Factors Affecting Acceptance of Voluntary HIV Counceling and Testing among Pregnant women Attending Antenatal care in Mekelle public Health Facilities, Mekelle,Ethiopia
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Date
2009-06
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Addis Abeba Universty
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
VIII
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.
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Factors Affecting Acceptance of Voluntary HIV Counceling