Growth Outcomes Among HIV-Exposed Infants in Africa: Emerging Vulnerabilities and Evidence Synthesis
1
Non Communicable Diseases Research Unit, South African Medical Research Council (SAMRC), Parrow valley, Tygerberg, Cape Town, South Africa
2
Department of Life and Consumer Sciences, College of Agriculture and Environmental Sciences,, University of South Africa, Florida Campus, Johannesburg 1709,, South Africa
3
Faculty of Health Sciences, University of Limpopo, Polokwane 0700, South Africa
Popul. Med. 2026;8(Supplement Supplement 1):A2069
ABSTRACT
BACKGROUND:
In sub-Saharan Africa, antiretroviral therapy (ART) and prevention of mother-to-child transmission (PMTCT) programs have reduced vertical HIV transmission, creating a growing population of HIV-exposed but uninfected (HEU) infants. Emerging evidence indicates these infants face distinct health vulnerabilities, particularly impaired growth, with stunting posing serious implications for long-term development.
OBJECTIVE:
To quantify and compare growth outcomes, stunting, underweight, and wasting, between HEU and HIV-unexposed uninfected (HUU) infants across African countries.
METHODS:
A scoping review and meta-analysis following PRISMA guidelines included 17 peer-reviewed studies reporting WHO-defined growth indicators for HEU and HUU infants. Studies on overweight, obesity, or metabolic factors were excluded. Quality was assessed using the Newcastle-Ottawa Scale. Random-effects models generated pooled odds ratios (ORs) and heterogeneity was evaluated using I² statistics.
RESULTS:
HEU infants had significantly higher odds of stunting (OR = 1.56; 95% CI: 1.23–1.97; p < 0.01), with pooled prevalence of 25% versus 19% in HUU infants. No significant differences were observed for underweight or wasting, though underweight outcomes showed high heterogeneity (I² = 82%).
CONCLUSIONS:
HEU infants face heightened risks of impaired growth, particularly stunting, highlighting the urgent need for tailored monitoring, nutritional interventions, and maternal support through HEU-sensitive frameworks embedded in early childhood development programs. Advocacy must drive policies that integrate growth surveillance within HIV care, strengthen maternal health services, and prioritize interventions for HEU populations. Mobilizing resources for longitudinal research and fostering multi-sectoral partnerships are critical to mitigate growth vulnerabilities and advance health equity for HIV-affected families in Africa.
In sub-Saharan Africa, antiretroviral therapy (ART) and prevention of mother-to-child transmission (PMTCT) programs have reduced vertical HIV transmission, creating a growing population of HIV-exposed but uninfected (HEU) infants. Emerging evidence indicates these infants face distinct health vulnerabilities, particularly impaired growth, with stunting posing serious implications for long-term development.
OBJECTIVE:
To quantify and compare growth outcomes, stunting, underweight, and wasting, between HEU and HIV-unexposed uninfected (HUU) infants across African countries.
METHODS:
A scoping review and meta-analysis following PRISMA guidelines included 17 peer-reviewed studies reporting WHO-defined growth indicators for HEU and HUU infants. Studies on overweight, obesity, or metabolic factors were excluded. Quality was assessed using the Newcastle-Ottawa Scale. Random-effects models generated pooled odds ratios (ORs) and heterogeneity was evaluated using I² statistics.
RESULTS:
HEU infants had significantly higher odds of stunting (OR = 1.56; 95% CI: 1.23–1.97; p < 0.01), with pooled prevalence of 25% versus 19% in HUU infants. No significant differences were observed for underweight or wasting, though underweight outcomes showed high heterogeneity (I² = 82%).
CONCLUSIONS:
HEU infants face heightened risks of impaired growth, particularly stunting, highlighting the urgent need for tailored monitoring, nutritional interventions, and maternal support through HEU-sensitive frameworks embedded in early childhood development programs. Advocacy must drive policies that integrate growth surveillance within HIV care, strengthen maternal health services, and prioritize interventions for HEU populations. Mobilizing resources for longitudinal research and fostering multi-sectoral partnerships are critical to mitigate growth vulnerabilities and advance health equity for HIV-affected families in Africa.
| eISSN: | 2654-1459 |
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