Assessment of Factors Associated with Women’s Informed Choice for HIV Testing under Opt-out Approach among Antenatal Attendees in Ghimbi Town, Western Ethiopia.
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Date
2013-06
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Addis Ababa University
Abstract
Introduction: Under routine antenatal HIV testing and counseling or an “opt-out” approach all antenatal attendees are tested for HIV apart from those who actively decline the test.There are concerns that refusal of the test could be difficult for some women given the substantial social status that health providers hold in many societies.
However, little is known about pregnant women‟s ability and associated factors to make informed choice for HIV testing under routine antenatal HIV testing in Ethiopia and particularly the selected study area.
Objective: To assess women‟s ability to make informed choice about HIV testing and associated factors under opt-out approach among pregnant women attending antenatal care at government health institutions in Ghimbi town.
Methodology: Health institution based cross-sectional study was conducted among 252 pregnant women attending antenatal care and known to be tested for HIV at government health facilities in Ghimbi Town from March 15 to May 9, 2013.
Pregnant women were interviewed after giving blood for HIV testing but before accepting test result using pretested structured interviewer administered questionnaire.
Descriptive statistics and multiple logistic regressions were carried out using SPSS version 17. Qualitative method was used to explore women‟s experience on HIV testing and counseling with focus on consent for HIV testing to clarify the results of quantitative analysis.
Results: Only 59.9% of the women described acceptance of HIV testing as their own personal decision and 53.2% felt that they could not able to decline HIV testing. When adjusted for other factors; being asked consent (OR = 12.184, 95% CI: 6.123, 24.243), knowing that antenatal HIV testing is offered for the purpose of PMTCT (OR=3.461, 95% CI: 1.523, 7.864), urban residence (OR=2.442, 95% CI: 1.251, 4.766), and knowing that antenatal HIV testing is optional (OR=2.899, 95% CI: 1.222, 6.876) were associated with the perceived ability do decline HIV testing/make informed choice to decline HIV testing.
Conclusion and recommendation: Women are tested in the expense of their right to make informed choice for HIV testing that contradicts with the basic principles of HIV testing.Providing the minimum components of pretest counseling is important to protect the autonomy of women and to ensure fully informed consent for HIV testing and women should be given a chance to decide about the test.
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Keywords
Consent, Pretest Information/Counseling, Routine Antenatal HIV testing, Informed Choice, PMTCT