Comprehensive knowledge of PMTCT among reproductive-age women in eight sub-Saharan African countries using multilevel...

Maternal comprehensive knowledge on the prevention of mother-to-child transmission (PMTCT) of HIV is crucial for eliminating new pediatric HIV infections. However, the burden of pediatric infection remains high in Sub-Saharan Africa, and substantial knowledge gaps in PMTCT persist among women in the region. Therefore, this study aimed to examine women's comprehensive knowledge of PMTCT for HIV and identify individual- and community-level factors using the nationally representative Demographic Health Survey (DHS) data from eight sub-Saharan African (SSA) countries with diverse HIV epidemic burdens. We conducted a secondary analysis of nationally representative DHS data collected from eight sub-Saharan African countries between 2019 and 2025. A total weighted sample of 101,043 reproductive-age women was included. Data was cleaned, weighted, and analyzed using STATA version 17.0 software. Mixed-effects multilevel logistic regression models were fitted to identify individual- and community-level factors associated with women's comprehensive knowledge of PMTCT. Overall, only 38.38% (95% CI: 38.08%, 38.68%) of reproductive-age women across eight sub-Saharan African countries had comprehensive knowledge of the PMTCT of HIV. Higher odds of comprehensive knowledge of PMTCT were found in women with secondary or higher education, employment, media exposure, multiparity, current pregnancy, recent health facility visits, antenatal care follow-up, prior HIV testing, modern contraceptive use, institutional delivery, and adequate knowledge of HIV. At the community level, residing in communities with high literacy and greater media exposure as well as in countries with a higher HIV burden was positively associated with comprehensive knowledge of PMTCT. In conclusion, comprehensive knowledge of PMTCT remains low among reproductive-age women across the included SSA countries. Improving women's education, expanding media access, and integrating PMTCT counseling into maternal and reproductive health services could improve women's knowledge and contribute to the elimination of mother-to-child HIV transmission. To enhance awareness and promote the uptake of PMTCT services, tailored community-based health education programs should be implemented, particularly for low-literacy and underserved communities.