Abstract

Mother-to-child transmission of HIV remains a major public health concern in Nigeria and contributes significantly to paediatric HIV infection. HIV can be transmitted from an infected mother to her child during pregnancy, labour, delivery, or breastfeeding. Prevention of Mother-to-Child Transmission (PMTCT) services provide a comprehensive approach to reducing this transmission through HIV testing and counselling, antiretroviral therapy, viral load monitoring, appropriate obstetric care, infant antiretroviral prophylaxis, early infant diagnosis, and follow-up services. Despite the availability of PMTCT services in many healthcare facilities, challenges such as late antenatal care attendance, inadequate HIV testing, treatment interruptions, limited access to diagnostic services, stigma, financial barriers, and poor follow-up may continue to contribute to paediatric HIV infection in Nigeria. Paediatric HIV infection refers to HIV infection occurring among infants and children as a result of mother-to-child transmission or other routes of exposure. Against this background, this study investigates the influence of Prevention of Mother-to-Child HIV Transmission services on paediatric HIV infection in Nigeria. The study will be anchored on the Health Belief Model, Health Systems Framework, and Continuum of Care Model. The Health Belief Model explains how women's perceptions of HIV susceptibility, severity, benefits of PMTCT services, barriers to utilization, and cues to action may influence their use of preventive healthcare services. The Health Systems Framework emphasizes service delivery, health workforce, health information, medical products and technologies, financing, and accessibility as essential components of effective healthcare delivery. The Continuum of Care Model emphasizes the provision of continuous and coordinated healthcare to mothers and infants from pregnancy through childbirth and the postnatal period. Collectively, these theoretical perspectives provide a suitable framework for explaining how PMTCT services may influence paediatric HIV infection in Nigeria. The study will adopt a quantitative cross-sectional or retrospective analytical research design. The study population will comprise pregnant women receiving antenatal and PMTCT services and HIV-exposed infants receiving follow-up care in selected healthcare facilities across Nigeria. A multistage sampling technique will be used to select states, local government areas, healthcare facilities, eligible mothers, and HIV-exposed infants or their medical records. PMTCT services will be measured using indicators such as availability of HIV testing and counselling, initiation and continuation of antiretroviral therapy, viral load monitoring, adherence support, skilled delivery services, infant antiretroviral prophylaxis, early infant diagnosis, counselling, and follow-up services. Paediatric HIV infection will be assessed using indicators such as HIV test results among HIV-exposed infants, early infant diagnosis outcomes, confirmed HIV infection, and HIV transmission rates. Data will be collected from antenatal registers, PMTCT registers, maternal and infant medical records, laboratory records, early infant diagnosis databases, structured questionnaires, and relevant programme documents. Descriptive statistics will be used to summarize participants' characteristics, PMTCT service utilization, and paediatric HIV infection patterns. Inferential statistical techniques, including chi-square tests, correlation analysis, and logistic regression analysis, will be used to determine the influence of PMTCT services on paediatric HIV infection. Diagnostic tests will also be conducted to assess the reliability, validity, and robustness of the findings. The study is expected to find that effective and comprehensive PMTCT services have a significant negative influence on paediatric HIV infection in Nigeria. Pregnant women who receive HIV testing, initiate and adhere to antiretroviral therapy, undergo appropriate monitoring, and complete recommended PMTCT interventions are expected to have a lower likelihood of transmitting HIV to their infants. Infant antiretroviral prophylaxis and timely early infant diagnosis are also expected to contribute to improved prevention and early identification of paediatric HIV infection. Effective counselling and follow-up services may further improve adherence to PMTCT interventions and reduce loss to follow-up among mothers and HIV-exposed infants. Conversely, inadequate access to PMTCT services, late antenatal care attendance, treatment interruptions, limited laboratory capacity, weak follow-up systems, stigma, and financial barriers may increase the risk of mother-to-child HIV transmission. The study therefore expects comprehensive and continuous PMTCT services to contribute significantly to reducing paediatric HIV infection in Nigeria. The study is expected to contribute to the literature on Prevention of Mother-to-Child Transmission, paediatric HIV infection, maternal and child health, HIV prevention, reproductive health, infectious disease control, epidemiology, and public health in Nigeria. The findings will provide useful information to the Federal Ministry of Health and Social Welfare, National AIDS and STIs Control Programme, National Primary Health Care Development Agency, state ministries of health, healthcare facilities, HIV programme managers, obstetricians, paediatricians, midwives, nurses, laboratory professionals, development partners, and policymakers regarding strategies for reducing mother-to-child HIV transmission. The study will also provide evidence-based recommendations for expanding PMTCT service coverage, improving HIV testing during pregnancy, strengthening access to and retention in antiretroviral therapy, improving viral load monitoring, strengthening infant prophylaxis and early infant diagnosis, reducing loss to follow-up, improving counselling and adherence support, and integrating PMTCT services into routine maternal and child healthcare across Nigeria.

Keywords: Prevention of Mother-to-Child Transmission, PMTCT, paediatric HIV infection, HIV transmission, Nigeria, antiretroviral therapy, maternal health, child health, early infant diagnosis, HIV prevention, reproductive health, epidemiology, public health.