Willingness to Seek HIV Testing and Counseling among Pregnant Women Attending Antenatal Clinics in Ogun State, Nigeria

Abstract

HIV counseling and testing (CT) is slowly being introduced as one of several key components of the comprehensive package of HIV/AIDS prevention and care in Nigeria, particularly in the prevention of mother-to-child transmission of HIV (PMTCT). A cross-sectional survey of 804 women attending antenatal clinics (ANC) in Ogun State, Nigeria was done using questionnaires to assess their willingness to seek and undergo CT and know the determinants. Focus group discussions were also held in the general community: 84.3% of respondents believed in AIDS reality, while 24.3% thought they were at risk of HIV infection. Only 27% knew about MTCT, while 69.7% of 723 who had heard of HIV/AIDS did not know about CT. Only 71 (8.8%) had thought about CT and 33 (4.5%) mentioned HIV testing as one of antenatal tests. After health education on CT, 89% of the women expressed willingness to be tested. Their willingness for CT was positively associated with education (p < 0.05), ranging from 77% (no education) to 93% (post-secondary). More of those with self-perceived risk expressed willingness to test for HIV (p < 0.05). Those willing to be tested had a higher knowledge score on how HIV spreads than those not willing. Multiple regressions identified four key factors that were associated with willingness for CT: increasing educational level; not fearing a blood test; perception that the clinic offered privacy; and perceptions of higher levels of social support from relatives and peers. Those unwilling or undecided about CT expressed strong fear of social stigma/rejection if tested positive. The results provided insights for planning promotional programs and showed that not only are IEC efforts needed to boost knowledge about HIV/AIDS, but that change in clinic setting and community are imperative in creating supportive environment to encourage uptake of CT services.

Willingness to undergo HIV testing among factory workers in Surabaya, Indonesia

“…In addition, less willingness to undergo and acceptance of HIV testing may be related to the fear of stigma and discrimination. Studies in Indonesia (Ford, Wirawan, Sumantera, Sawitri, & Stahre, 2004) and China (Ma et al, 2007) have indicated that stigma and discrimination as a result of testing positive for HIV were the major reasons for a lack of willingness to undergo HIV testing. Rogers et al (2006) also reported that even individuals who were willing to undergo HIV testing were concerned about confidentiality and negative reactions from their friends and relatives in the community.…”

Understanding and Responding to HIV/AIDS Stigma and Disclosure: An International Challenge for Mental Health Nurses

“…It is well documented that the fear of being stigmatized and facing discrimination is one of the primary factors preventing many individuals from accessing HIV testing and counseling services as well as from disclosing their status when HIV infection is identified (Adeneye et al, 2006;Akani & Erhabor, 2006;Brown, Macintyre, & Trujillo, 2003;Parker & Aggleton, 2003;UNAIDS, 2003). For women, in particular, this fear may be compounded by concerns that their families, especially children, will be stigmatized or face discrimination (Moneyham et al, 1998;UNAIDS, 2004).…”

Sociodemographic predictors of acceptance of voluntary HIV testing among pregnant women in a large maternity hospital, Omdurman, Sudan

“…However, many barriers to acceptability of HIV testing still prevail (3,4). Some studies reported that low educational level (5,6), lack of knowledge about mother-to-child transmission (MTCT) (7,8), and HIV-related stigma (9) are factors that negatively affected acceptance of testing. The national average fertility rate for Sudan is 5.6 (10).…”

“…There are many factors that influence the acceptance of HIV testing among pregnant women (5,7). Such factors may include, but are not limited to, HIV-related stigma as well as various sociodemographic characteristics (12,14).…”