HIV infection during pregnancy: antiretroviral therapy and the associations with migrant status

Both migrant status and HIV infection pose significant barriers to accessing antenatal healthcare. This study examined the characteristics and temporal trends of HIV-infected pregnant women by migrant status in eastern China, and identified factors associated with antiretroviral therapy (ART) uptake.

Data were obtained from the Zhejiang Provincial Information System for the Prevention of Mother-to-Child Transmission of HIV, including HIV-infected pregnant women registered between 2011 and 2021. Participants were categorized into four groups based on migrant status: (1) permanent residents within Zhejiang Province; (2) permanent residents outside Zhejiang Province; (3) inter-provincial migrants; (4) intra-provincial migrants.

A total of 2560 HIV-infected pregnant women were reported during the study period. Of these, 65.74% were migrants from outside Zhejiang Province, 25.43% were permanent residents within Zhejiang Province, 6.33% were permanent residents outside Zhejiang Province, and 2.50% were intra-provincial migrants. Maternal age, education, marital status, reproductive history, HIV awareness time, and birth outcomes varied significantly by migration status. The proportion of inter-provincial migrants showed a significant increasing trend over time (APC = 1.16, 95% CI 0.01 to 2.61, P < 0.05). Although the overall ART coverage rate increased, it remained lowest among inter-provincial migrants (84.74%) compared to local residents (95.72%), with multivariate analysis indicating that migrant women from outside Zhejiang had significantly lower odds of ART usage (OR = 0.340, 95% CI 0.158-0.739).

Socio-demographic disparities among HIV-infected pregnant women are strongly associated with migrant status, with migrant women less likely to access ART. These findings highlight the need for targeted interventions to enhance HIV treatment access and retention among migrant populations.