Coverage and Determinants of the Continuum of Care for the Prevention of Mother-to-Child Transmission of HIV in Sub-Saharan Africa: A Scoping Literature Review, 2025
Background: The human immunodeficiency virus (HIV) remains a major public health threat in sub-Saharan Africa (SSA), where prevention of mother-to-child transmission (PMTCT) is a cornerstone of the epidemic response. This scoping review aimed to examine coverage levels of PMTCT services and to identify factors influencing their utilization, whether facilitating or hindering. Methods: The review included cross-sectional, qualitative, and mixed-methods studies addressing PMTCT coverage and determinants of service utilization in SSA. A descriptive synthesis was conducted to summarize publication characteristics, assess screening and treatment coverage, and highlight the reported determinants. Results: Findings revealed that in several countries (Chad, C？te d’Ivoire, Guinea, Mali, Mauritania, Niger, and Senegal) HIV testing coverage remained below 40%, reflecting limited access to and uptake of PMTCT services. Facilitating factors included media exposure, geographic proximity to health facilities, higher socioeconomic status, urban residence, women’s satisfaction with the quality of care, partner involvement in treatment follow-up and appointments, and support from social networks. Additional organizational strategies, such as service co-location, home delivery of medications, phone reminders, and peer support among women, were also reported as enablers. Conversely, multiple barriers hindered access and adherence, including illiteracy, rural residence, refusal of HIV testing by some pregnant women, low social acceptability of HIV-related services, partner opposition, doubts about test results, lack of confidentiality, mobility among HIV-positive women, and fear of stigma. Conclusion: This review underscores that despite the presence of several enabling factors, persistent challenges remain in HIV testing, treatment adherence, and stigma reduction. Strengthened interventions that enhance awareness, improve service accessibility, and foster social acceptability are needed to maximize the effectiveness of PMTCT programs in SSA. This would allow Guinea to readjust its interventions for the prevention of mother-to-child transmission of HIV. However, it remains essential to conduct a prospective mixed-methods study in Guinea to further analyze access and the determinants of the continuum of care for the prevention of mother-to-child transmission of HIV.
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