Coverage and determinants of HIV testing and counseling services among mothers attending antenatal care in sub-Saharan African countries: a multilevel analysis.
ANC
Counseling
Coverage
Determinants
HIV
HTC
Sub-sahara Africa
Testing
Women
Journal
BMC public health
ISSN: 1471-2458
Titre abrégé: BMC Public Health
Pays: England
ID NLM: 100968562
Informations de publication
Date de publication:
27 Mar 2024
27 Mar 2024
Historique:
received:
23
08
2023
accepted:
17
03
2024
medline:
28
3
2024
pubmed:
28
3
2024
entrez:
28
3
2024
Statut:
epublish
Résumé
HIV/AIDS is one of the top global public health threats that causes significant cases, deaths, and socioeconomic impact. Even though both HIV testing and counseling are identified as essential HIV interventions during pregnancy, large population-representative data shows that service coverage and determinants are limited. Therefore, this study aimed to assess the coverage and determinants of HIV testing and counseling services among pregnant mothers attending antenatal care services in sub-Saharan African countries using different nationwide data. This study was conducted on large national-representative data from the Demographic Health Survey (DHS) using multilevel analysis. Data extraction, cleaning, coding, and statistical analysis were performed using STATA version 17. Weighting was used to ensure the representativeness of the sample and to obtain reliable estimates and standard errors. The multivariable multilevel logistic regression model was used to identify the determinants of HIV testing and counseling during the antenatal care visit. Adjusted odds ratios with 95% confidence intervals were used to measure statistical significance. A total of 83,584 women attending antenatal care were included in this study. HIV testing and counseling coverage in sub-Saharan Africa was found to be 62.87% with a 95% CI of 62.54-63.19%. The HIV testing and counseling determinants included being in the age group of 35-49 (AOR = 1.64; 95% CI: 1.46-1.83), secondary and above education levels (AOR = 1.50; 95% CI: 1.39-1.60), having at least four ANC visits (AOR = 1.85; 95% CI: 1.68-2.02), living in an urban area (AOR = 1.40; 95% CI: 1.30-1.52), and living in countries such as Rwanda (AOR = 6.19; 95% CI: 5.19-7.38) and Mauritania (AOR = 0.02; 95% CI: 0.01-0.03). This study revealed that HIV testing and counseling coverage was 62.87% in sub-Saharan Africa. Factors affecting the HIV testing and counseling coverage were age, education, frequency of antenatal care visits, residence area, and living in Rwanda and Mauritania. Therefore, to increase HIV testing and counseling coverage in sub-Saharan Africa, policymakers on maternal health and other stakeholders should work with an integrated approach with other sectors and give prior attention to modifiable factors such as promoting women's education and the comprehensiveness of antenatal care follow-up services during the follow-up.
Sections du résumé
BACKGROUND
BACKGROUND
HIV/AIDS is one of the top global public health threats that causes significant cases, deaths, and socioeconomic impact. Even though both HIV testing and counseling are identified as essential HIV interventions during pregnancy, large population-representative data shows that service coverage and determinants are limited. Therefore, this study aimed to assess the coverage and determinants of HIV testing and counseling services among pregnant mothers attending antenatal care services in sub-Saharan African countries using different nationwide data.
METHODS
METHODS
This study was conducted on large national-representative data from the Demographic Health Survey (DHS) using multilevel analysis. Data extraction, cleaning, coding, and statistical analysis were performed using STATA version 17. Weighting was used to ensure the representativeness of the sample and to obtain reliable estimates and standard errors. The multivariable multilevel logistic regression model was used to identify the determinants of HIV testing and counseling during the antenatal care visit. Adjusted odds ratios with 95% confidence intervals were used to measure statistical significance.
RESULTS
RESULTS
A total of 83,584 women attending antenatal care were included in this study. HIV testing and counseling coverage in sub-Saharan Africa was found to be 62.87% with a 95% CI of 62.54-63.19%. The HIV testing and counseling determinants included being in the age group of 35-49 (AOR = 1.64; 95% CI: 1.46-1.83), secondary and above education levels (AOR = 1.50; 95% CI: 1.39-1.60), having at least four ANC visits (AOR = 1.85; 95% CI: 1.68-2.02), living in an urban area (AOR = 1.40; 95% CI: 1.30-1.52), and living in countries such as Rwanda (AOR = 6.19; 95% CI: 5.19-7.38) and Mauritania (AOR = 0.02; 95% CI: 0.01-0.03).
CONCLUSION
CONCLUSIONS
This study revealed that HIV testing and counseling coverage was 62.87% in sub-Saharan Africa. Factors affecting the HIV testing and counseling coverage were age, education, frequency of antenatal care visits, residence area, and living in Rwanda and Mauritania. Therefore, to increase HIV testing and counseling coverage in sub-Saharan Africa, policymakers on maternal health and other stakeholders should work with an integrated approach with other sectors and give prior attention to modifiable factors such as promoting women's education and the comprehensiveness of antenatal care follow-up services during the follow-up.
Identifiants
pubmed: 38539158
doi: 10.1186/s12889-024-18373-5
pii: 10.1186/s12889-024-18373-5
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
910Informations de copyright
© 2024. The Author(s).
Références
Vitoria M, et al. The global fight against HIV/AIDS, Tuberculosis, and malariacurrent status and future perspectives. Am J Clin Pathol. 2009;131(6):844–8.
doi: 10.1309/AJCP5XHDB1PNAEYT
pubmed: 19461091
Kecojevic A et al. Public Health and Clinical Impact of Increasing Emergency Department–Based HIV Testing: Perspectives From the 2007 Conference of the National Emergency Department HIV Testing Consortium Annals of Emergency Medicine, 2011. 58(1, Supplement): p. S151-S159.e1.
Cohen MS, et al. The spread, treatment, and prevention of HIV-1: evolution of a global pandemic. J Clin Investig. 2008;118(4):1244–54.
doi: 10.1172/JCI34706
pubmed: 18382737
pmcid: 2276790
Kharsany ABM, Karim QA. HIV infection and AIDS in sub-saharan Africa: current status, challenges and opportunities. open AIDS J. 2016;10:34–48.
doi: 10.2174/1874613601610010034
pubmed: 27347270
pmcid: 4893541
Obermeyer CM, Osborn M. The utilization of testing and counseling for HIV: a review of the social and behavioral evidence. Am J Public Health. 2007;97(10):1762–74.
doi: 10.2105/AJPH.2006.096263
pubmed: 17761565
pmcid: 1994175
Organization WH. Rapid HIV tests: guidelines for use in HIV testing and counselling services in resource-constrained settings 2004.
Kwapong GD, et al. Health service barriers to HIV testing and counseling among pregnant women attending Antenatal Clinic; a cross-sectional study. BMC Health Serv Res. 2014;14(1):267.
doi: 10.1186/1472-6963-14-267
pubmed: 24942820
pmcid: 4067520
Mitiku I, Addissie A, Molla M. Perceptions and experiences of pregnant women about routine HIV testing and counselling in Ghimbi town, Ethiopia: a qualitative study. BMC Res Notes. 2017;10(1):101.
doi: 10.1186/s13104-017-2423-1
pubmed: 28209187
pmcid: 5314483
Sasaki Y, et al. Prevalence and barriers to HIV testing among mothers at a tertiary care hospital in Phnom Penh, Cambodia. Barriers to HIV testing in Phnom Penh, Cambodia. BMC Public Health. 2010;10(1):494.
doi: 10.1186/1471-2458-10-494
pubmed: 20716380
pmcid: 2930599
Homsy J, et al. Routine Intrapartum HIV Counseling and Testing for Prevention of Mother-to-child transmission of HIV in a rural Ugandan Hospital. JAIDS J Acquir Immune Defic Syndr. 2006;42(2):149–54.
doi: 10.1097/01.qai.0000225032.52766.c2
pubmed: 16760796
Peltzer K, Mlambo G, Phaweni K. Factors determining prenatal HIV Testing for Prevention of Mother to Child Transmission of HIV in Mpumalanga, South Africa. AIDS Behav. 2010;14(5):1115–23.
doi: 10.1007/s10461-009-9662-7
pubmed: 20049520
Ujiji OA, et al. Is ‘Opt-Out HIV Testing’ a real option among pregnant women in rural districts in Kenya? BMC Public Health. 2011;11(1):151.
doi: 10.1186/1471-2458-11-151
pubmed: 21385423
pmcid: 3061915
Demissie A, Deribew A, Abera M. Determinants of acceptance of voluntary HIV testing among antenatal clinic attendees at Dil Chora Hospital, dire Dawa, East Ethiopia. Ethiop J Health Dev, 2009. 23(2).
Croft TN, Allen MA. CK., The DHS Program - Guide to DHS Statistics (English) D.a.H. Surveys, Editor. 2018. p. 22–51.
Demographic T. P.H., Guide to DHS Statistics. 2016.
UNICEF. Reimagining a resilient HIV response for children, adolescents and pregnant women living with HIV 2020.
WHO. ELIMINATION OF MOTHER-TO-CHILD TRANSMISSION OF HIV, SYPHILIS AND HEPATITIS B VIRUS 2021.
WHO. Global progress report on HIV, viral hepatitis and sexually transmitted infections, 2021 2021.
Muyunda B, et al. Estimating levels of HIV testing coverage and use in prevention of mother to-child transmission among women of reproductive age in Zambia. Arch Public Health. 2018;76:80.
doi: 10.1186/s13690-018-0325-x
pubmed: 30619607
pmcid: 6310990
Tabana H, et al. Knowledge of HIV status prior to a community HIV counseling and testing intervention in a rural district of South Africa: results of a community based survey. BMC Infect Dis. 2012;12:73.
doi: 10.1186/1471-2334-12-73
pubmed: 22458410
pmcid: 3338079
Kwapong GD, et al. Health service barriers to HIV testing and counseling among pregnant women attending Antenatal Clinic; a cross-sectional study. BMC Health Serv Res. 2014;14:267.
doi: 10.1186/1472-6963-14-267
pubmed: 24942820
pmcid: 4067520
Gizaw R, Gebremdhin S. Acceptance of HIV Counseling and Testing among Antenatal Clinic attendees in Southern Ethiopia. Ethiop J Health Sci. 2018;28(4):413–22.
pubmed: 30607054
pmcid: 6308730
Kolawole Jospeh O. An Assessment of HIV Counselling and Testing (HCT) Service Utilization in Nigeria: A Binary Logistic Regression Approach International Journal of HIV/AIDS Prevention, Education and Behavioural Science, 2019. 5(1).
Wakgari Deressa1* AS, A.A., and, T.a.F G. E., Utilization PMTCT Serv Assoc Factors among Pregnant Women Attending Antenatal Clin Addis Ababa Ethiopia. 2014.
Atnafu Gebeyehu N, Yeshambel Wassie A, Abebe Gelaw K. Acceptance of HIV Testing and Associated factors among pregnant women attending Antenatal Care. Gunino Health Center, Southern Ethiopia 2019: an institutional based cross-sectional study. Volume 11. HIV AIDS (Auckl); 2019. pp. 333–41.
Fana A, Debela M, Giref MPHAZ, Gebreyesus PDSH, Tewodros PD, Yirtaw G, MSc2, Sisay, Bahaga T. MSc2, Tesfalem T. Tessema, MSc2, Impact of Integrated Services on HIV Testing: A Nonrandomized Trial among Kenyan Family Planning Clients 2019.
Merga H, Woldemichael K, Dube L. Utilization of Prevention of Mother-to-Child Transmission of HIV Services and Associated Factors among Antenatal Care attending mothers in Sebeta Town, Central Ethiopia. Adv Public Health. 2016;2016:1–10.
doi: 10.1155/2016/6250898
Abtew S, Awoke W, Asrat A. Acceptability of provider-initiated HIV testing as an intervention for prevention of mother to child transmission of HIV and associated factors among pregnant women attending at Public Health Facilities in Assosa town, Northwest Ethiopia. BMC Res Notes. 2015;8:661.
doi: 10.1186/s13104-015-1652-4
pubmed: 26553035
pmcid: 4638027
Chizoba AF, et al. Increasing HIV testing among pregnant women in Nigeria: evaluating the traditional birth attendant and primary health center integration (TAP-In) model. AIDS Care. 2017;29(9):1094–8.
doi: 10.1080/09540121.2017.1317325
pubmed: 28420249