Teenage pregnancy is a pregnancy occurring in females aged 13 to 19 years [1]. Teenage HIV is a global problem. Adolescent girls and young women account for one in four new HIV infections in sub-Saharan Africa [2]. Globally 22% of all new HIV infections were attributed to infections among young women, with sub-Saharan Africa bearing the greatest burden at 31% [3]. Earlier studies have associated the Level of education, income levels, and socio-economic background with acquiring HIV infection among teenage mothers in Uganda [4] [5]. Young women are particularly at higher risk due to cervical ectopy associated with the hormonal surge in puberty which facilitates greater exposure of target cells to trauma and pathogens in the vagina [6]. HIV, when not treated early, leads to AIDS compromising the mother’s immunity which impacts the overall outcome of the pregnancy for the mother and the baby.

Literature in a South African study showed that the risk of contracting HIV is higher during pregnancy than in the general population [7]. High levels of estrogen and progesterone during pregnancy cause changes in the structure of the genital mucosa and immunological changes which are associated with HIV infection [7].

Uganda’s demographic health survey of 2011 showed that urban women were more likely to engage in riskier sexual behaviors like having more sexual partners than those in a rural setting. Hence we measured the prevalence of teenage HIV in an urban setting like Mulago against the national average. The study also assessed factors associated with HIV infection among teenage mothers at Mulago.

The design for this study was cross-sectional with both descriptive and analytical components.

We conducted the study at Mulago National Referral Hospital, Kawempe Campus. Mulago national referral hospital is located in Kawempe south division of Kampala, the Capital City of Uganda. Most of the patients were residents of the five divisions of Kampala. The hospital also receives patients from neighboring districts of Wakiso, Luwero, Nakaseke, Buikwe, Mukono, and Mpigi.

In January 2016, of 1775 mothers that delivered at Mulago, 257 (15%) were teenagers. We targeted all Teenage mothers delivered at Mulago National referral hospital and our study population consisted of Teenage mothers who were delivered at the facility between November 2016 and January 2017.

All mothers 13 to 19 years who delivered at Mulago were included. We excluded all teenage mothers who were very sick, and at the analysis point for factors associated with HIV infection, we also excluded mothers who were infected through vertical transmission by their parents since they had a known risk. The Dependent variable was; the HIV status of mothers recorded on either ANC card or the HIV test results obtained at admission after carrying out a blood test. Independent variables were categorized into demographic, safe motherhood, sexual reproductive characteristics, and socio-economic factors.

Using Kish & Leslie’s (1965) formula and considering a 10% nonresponse rate a total of 424 participants were sampled but were only able to achieve 395 completed questionnaires.

The researchers and the research assistants enrolled eligible participants, collected blood samples, obtained blood samples were tested and we followed standard HIV testing guidelines using all three HIV test kits, i.e. determine, starter pack, and unigold as the tiebreaker.

Data analysis was done using STATA, we described socio-demographic characteristics of the participants and we also compared Social demographic factors, socioeconomic status, and reproductive health factors among teenage mothers to their HIV status using the Pearson Chi-Square test we obtained Bivariate analysis data, and all factors that had P-Value < 0.2 were considered to be significant and Then performed logistic regression to compare relationships between the dependent variable (HIV status) and the independent variables.

We found the prevalence of HIV among teenage mothers delivered at Mulago to be 8.61%. We also found out that the prevalence of HIV excluding the 10 mothers who contracted HIV vertically from their parents is 6.23%.

In Table 1 below, we found the mean age of study participants was 18.1 years (SD = ±1.1) meanwhile the average age for their spouses was 24.3 years (SD = 4.7). Age at sexual debut was 16.4 (±1.4), most of the study participants had attained an education level more than in secondary education 190 (48.1%), and most of the participants had one sexual partner (SD = 1.1) at the time of the study. meanwhile, their lifetime number of sexual partners was 1.5 (SD = 0.8). most of the teenagers who lived with a caretaker with no gainful employment were 330 (83.5%). The age difference between the teenage mothers and their spouses was 6.2 years with SD = ±4.7, majority of teenagers were either married or cohabiting with their spouses 255 (64.5%). knowledge of contraception was 264 (52.9), and only 161 (40.8%) ever used condoms. The majority of the participants were Baganda 248 (62.8%), followed by Banyankole 54 (13.7%) and the rest were from other tribes of Uganda.

In the Bivariate Table 2 below, age of the subject, age of spouse, age at sexual debut, previous sexual relationships, history of having STIs, alcohol consumption by the participants, caretaker’s occupation, living in a polygamous relationship, the age difference between couples, living with the partner, lifetime number of sexual partners and the number of other sexual relationships currently were associated with HIV status of the participants. However, there was no association, between levels of education, income levels of participants, and condom use. The factors in bivariate analysis that had P-value < 0.2 were run in a logistical regression model to eliminate cofounding in the association.

Multivariate analysis in Table 3 below, shows for every one-year increase in age at sexual debut, the risk of HIV infection reduces by 40% (AOR = 0.6, CI = 0.43 - 0.94). We found out that for every one-year increase in the age of the participant the risk of HIV infection increases by 2.8 times (AOR = 2.8, CI = 1.50 - 5.33). Teenagers who live in a polygamous relationship are ten times at risk of

HIV infection than those whose partners do not have other sexual relationships (AOR = 10, CI = 2.56 - 17.85). We also found that age difference between couples contributes to an increased risk of HIV infection by 1.1 times (AOR = 1.1, CI = 1.02 - 1.18). Meanwhile, the age of spouse, previous sexual relationships, not living with the partner, and lifetime number of sexual partners were not independently associated with HIV infections among participants.

The prevalence of HIV among teenage mothers delivered at Mulago hospital was 8.61%. Sexual debut, age of the subjects, the age difference between the couples, and living in a polygamous relationship was significantly associated with HIV infection among the mothers.

We are grateful to the head of the department Dr. Nakimuli Annettee and the entire staff of the department of obstetrics and Gynecology for allowing us to conduct the study at the department.

We also recognize the contribution of our research assistants Faith Mbambu and Rita kukundakwe.

ADE was involved in concept development, data collection, analysis, and research report writing. SM was involved in the concept development and review of the research report. BJK was involved in concept development, review of research results, and manuscript development. All authors have read and approved the final version of this manuscript.

Not applicable, the manuscript does not contain data from any individual or institution such as pictures.

All data generated or analyzed during this study are included in this published article and supplementary information can be obtained on reasonable request from corresponding authors who are in the custody of the files.

This is to certify that the work presented in this book was done by the authors at Mulago women’s hospital, Kawempe campus. And that this dissertation has never been presented in any other journal for publication.

Permission to do the research was sought from the School of Medicine Research and Ethics committee, quote approval reference #REC REF 2016-121 for queries. Informed consent was obtained from all participants. Participants who were younger than 18 years were allowed to provide consent since they were regarded as emancipated minors according to Uganda national council of science and technology 2014 guidelines amongst human subjects. They were explained that they would get minor trauma during venipuncture. Their HIV serology results are being kept confidential.

The procedures that were being undertaken in this study were explained to each participant and they were also encouraged to ask questions and seek clarification on any item related to the study. Participants’ participation and withdrawal from the study were voluntary and there was no compensation and allowances given to participants. All the principles of Ethics were observed in this study.

All the authors work Mulago National referral/Teaching Hospital at the time of the study.

Elly, A.D., Musa, S. and Kafunjo, B.J. (2022) Prevalence and Factors Associated with HIV Infection among Teenage Mothers Delivered at Mulago Hospital—A Cross-Sectional Study. Open Journal of Obstetrics and Gynecology, 12, 661-670. https://doi.org/10.4236/ojog.2022.127059