Utilization of PMTCT services and associated factors among pregnant women attending antenatal clinics in Addis Ababa, Ethiopia

Abstract

BackgroundMother-to-child transmission (MTCT) of human immunodeficiency virus (HIV) remains the major source of HIV infection in young children. Targeting pregnant women attending antenatal clinics provide a unique opportunity for implementing prevention of mother-to-child transmission (PMTCT) programmes against HIV infection of newborn babies. This study aimed to investigate factors associated with the acceptability and utilization of PMTCT of HIV.MethodsAn institution based cross-sectional study was conducted in April 2010 using exit interviews with 843 pregnant women attending antenatal care (ANC) clinics of 10 health centers and two hospitals in Addis Ababa, Ethiopia. Trained nurses administered structured questionnaires to collect data on socio-demographic characteristics, knowledge about MTCT, practice of HIV testing and satisfaction with the antenatal care services. Six focus group discussions among pregnant women and 22 in-depth interviews with service providers complemented the quantitative data.ResultsAbout 94% of the pregnant women visited the health facility for ANC check-up. Only 18% and 9% of respondents attended the facility for HIV counselling and testing (HCT) and receiving antiretroviral prophylaxis, respectively. About 90% knew that a mother with HIV can pass the virus to her child, and MTCT through breast milk was commonly cited by most women (72.4%) than transmission during pregnancy (49.7%) or delivery (49.5%). About 94% of them reported that they were tested for HIV in the current pregnancy and 60% replied that their partners were also tested for HIV. About 80% of the respondents reported adequacy of privacy and confidentiality during counseling (90.8% at hospitals and 78.6% at health centers), but 16% wished to have a different counselor. Absence of counselors, poor counselling, lack of awareness and knowledge about HCT, lack of interest and psychological unpreparedness were the main reasons cited for not undergoing HIV testing during the current pregnancy.ConclusionsHIV testing among ANC attendees and knowledge about MTCT of HIV was quite high. Efforts should be made to improve the quality and coverage of HCT services and mitigate the barriers preventing mothers from seeking HIV testing. Further research should be conducted to evaluate the uptake of antiretroviral prophylaxis among HIV-positive pregnant women attending ANC clinics.Electronic supplementary materialThe online version of this article (doi:10.1186/1471-2393-14-328) contains supplementary material, which is available to authorized users.

Voluntary HIV Counseling and Testing Service Utilization among Pregnant Mothers in North West Ethiopia In 2014

“…In this study about three quarter (76.2%) pregnant mothers underwent HIV testing on current pregnancy and this finding was in in line with a study in Ghana (76%) [14], Cambodia (76%) [15] and it was lower than the studies conducted in Northwestern Ethiopia at Gondar town (82.5%) [10], in a capital city of Ethiopia, Addis Ababa town (94%) [12], in South Ethiopia at Hawassa Referral Hospital (96%) [16], Southern Ethiopia (100%) [17] and Northern Tanzania (98%) [18]. The possible reasons for increment in prior studies might be using of health institution based study [10,12,[16][17][18] since pregnant mothers having positive attitude and better awareness may visit health institution and tested for HIV and in studies [10,12,16,17] the study participants were living in town thus they can easily access the information about VHCT and health services for test. The current finding of VHCT uptake was also having slight increment when compared with a studies in Northwest Ethiopia (72.0%) [9], Kumasi in Ghana (73.0%) [19], Komfo Anokye Teaching Hospital in Ghana (73.9%) [20], hospital ANC clients in western Kenya (68%) [21], Uyam District in Nigeria (55.7%) [22], Botswana (54%) [23], and Oman (51.9%) [24].…”

“…The frequently mentioned reason for not up taking VHCT service in this study was fear of stigma and discrimination both in qualitative and quantitative (40.9%) results. This finding was supported by studies in Northwest Ethiopia [9,11] and other studies [9,12,22,16,17,[25][26][27][28]. The reason of no tested for HIV in about 63.5% pregnant mothers in North-West Ethiopia was fear of rejection by the community if result become positive [9].…”

“…In Debre Markos town about half (55.5%) of pregnant mothers attending ANC (antenatal care) were not ready to use VHCT service [11]. In Addis Ababa which is a capital city of Ethiopia, only 18% of pregnant mothers attended the facility were coming for VHCT though 90% knew that a mother with HIV can pass the virus to her child [12].…”

Healthcare provider attitudes regarding the provision of assisted reproductive services for HIV‐affected couples in Addis Ababa, Ethiopia

“…Previously, HIV‐affected couples were stigmatized for having or desiring children, but acceptance has grown because the risk of transmitting HIV to the child has been greatly reduced by engagement in prevention of mother‐to‐child transmission (PMTCT) programs. The HCPs noted that if an HIV‐affected woman is provided with information on antiretroviral therapy and PMTCT, she will be more likely to have a positive attitude toward having a healthy, HIV‐uninfected child . They also reported that HIV infection does not change reproductive desires, which are influenced by multiple factors including the number of children the woman already has, time since HIV diagnosis, current health status of the HIV‐infected individual, age, and disclosure of the HIV‐positive status to the sexual partner …”

Factors influencing prevention of mother to child HIV transmission service utilization among HIV positive women in Amhara National Regional State, Ethiopia: A thematic content analysis

“…PMTCT service utilization was influenced by different factors. Studies revealed that factors associated with the uptake of PMTCT services are knowledge and attitudes of mothers on HIV, stigma and discrimination, male partner involvement, disclosure of HIV status, quality of the service, health workers approach, access to and availability of PMTCT services, and educational status of the women [9][10][11][12].…”