Objective To evaluate the performance of the cascade of activities for prevention of mother-to-child transmission (PMTCT) of human
immunodeficiency virus (HIV) at the second immunization visit in Burkina Faso.
Methods In a cross-sectional study, we recruited mothers attending the second immunization visit for their infant in 20 health centres of
Bobo-Dioulasso city, Burkina Faso over 12 months (2019–2020). We administered a short questionnaire to 14 176 mothers and performed
HIV serological tests on mothers who had not been tested in the last 3 months. All mothers were asked about their attendance for antenatal
care and HIV rapid testing. HIV-infected mothers were also asked about the timing of their HIV diagnosis, antiretroviral therapy, pre-exposure
prophylaxis initiation at birth and infant diagnosis of HIV.
Findings Of 14 136 respondents, 13 738 (97.2%) had at least one HIV serological test in their lifetime. Of 13 078 mothers who were never
tested or were HIV-negative, 12 454 (95.2%) were tested during or after their last pregnancy. Among HIV-infected mothers already aware of
their status, 110/111 (99.1%) women were on antiretroviral therapy. Among HIV-exposed infants, 84/101 (83.2%) babies received 6 weeks
of antiretroviral prophylaxis at birth and 58/110 (52.7%) had a blood sample collected for early infant diagnosis. Only two mothers received
their child’s test results at the time of the second immunization visit. Four mothers were newly diagnosed as HIV-positive during the study.
Conclusion Collecting data at the second immunization visit, a visit rarely missed by mothers, could be useful for identifying gaps in the
PMTCT cascade in settings where mothers are difficult to reach, such as in low-income countries with intermediate or low HIV prevalence