This study investigated the factors contributing to delayed presentation, infrequent antenatal care (ANC) attendance and low uptake of prevention of mother-to-child transmission (PMTCT) services among pregnant adolescent girls (15-19 years) at Berea Government Hospital, Lesotho.

Employing a retrospective cross-sectional method, routine patient-level data from the maternal, neonates and child health department was reviewed. Data on ANC attendance among adolescent girls was collected from health facility sources using paper-based and telephonic surveys. Descriptive statistics revealed that adolescents had a mean gestational age of 21 weeks at their first ANC visit, with a 16,6% MTCT rate.

Fear of stigma and discrimination, particularly among schoolgoing adolescents, was identified as a significant barrier to ANC attendance. Recommendations included enhancing sexual and reproductive health education, empowering teachers and guardians to communicate HIV-related matters effectively and disaggregating PMTCT data by finer age bands. Strengthening these measures could mitigate late ANC attendance and improve PMTCT outcomes.