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???metadata.dc.contributor.*???: Solomon Shiferaw (MD, MPH)
Keywords: Sub-Saharan Africa remains most heavily affected by HIV,
Issue Date: Jun-2009
Publisher: AAU
Abstract: Abstract Back ground: - Mother-to-child transmission (MTCT) is by far the largest source of HIV infection children below the age of 15 years. Globally there were an estimated 33 million people living with HIV in 2007. An estimated 370, 000 children under age 15 became infected with HIV in 2007 globally. Almost 90% live in sub-Saharan Africa. Around 90% of all children living with HIV acquired the infection from their mothers during pregnancy, birth or breastfeeding. For women to take advantage of measures to reduce transmission, they need to know their HIV status. Despite this fact many women are not willing to take voluntary HIV counseling and testing. Objective: - To assess factors that contribute to the low uptake of HCT acceptance among pregnant women attending antenatal care services in public facilities in Mekelle Town Methodology: - A health facility based cross sectional survey was conducted using structured questionnaire among 384 pregnant women following antenatal care (ANC) at selected health facilities of Tigray region, Mekelle town from February 2009-March 2009. Results: - A total of 384 pregnant women fulfilling the inclusion criteria were enrolled in the study with 100% of response rate. 353 (91.9%) knew that a mother with HIV can pass the virus to her child. 309 (80.5%) of the pregnant women had heard the existence of PMTCT in the health facilities and 75 (19.5%) didn't know the existence of the program. 252 (65.6%) believed they were at risk for getting HIV. 330(85.9%) discus freely about HIV testing with their husbands which had a significant association with accepting of HIV testing[(AOR (95%CI) = 7.1 (2.78-18.09)]. And of those participants who had been tested 253 (74.6%) were during the current pregnancy. 335(87.2%) of those who were tested received their test result. Both the bivariate and the multivariate have shown that as the number of ANC visits increase the likelihood of accepting HCT among the pregnant women increases [(AOR (95%C.I = 0.14(0.24-0.79)]. Getting pre-test counseling had a significant association with acceptance of HIV testing among the pregnant mothers [(AOR (95%C.I) = 7.01 (2.77- 17.71)]. Conclusions: - Increasing frequency of antenatal care visits had a major role in spreading information on HIV/AIDS, MTCT and appears to be a significant factor to increase of HCT acceptance. Discussing freely about HIV sero status with partner is crucial for the acceptance of HCT and successful management of the present and future pregnancies. Despite higher knowledge of HIV prevention still there are misconceptions influencing HCT/PMTCT uptake like as trust on God, self confidence, husbands faithfulness, fear of stigma and discrimination, they do not want to know their status , could not tolerate the positive result and because of uncertainty about the partners response on HIV testing result. Such factors affected acceptance of HCT among pregnant mothers. Recommendations: - The health facilities should strengthen ANC services utilization and decrease missed opportunities for counseling and testing. To increase acceptance rate of HCT the government, Regional health bureau, zonal health office and the facilities should prepare more sources of information to be accessed by all the families and community members to educate on HIV/ AIDS, MTCT and PMTCT issues. Religious leaders, community leaders and other member of the society should play their role through awareness creation and sensitization activities to reduce the misconceptions of HIV infection among pregnant mothers.
Description: A Thesis submitted to the School of Graduate Studies of Addis Ababa University in Partial Fulfillment of the Requirements for the Degree of Master in Public Health in school of public health.
Appears in Collections:Thesis - Public Health

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