Research Report: Antenatal HIV testing from the perspective of pregnant women and health clinic staff in South Africa—implications for pre- and post-test counselling

Sherr, Lorraine; Hackman, Natalie; Mfenyana, Kaya; Chandia, Jimmy; Yogeswaran, Parimalarani

doi:10.1080/0951507032000156880

Cited by 9 publications

(7 citation statements)

References 2 publications

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“…Therefore, testing and knowing one’s HIV status was no longer associated with death, but as a path to start treatment and prolong one’s life. For pregnant women, and despite the reported existence of gender inequality in health seeking decision making, testing was often undertaken as maternal obligation to protect the unborn child from HIV infection [29,34,40-42,44,47,52,54,58]. …”

Section: Resultsmentioning

confidence: 99%

“…The implementation of ‘opt-out’ provider-initiated HIV testing - HIV testing and counselling which is recommended by health care providers to persons seeking health care services as a standard component of medical care - has contributed to increased uptake of HIV testing. For instance, service users reported being tested at antenatal care [41,54,57,58,62], or as TB patients [30,45,68] as an integral part of health care. This strategy was sometimes regarded as non-voluntary.…”

Section: Resultsmentioning

confidence: 99%

“…Even with availability of life-prolonging treatment, in many settings of SSA, a positive-HIV test result was still associated with death [29,33,34,38,40,42,43,47],[48,54,55,60,65,69] and mental distress was anticipated [32,34,36,61,69] with an HIV positive test causing an individual to ‘begin to think too much.’ This was perceived as hastening physical deterioration of health:…”

Section: Resultsmentioning

confidence: 99%

“…The reported absence of, or limited access to, treatment in some settings was a disincentive to test [32,40,48,54,55,65,66,68]. Similarly, given the prevalence of HIV-TB co-infection, TB patients in Cameroon and South Africa avoided HIV testing to avoid the burden of being on dual strong treatment regimens for two diseases [30,68].…”

Section: Resultsmentioning

confidence: 99%

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A systematic review of qualitative findings on factors enabling and deterring uptake of HIV testing in Sub-Saharan Africa

et al. 2013

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BackgroundDespite Sub-Saharan Africa (SSA) being the epicenter of the HIV epidemic, uptake of HIV testing is not optimal. While qualitative studies have been undertaken to investigate factors influencing uptake of HIV testing, systematic reviews to provide a more comprehensive understanding are lacking.MethodsUsing Noblit and Hare’s meta-ethnography method, we synthesised published qualitative research to understand factors enabling and deterring uptake of HIV testing in SSA. We identified 5,686 citations out of which 56 were selected for full text review and synthesised 42 papers from 13 countries using Malpass’ notion of first-, second-, and third-order constructs.ResultsThe predominant factors enabling uptake of HIV testing are deterioration of physical health and/or death of sexual partner or child. The roll-out of various HIV testing initiatives such as ‘opt-out’ provider-initiated HIV testing and mobile HIV testing has improved uptake of HIV testing by being conveniently available and attenuating fear of HIV-related stigma and financial costs. Other enabling factors are availability of treatment and social network influence and support. Major barriers to uptake of HIV testing comprise perceived low risk of HIV infection, perceived health workers’ inability to maintain confidentiality and fear of HIV-related stigma. While the increasingly wider availability of life-saving treatment in SSA is an incentive to test, the perceived psychological burden of living with HIV inhibits uptake of HIV testing. Other barriers are direct and indirect financial costs of accessing HIV testing, and gender inequality which undermines women’s decision making autonomy about HIV testing. Despite differences across SSA, the findings suggest comparable factors influencing HIV testing.ConclusionsImproving uptake of HIV testing requires addressing perception of low risk of HIV infection and perceived inability to live with HIV. There is also a need to continue addressing HIV-related stigma, which is intricately linked to individual economic support. Building confidence in the health system through improving delivery of health care and scaling up HIV testing strategies that attenuate social and economic costs of seeking HIV testing could also contribute towards increasing uptake of HIV testing in SSA.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

A systematic review of qualitative findings on factors enabling and deterring uptake of HIV testing in Sub-Saharan Africa

et al. 2013

View full text Add to dashboard Cite

show abstract

“…The findings of three of these studies were found to be transferable to the local context (De Paoli et al. 2002, Sherr et al. 2003 and Toivo 2005), but the fourth was conducted in a setting that displays very low HIV prevalence and completely different social and cultural issues (Boyd et al.…”

Section: Methodsmentioning

confidence: 99%