Predictors of hiv counseling and testing among pregnant Women attending antenatal care service at butagira and Atat hospital in gurage zone, southern ethiopia

Abstract

Background: Due to under utilization of client-initiated HIV testing, the revised world health organization policy statement on HIV testing recommended provider-initiated HIV testing. The national prevention of mother to child transmission guideline in Ethiopia recommends HIV counseling and testing as a routine care for pregnant women. However, the acceptability of this approach and determinants has not been well studied using strong study designs and few available studies are cross-sectional. Objective: The objective of this study was to assess predictors of acceptance of HIV testing among pregnant women attending antenatal care service at Butagira and Atat Hospitals, Gurage Zone, South Ethiopia. Method: A case-control study was conducted among 327 pregnant women in Butagira and Atat Hospitals from February18-March 25, 2011. The sample size was allocated to each Hospital based on the number of pregnant women visiting the hospitals. Subjects were identified based on the information obtained from the client card and the client’s information about whether they were tested or not. Two controls were selected, consecutively immediately after one case was identified and interviewed. Data were collected by face to face interview method using a structured and pre tested questionnaire. Data were edited, coded, entered, cleaned and analyzed using SPSS version16. Multiple logistic regressions were fitted to identify independent predictors HIV testing acceptance. Result and Conclusion: knowledge on HIV transmission, almost equal proportions, 95.9% of the acceptors and 96.3% of non-acceptors mentioned sexual contact, 88% of acceptors and 87% of non-acceptors mentioned that contaminated blood and blood product and 94.5% of acceptors and 90.8% of non-acceptors contaminated sharps as a main route of HIV transmission respectively. However, Mother to child transmission (MTCT) was mentioned by relatively lower proportion of acceptors and non-acceptors of HIV testing (49.5% and 38.5% respectively). In this study women also asked about the time when MTCT could occur, most acceptors and non-acceptors of HIV testing mentioned transmission of the virus during pregnancy, delivery and breast-feeding. Regarding to intervention to reduce MTCT, about 89% of acceptors and 92% of non-acceptors mentioned use of antiretroviral drug and 88.5% of acceptors and 86% of nonacceptors mentioned avoidance of breast-feeding as a means of reducing MTCT. In this study also Living with husband at same place, MTCT as a route of HIV transmission, number of antenatal care visits of greater than two, perceived risk of acquiring HIV, know existence of intervention that reduce MTCT were found to have positive effect on the acceptance of HIV testing. Recommendation. Agencies should give intensive and continued education, to both pregnant mother and their partners, about prenatal HIV transmission, the role of HIV counseling and testing on the prevention of mother-to-child transmission of the virus, and about the existence of intervention that reduce the possibility of prenatal transmission of the virus, with special emphasis to those couples who live apart.