Patterns and risk factors for HIV infection in children in eastern Zimbabwe

Background: The epidemiology of HIV in children in sub-Saharan Africa remains poorly understood. We describe patterns of HIV infection in children aged 2-14 years in eastern Zimbabwe in 2009-2011.
Methods: Data on possible socio-demographic correlates of HIV prevalence, sources of childhood infection, and the effects of HIV were collected in a general population survey and analysed using multi-variable logistic regression. The possibility of horizontal transmission was assessed by comparing the age-pattern of HIV prevalence with a mathematical model of the pattern expected from survival of infants infected through mother-to-child transmission (MTCT).
Results: HIV prevalence in children was 2.2% (73/3,399). Prevalence did not differ by sex, age, socio-economic status, location or religion. The age-specific HIV pattern was consistent with the model prediction of that expected from survival of infants infected through MTCT, but 9/73 infected children had living HIV-negative mothers. Infected children were more likely than uninfected ones to be malnourished (21.6% vs 9.9%, p=0.006) and stunted (42.0% vs 30.6%, p=0.03). HIV status was not correlated with physical or psychological ill-health, or school drop-out.
Conclusion: Childhood HIV infection in Zimbabwe is due primarily to MTCT and is linked with poor physical development.