurred before pregnancy (42%), during pregnancy (40%), and postnatally (15%). Key MTCT risk factors were late HIV diagnosis (47%), unsuppressed viral load (12%), obstetric complications (11%), missed infant prophylaxis (10%), and poor ART adherence (3%). Recommendations: Strengthen early HIV testing, ANC linkage, male involvement, ART adherence, infant prophylaxis, viral load monitoring, and data systems; address structural barriers; and leverage church networks to reduce stigma. Conclusion Enhanced community driven PMTCT interventions in faith-based settings are vital to eliminating pediatric HIV in Uganda.