An assessment of the understanding of the offer of routine HIV testing among pregnant women in rural Zimbabwe

Mugore, Linnetie; Engelsmann, Barbara; Ndoro, Tinashe Tsungai Raphael; Dabis, François; Pérez, Freddy

doi:10.1080/09540120701687034

Cited by 14 publications

(12 citation statements)

References 23 publications

(24 reference statements)

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“…Nurses in the Ugandan referral hospital said they could not keep up with demand. A few quantitative studies from Sub-Saharan Africa confirmed that acceptance rates for PITC in hospital, home-based, and antenatal care settings were very high: in Botswana (94 percent accepted the offer of an HIV test in a household survey), in Uganda (95 percent and 98 percent in two hospital-based studies), in Malawi (95 percent of women attending antenatal care), and Zimbabwe (93 percent of women attending antenatal care) (Nakanjako et al 2007; Wanyenze et al 2008; Cockcroft et al 2007; Mugore et al 2008; Weiser et al 2006; Manzi et al 2005). Wanyenze and colleagues attributed the high acceptance of PITC to the fact that the tests are free of charge and that they are associated with improved access to HIV care and treatment.…”

Section: From Choice To Care: Evolving Testing Constellationsmentioning

confidence: 90%

Dynamics of Care, Situations of Choice: HIV Tests in Times of ART

Hardon

Kageha

Kinsman

et al. 2011

Medical Anthropology

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In the 1990s, African AIDS programs followed a voluntary counseling and testing (VCT) approach to HIV testing. In the wake of large scale AIDS treatment programs, policymakers opted for routine provider-initiated testing (PITC) with less emphasis on counseling, which led to concerns about the ethical conduct of HIV testing. Inspired by Annemarie Mol, we ask if PITC can be framed as good care, rather than as medical domination that threatens to violate patients’ rights. Based on fieldwork in Ugandan and Kenyan health facilities, we reveal that situations of choice vary: patients in hospital wards, are given time to decide whether they want a test, while in antenatal care testing women find it very hard to optout. We argue that the medical context inherent in PITC provides an attractive moral space for people to undergo HIV tests.

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Section: From Choice To Care: Evolving Testing Constellationsmentioning

confidence: 90%

Dynamics of Care, Situations of Choice: HIV Tests in Times of ART

Hardon

Kageha

Kinsman

et al. 2011

Medical Anthropology

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“…In the younger age groups (15–19 and 20–24), the testing coverage more than doubled in the same period 36. An opt-out testing strategy in the ANC setting was rolled out after a successful evaluation of the strategy in two rural districts in Zimbabwe 37, 38. It is thus expected that HIV testing coverage will increase in the years after the ZDHS 2005–2006 as this strategy is implemented nationwide 39.…”

Section: Discussionmentioning

confidence: 99%

The contribution of antenatal care to the coverage and correlates of HIV testing among adults in Zimbabwe 2005–06

Saito

Nankabirwa³

et al. 2012

Int J STD AIDS

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Summary Expanding the availability, utilization and coverage of HIV testing services is a critical step towards primary prevention and successful delivery of antiretroviral therapy (ART) in Zimbabwe. We used data from the Zimbabwe Demographic and Health Survey (2005–2006) to examine the coverage and correlates of recent HIV testing (HIV testing, <24 months preceding the survey) among HIV-positive and HIV-negative adults. We estimated the relative contribution of HIV testing in both the antenatal care (ANC) setting and non-ANC settings. Uptake of recent HIV testing was 14.4% among women and 11.1% among men, with HIV testing in ANC accounting for 42.3% and 10.3% of all recent testing among women and men, respectively. In the multivariate analyses, recent pregnancies and being aware of ART were independent correlates after controlling for demographic and socioeconomic variables. HIV testing in ANC was an important contributor to HIV testing coverage in Zimbabwe by reaching not only pregnant women but also their partners.

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“…In Botswana, 68% of individuals who were tested for HIV under a national policy of PITC believed that they were not able to refuse the test when it was offered [20]. In rural Zimbabwe, 55% of women who accepted HIV testing directly after group education as part of their routine ANC blood tests were not aware of the possibility of opting for individual pre-test counseling [21]. …”

Section: Discussionmentioning

confidence: 99%

Prevalence and barriers to HIV testing among mothers at a tertiary care hospital in Phnom Penh, Cambodia. Barriers to HIV testing in Phnom Penh, Cambodia

et al. 2010

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BackgroundOne-third of all new HIV infections in Cambodia are estimated to be due to mother-to-child transmission. Although the Ministry of Health adopted a policy of provider-initiated HIV testing and counseling (PITC), nearly a quarter of pregnant mothers were not tested in 2007. Greater acceptance of HIV testing is a challenge despite Cambodia's adoption of the PITC policy.MethodsA hospital-based quantitative and cross-sectional survey was conducted to assess the prevalence of and barriers to HIV testing among mothers after delivery at the National Maternal and Child Health Center in Phnom Penh. The Center is one of the largest maternal and child care hospitals in the country to offer PITC services. All 600 eligible mothers who were admitted to the hospital after delivery from October to December 2007 were approached and recruited. Data were collected via a semi-structured questionnaire.ResultsThe prevalence of HIV testing among women who delivered at the hospital was 76%. In multivariate logistic regression, factors such as the perceived need to obtain a partner's permission to be tested (OR=0.27, 95% CI=0.14-0.51, p<0.01), the lack of knowledge about HIV prevention and treatment (OR=0.38, CI=0.22-0.66, p<0.01), and the lack of access to ANC services (OR=0.35, 95% CI=0.21-0.58, p<0.01) were found to be the main barriers to HIV testing.ConclusionTo achieve greater acceptance of HIV testing, counseling on HIV prevention and treatment must be provided not only to mothers but also to their partners. In addition, utilization of non-laboratory staff such as midwives to provide HIV testing services in rural health facilities could lead to the greater acceptance of HIV testing.

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An assessment of the understanding of the offer of routine HIV testing among pregnant women in rural Zimbabwe

Cited by 14 publications

References 23 publications

Dynamics of Care, Situations of Choice: HIV Tests in Times of ART

Dynamics of Care, Situations of Choice: HIV Tests in Times of ART

The contribution of antenatal care to the coverage and correlates of HIV testing among adults in Zimbabwe 2005–06

Prevalence and barriers to HIV testing among mothers at a tertiary care hospital in Phnom Penh, Cambodia. Barriers to HIV testing in Phnom Penh, Cambodia

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