HIV-1 testing in pregnancy: acceptability and correlates of return for test results

Kiarie, James; Nduati, Ruth; Kamau, K; Musia, Janet; John, Grace C.

doi:10.1097/00002030-200007070-00030

Cited by 40 publications

(27 citation statements)

References 5 publications

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“…Several studies have also reported similarly higher infection rate among adolescents in Nigeri and sub-saharan Africa [4,25,26], thus suggesting that most infections in women occur at this age, during the first few years after sexual debut. The comparatively low rate of HIV testing among the teenagers reported in this study has also been documented by several studies conducted in sub-Saharan Africa [27,28]. This may remain a major challenge for the PMTCT programme in Nigeria and other developing countries.…”

Section: Discussionsupporting

confidence: 70%

“…This may actually be due to fear of being perceived as wayward and the stigma still attached to HIV infection in this semi-rural environment. Routine HIV testing approach is not common in most rural area in sub-Saharan Africa, [27] where HIV infection rates are very high and HIV testing faces considerable barriers, including the fear of stigma and discrimination [29,30]. VCCT should be presented in such a way as to enable the community adopt it as “standard of care” offered to all patients attending a PHC, thereby reducing the risk of stigma and other adverse social consequences attached to its uptake in rural areas [31,32].…”

Section: Discussionmentioning

confidence: 99%

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A comparative analysis of teenagers and older pregnant women in the utilization of prevention of mother to child transmission [PMTCT] services in, Western Nigeria

Amoran

Salami

Oluwole

2012

BMC Int Health Hum Rights

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IntroductionMost HIV/AIDS infections in women occur at a younger age, during the first few years after sexual debut. This study was therefore designed to assess factors associated with the knowledge and utilization of the prevention of mother-to-child transmission (PMTCT) services by the teenage pregnant women when compared to mature pregnant women in Ogun state, Nigeria.MethodsThis study is an analytical cross-sectional study. A total sample of all pregnant women [52 teenagers and 148 adults] attending the primary health care centres in Sagamu local government area, Ogun State, Nigeria within a 2 months period were recruited into the study.ResultsA total of 225 respondents were recruited into the study. The overall point prevalence of HIV/AIDS infection among those that had been tested and disclosed their result was 4 [2.8%]. The prevalence of HIV among the teenagers was 2 [7.4%] compared with 2 [1.8%] among older women. Only 85 [37.8%] of all respondents were tested through the Voluntary counseling and testing (VCCT) programme and 53 (23.7%) were aware of antiretroviral therapy while 35 (15.6%) have ever used the PMTCT services before.There was no statistically significant difference in the knowledge of the teenage pregnant women when compared with the older women about mother to child transmission (MTCT) [OR = 1.47, C.I = 0.57-3.95] and its prevention [OR = 0.83, C.I = 0.38-1.84]. The teenagers were 3 times less likely to use the services when compared with the older women. [OR = 0.34, C.I = 0.10-1.00]. Those from the low socio-economic background were about 6 times more likely to utilize PMTCT facilities when compared to those from high socioeconomic background [OR = 6.01, C.I = 1.91-19.19].ConclusionThe study concludes that the teenage pregnant women who were more vulnerable to HIV/AIDS infection did not utilize PMTCT services as much as the older pregnant women. Special consideration should be given to teenagers and those from high socioeconomic group in the design of scale up programmes to improve the uptake of PMTCT services in Nigeria and other low income countries.

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Section: Discussionsupporting

confidence: 70%

Section: Discussionmentioning

confidence: 99%

A comparative analysis of teenagers and older pregnant women in the utilization of prevention of mother to child transmission [PMTCT] services in, Western Nigeria

Amoran

Salami

Oluwole

2012

BMC Int Health Hum Rights

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“…The findings in Kenya suggested that obstacles to returning for HIV test results may include childcare commitments (J. Kiarie, Nduati, Koigi, Musia, & John, 2000). Multiple reasons are likely to contribute to our observed attrition.…”

Section: Discussionmentioning

confidence: 87%

Reducing vertical HIV transmission in Kinshasa, Democratic Republic of Congo: trends in HIV prevalence and service delivery

et al. 2009

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Scale-up of vertical HIV transmission prevention has been too slow in sub-Saharan Africa. We describe approaches, challenges, and results obtained in Kinshasa. Staff members of 21 clinics managed by public servants or non-governmental organizations were trained in improved basic antenatal care (ANC) including nevirapine (NVP)-based HIV transmission prevention. Program initiation was supported on-site logistically and technically. Aggregate implementation data were collected and used for program monitoring. Contextual information was obtained through a survey. Among 45,262 women seeking ANC from June 2003 through July 2005, 90% accepted testing; 792 (1.9%) had HIV of whom 599 (76%) returned for their result. Among 414 HIV+ women who delivered in participating maternities, NVP coverage was 79%; 92% of newborns received NVP. Differences were noted by clinic management in program implementation and HIV prevalence (1.2 to 3.0%). Initiating vertical HIV transmission prevention embedded in improved antenatal services in a fragile, fragmented, severely resource-deprived health care system was possible and improved over time. Scope and quality of service coverage should further increase; strategies to decrease loss to follow-up of HIV+ women should be identified to improve program effectiveness. The observed differences in HIV prevalence highlight the importance of selecting representative sentinel surveillance centers.

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“…One way is to opt-out of the encounter all together. Prior to the onset of rapid testing, many researchers have reported high uptake of testing, yet low rates of follow-up to collect results (Jurgens, 2007; Kiarie, Nduati, Koigi, Musia, & John, 2000). In our study, one participant described other women running from the clinic to avoid testing.…”

Section: Discussionmentioning

confidence: 99%

The complexity of consent: women's experiences testing for HIV at an antenatal clinic in Durban, South Africa

et al. 2010

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Informed consent has historically been a cornerstone to ensuring autonomy during HIV testing. However, recent changes to global guidance on HIV testing have led to substantial debate on what policy provisions are necessary to ensure that consent remains meaningful in the context of testing. Despite disproportionate rates of testing during pregnancy, pregnant women's perspectives on the HIV testing process are underrepresented in the testing discourse. This study explores women's experiences with HIV testing and the consent process in a public antenatal clinic in South Africa. Qualitative interviews with 25 women were conducted at the clinic at either an antenatal visit or an infant immunization visit that followed HIV testing. Interviews were transcribed, translated, and coded for analysis. Women were categorized into one of the three groups based on their perceptions of choice in consenting for an HIV test. Matrices were used to allow for cross-category and cross-case comparison. Half of the women described having a clear choice in their decision to test. Others were less clear about their choice. Some women felt they had no choice in testing for HIV. None of the women stated that they were tested without having signed a consent form. We found that half of the women's narratives illustrated direct and indirect ways in which providers coerced them into taking an HIV test while receiving antenatal care. As the new guidance on HIV testing is implemented in different settings, it is critical to monitor women's testing experiences to ensure that a woman's right to make an informed, voluntary choice is not violated. Furthermore, models of testing that allow us to meet broader public health goals while simultaneously respecting women's autonomy are needed.

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HIV-1 testing in pregnancy: acceptability and correlates of return for test results

Cited by 40 publications

References 5 publications

A comparative analysis of teenagers and older pregnant women in the utilization of prevention of mother to child transmission [PMTCT] services in, Western Nigeria

A comparative analysis of teenagers and older pregnant women in the utilization of prevention of mother to child transmission [PMTCT] services in, Western Nigeria

Reducing vertical HIV transmission in Kinshasa, Democratic Republic of Congo: trends in HIV prevalence and service delivery

The complexity of consent: women's experiences testing for HIV at an antenatal clinic in Durban, South Africa

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