As shown in the Table 1, the majority of the mother with HIV infection (52,1%) were aged 30 - 39 years. Of 420 children born from HIV positive mothers 91.7% were aged between 18-24 months, 55.2% were female. The majority of HIV positive mothers 80.2% who participated in the study were married, 85.5% had only primary education, and 86.5% had informal work. Table 2.

The majority of HIV Positive mother were ART during pregnancy period 410 (97.6%), 408 (97.1%) were suppressed their viral load, 420 (90.0%) demonstrated good adherence to ART medication, (85.7%) of mothers which correspond to 360 mothers were in WHO stage I. Table 3.

The majority (91.2%) of children under the study were delivered by Spontaneous Delivery Vaginal, 96% were delivered at health facilities. The majority of children (96.2%) received ART Prophylaxis in the First 4 hours after birth, 96% were given cotrimaxazol prophylaxis at 6 weeks post-delivery

Prevalence of HIV Infection Among Children Born from HIV Positive Mother. Figure 1.

As can be seen in the table above, in 420 infants, (97.1%) tested negative on final HIV test and (2.9%) infants tested positive on final HIV test positive.Factors associated with HIV Infection among children born from HIV Positive women Musanze district, Rwanda.

The findings of the factors associated with HIV infection among children born from HIV positive mothers are presented in table 4. The results shows that children born from mother who works in private sector had higher risk of HIV infection compared to those born from unemployed mother (AOR = 1.97; 95% CI: (1.13-3.25)).

Children whose mother had poor adherence to ART were 1.5 times more likely to get HIV at birth compared to those whose mother had good adherence (AOR = 1.5; 95% CI: (1.12-2.21)). Children born from mothers in WHO stage I and II were more likely to get HIV from their mother with odd ratios of (AOR = 1.54; 95% CI: (1.12-2.32)), (AOR = 1.24; 95% CI: (1.32-2.207)) respectively.

Children born from HIV positive mother with one ANC visit were 2.5 times more likely to get HIV from their mothers (AOR = 1.56; 95% CI: (2.31-5.17)). Similarly, children born from HIV positive mother who attended only two ANC were 1.6 times more likely to get HIV from their mothers (AOR = 1.62; 95% CI: (1.10-2.63)).

The main objective of this study was to determine the Prevalence and Risk Factors of HIV Infection among Children born from HIV Positive Women in Musanze District. Mother to child transmission of HIV infection occurs when HIV positive women passes the virus to her baby during pregnancy, delivery and breastfeeding period. Of 420 children born from HIV positive mother 12 (2.9%) were HIV positive. The prevalence of HIV infections among children born from HIV positive mother in Musanze District was 2.9%.

In the research conducted by UNAID in 2017 in worldwide founded that the route of HIV infection from mother to child is during pregnancy period, delivery period and breastfeeding period. It is believed that about 2/3 are infected during pregnancy and around the time of delivery, and about 1/3 are infected through breastfeeding period.

A lower HIV prevalence among children born from HIV mother was observed in Musanze District. In contrast the higher prevalence was reported in the study conducted in Ethiopia. The study conducted in Amhara region, Ethiopia showed that the prevalence of HIV infection among HIV exposed infants was 10.1% 10. In Ethiopia an estimated 1.2 % of pregnant women are living with HIV. Consequently, one of every 3 (33.3%) children born to these women is being infected with HIV 11.

The higher prevalence as also reported in the study conducted in Zimbabwe where mother-to-child HIV transmission is between 15-25%. In Zimbabwe like any other country in sub-Saharan Africa, breastfeeding is the norm with 97% of children reported as ever breastfed 12. In Tanzania, a study showed that, the overall rate of transmission can go up to 20% if an HIV infected mother breastfeeds for 18-24 months 13. Similarly to these findings, a research conduct by Rwanda Biomedical Center in 2018 revealed that the prevalence of HIV transmission from mother to child is 1.56% 8. From 2012, the Government of Rwanda has opted for the WHO option in which all HIV positive pregnant women got engaged in ART regardless of the CD4 count. The process excluded breast feeding protected by ART and women continuing ART as a lifelong treatment. Implementation of WHO option resulted in the reduction of MTCT rate at 18 months. Recent data concluded that MTCT rate dropped to 1.8% in a cohort of exposed infants 9.

Factors such as working in private sector, maternal poor adherence to ART, advanced stage of HIV, poor ANC visits were associated with HIV infection among mothers born from HIV positive mothers.

Rwanda Government continue to work together with partners to ensure full implementation of national standards for HIV prevention, care and treatment for pregnant women, mothers and their children; and to develop evidence-based strategies and define baselines and indicators that promote the integration of PMTCT into maternal, newborn and child health services, thus strengthening Rwanda health systems.