Low Proportion of Women who came knowing their HIV Status at First Antenatal Care Visit, Uganda, 2012-2016: A Descriptive Analysis of Surveillance Data

Abstract Background: HIV testing is the cornerstone for HIV care and support services, including Prevention of Mother to Child Transmission of HIV (PMTCT). Knowledge of HIV status is associated with better reproductive health choices and outcomes for the infant’s HIV status. We analyzed trends in known current HIV status among pregnant women attending the first antenatal care (ANC) visit in Uganda, 2012-2016. Methods: We conducted secondary data analysis using District Health Information Software2 data on all pregnant women who came for ANC visit during 2012-2016. Women who brought documented HIV negative test result within the previous four weeks at the first ANC visit or an HIV positive test result and/or own HIV care card were considered as knowing their HIV status. We calculated proportions of women with known current HIV status at first ANC visit, and described linear trends both nationally and regionally. We tested statistical significance of the trend using modified Poisson regression with generalized linear models. For known HIV positive status, we only analyzed data for years 2015-2016 because this is when this data became available. Results: There was no significant difference in the number of women that attended first ANC visits over years 2012-2016. The proportion of women that came with known HIV status increased from 4.4% in 2012 to 6.9% in 2016 and this increase was statistically significant (p<0.001). Most regions had an increase in trend except the West Nile and Mid-Eastern (p<0.001). The proportion of women that came knowing their HIV positive status at first ANC visit was slightly higher than that of women that were newly tested HIV positive at first ANC visit in 2015 and 2016. Conclusion: Although the gap in women that come at first ANC visit without knowing their HIV positive status might be reducing, a large proportion of women who were infected with HIV did not know their status before the first ANC visit indicating a major public health gap. We recommend advocacy for early ANC attendance and hence timely HIV testing and innovations to promptly identify HIV positive women of reproductive age so that timely PMTCT interventions can be made.

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Low Proportion of Women who came knowing their HIV Status at First Antenatal Care Visit, Uganda, 2012-2016: A Descriptive Analysis of Surveillance Data

10.21203/rs.2.12401/v1 ◽

2019 ◽

Author(s):

Miriam Nakanwagi ◽

Lilian Bulage ◽

Benon Kwesiga ◽

Alex Riolexus Ario ◽

Doreen Agasha Birungi ◽

...

Keyword(s):

Antenatal Care ◽

Pregnant Women ◽

Hiv Testing ◽

Hiv Care ◽

Hiv Positive ◽

Hiv Status ◽

Antenatal Care Visit ◽

Care Visit ◽

Hiv Test ◽

Significant Difference

Abstract Background HIV testing is the cornerstone for all HIV care and support services, including Prevention of Mother to Child Transmission of HIV (PMTCT). The earlier women of reproductive age know their HIV status, the better informed their reproductive decisions and their infants’ outcomes may be. We analyzed trends in known current HIV status among pregnant women attending their first antenatal care visit (ANC1) in Uganda, 2012-2016. Methods We conducted secondary data analysis using District Health Information Software2 data on all pregnant women who came for ANC1 during 2012-2016. Women who brought documentation with them to ANC1 of an HIV test within the previous four weeks or an HIV care card as evidence of being in HIV care were considered as knowing their HIV status in antenatal care clinics. We calculated proportions of women with known current HIV status at ANC1, and described the linear trends both nationally and regionally. We used improved Poisson regression with generalized linear models to test the statistical significance of the trend. Results There was no significant difference in the number of women that attended ANC1 visits over the years 2012 to 2016. The proportion of women that came with known HIV status was highest at 6.9% in 2016 and this was an increasing trend (p<0.001). Most of the regions had an increase in trend except the West Nile and Mid-Eastern (p<0.001). The proportion of women that came knowing their HIV positive status at ANC1 is slightly higher than that of women that were newly tested HIV positive at ANC1 in 2015 and 2016. Conclusion Although the gap in women that come at ANC1 without knowing their HIV positive status might be reducing, still a large proportion of women who were infected with HIV did not know their status before their ANC1 HIV test, indicating a major public health gap. Therefore, more efforts are still required to achieve full PMTCT. In light of the considerable number that comes not knowing their HIV positive status at ANC1, we recommend advocacy for early ANC attendance and hence HIV testing so that timely PMTCT interventions can be made.

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Comparison of Urine and Blood Testing for HIV among Pregnant Women in Calabar, Nigeria

Recent Advances in Biology and Medicine ◽

10.18639/rabm.2018.04.654377 ◽

2018 ◽

Vol 04 ◽

pp. 33

Author(s):

Ezukwa E. Omoronyia ◽

Mabel I. Ekott ◽

Ogban E. Omoronyia ◽

Atim Udo ◽

◽

...

Keyword(s):

Antenatal Care ◽

Pregnant Women ◽

Hiv Testing ◽

Health Care Providers ◽

Care Providers ◽

Hiv Status ◽

Childbearing Age ◽

Suitable Alternative ◽

Blood Samples ◽

Significant Difference

Testing for HIV is an essential component of the diagnosis and treatment of persons infected with the virus, and antenatal care provides a golden opportunity for detection of HIV infection in women of childbearing age. The use of blood sample to test for HIV has been the gold standard in clinical practice. However other body fluids such as urine, cervical secretion, tears, and saliva have potential as alternative media for HIV testing. This was a comparative noninferiority experimental study, comparing rapid diagnostic HIV testing using urine and blood samples. Two hundred and fifty new antenatal care clients and laboring women of unknown HIV status, were randomly recruited from antenatal care and delivery units. The seroprevalence of HIV was 6.31 and 5.86%, with use of urine and blood samples, respectively. The use of both urine and blood samples yielded a sensitivity of 100%. However, specificity was 99.05 and 99.52% for urine and blood samples, respectively. Area under receiver operating characteristic (ROC) curve was 0.995 and 0.998 for urine and blood samples, respectively. There was no significant difference in subjects’ perception toward the use of blood or urine for HIV testing (p > 0.05). More subjects however preferred the use of blood rather than urine for HIV testing. In keeping with previous studies, the use of urine or blood for HIV testing in this study yielded similar results, with comparable sensitivities and specificities. Urine samples may therefore well be considered as alternative to blood samples for HIV testing. The use of urine should be considered by health-care providers as suitable alternative to blood for HIV testing. Pregnant women should be educated on the benefits and accuracy of using urine for HIV testing, for improvement in the perception toward its usage and its acceptability and preference.

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The yield of HIV testing during pregnancy and postnatal period, Uganda, 2015–2018: analysis of surveillance data

AIDS Research and Therapy ◽

10.1186/s12981-021-00360-0 ◽

2021 ◽

Vol 18 (1) ◽

Author(s):

Yvette Wibabara ◽

Ivan Lukabwe ◽

Irene Kyamwine ◽

Benon Kwesiga ◽

Alex R. Ario ◽

...

Keyword(s):

Antenatal Care ◽

Pregnant Women ◽

Hiv Testing ◽

Postnatal Period ◽

Surveillance Data ◽

Hiv Positive ◽

Health Management Information System ◽

Mother To Child Transmission ◽

Child Transmission ◽

Mother To Child

Abstract Background Uganda has registered a reduction in new HIV infections among children in recent years. However, mother-to-child transmission of HIV still occurs, especially among pregnant women who present late. To eliminate this transmission, all HIV-positive pregnant women should be identified during antenatal HIV testing. We described women newly identified HIV-positive during pregnancy and postnatal period 2015–2018. Methods We extracted surveillance data for women identified as HIV-positive during pregnancy and the postnatal period reported through the Health Management Information System from 2015–2018. We calculated proportions newly positive at antenatal, labor, and postnatal periods nationally and at district levels. We disaggregated data into ‘tested early’ (during antenatal care) and ‘tested late’ (during labor or postnatal period) and calculated the proportion positive. We evaluated trends in these parameters at national and district levels. Results Overall, 8,485,854 mothers were tested for HIV during this period. Of these, 2.4% tested HIV-positive for the first time. While the total number of mothers tested increased from 1,327,022 in 2015 to 2,514,212 in 2018, the proportion testing HIV-positive decreased from 3.0% in 2015 to 1.7% in 2018 (43% decline over the study period, p < 0.001). Of 6,781,047 tested early, 2.2% tested HIV-positive. The proportion positive among those tested early dropped from 2.5% in 2015 to 1.7% in 2018. Of 1,704,807 tested late, 3.2% tested HIV-positive. The proportion positive among those tested late dropped from 5.2% in 2015 to 1.6% in 2018. At the district level, Kalangala District had the highest proportion testing positive at 13% (909/11,312) in 2015; this dropped to 5.2% (169/3278) in 2018. Conclusion The proportion of women newly testing HIV-positive during pregnancy and postnatal declined significantly during 2015–2018. A higher proportion of mothers who tested late vs early were HIV-positive. Failure to identify HIV early represents an increased risk of transmission. Ministry of Health should strengthen Elimination of Mother to Child Transmission (eMTCT) services to sustain this decrease through targeted interventions for poorly-performing districts. It should strengthen community-based health education on antenatal care and HIV testing and enhance the implementation of other primary prevention strategies targeting adolescents and young women.

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Fertility Intentions among HIV-positive and HIV-negative mothers in Zambia: Analysis of 2013-14 and 2018 DHS data

10.21203/rs.3.rs-58160/v1 ◽

2020 ◽

Author(s):

David Mulemena ◽

Million Phiri ◽

Namuunda Mutombo

Keyword(s):

Marital Status ◽

Multiple Logistic Regression Analysis ◽

Fertility Intentions ◽

Education Level ◽

Reproductive Age ◽

Hiv Positive ◽

Hiv Status ◽

Hiv Positive Mothers ◽

Significant Difference ◽

Hiv Negative

Abstract Background: HIV infection is a strong predictor of fertility as it might influence one’s fertility desire. With advent treatment, HIV-infected mothers are now living longer and healthier just like the HIV-negative mothers. Zambia is among the developing countries in the region with high desire for more children in spite of government efforts to reduce the fertility rate. However, little is known on the influence of HIV status on the desire for children among mothers of reproductive ages in Zambia. Methods: The analyses are based on mothers with linkable information on HIV testing and fertility preferences from the 2013-14 and 2018 Zambia and Demographic Health Survey data, with national representative samples of 16,411 and 13,683 women, respectively. HIV data was merged with each woman’s individual file, which also contained household variables to create an analytical file. Of the total sample; 11,683 mothers in 2013-14 and 9,172 mothers in 2018 were eligible for the study. Cross-tabulations with statistical tests were conducted to ascertain the crude relationship and finally multiple logistic regression analysis were employed to identify the major predictors of fertility intentions among HIV positive and HIV negative mothers using Stata software version 14.0.Results: Findings indicate that fertility intentions among women either HIV-positive or HIV-negative reduced as parity increases. Generally, in both data sets, there is a significant difference between HIV-negative mothers preferring more children compared to HIV-positive mothers. Interestingly, in the 2018 survey, HIV-positive mothers residing in urban areas were 33 percent more likely to prefer more children compared to HIV-negative mothers. Conclusion: According to this study, predictors of fertility intentions among women of reproductive age are different by HIV status. Other significant variables are age, education level, marital status, and parity, which were found to be the major predictors of fertility intentions among HIV-positive. Among the HIV-negatives, age, education level, parity, marital status, employment status, wealth quintile and region explained their fertility intentions. The fact that many HIV-infected mothers expect to have more children has important implications for the prevention of vertical and horizontal transmission of HIV. There is, therefore, the need for comprehensive and continuous expansion of family planning, voluntary counseling, and prevention of mother-to-child transmission (PMTCT) and integration of HIV treatment care among HIV-positive mothers to meet diverse reproductive intentions.

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A counseling intervention to address HIV stigma at entry into antenatal care in Tanzania (Maisha): Study protocol for a pilot randomized controlled trial

10.21203/rs.2.13793/v3 ◽

2019 ◽

Author(s):

Melissa H. Watt ◽

Elizabeth T. Knippler ◽

Linda Minja ◽

Godfrey Kisigo ◽

Brandon A. Knettel ◽

...

Keyword(s):

Antenatal Care ◽

Health Outcomes ◽

Hiv Testing ◽

Hiv Stigma ◽

Hiv Care ◽

Hiv Positive ◽

People Living With Hiv ◽

Counseling Intervention ◽

Hiv Care Engagement

Abstract Background: HIV-related stigma significantly impacts HIV care engagement, including in prevention of mother-to-child transmission of HIV (PMTCT) programs. Maisha is a stigma-based counseling intervention delivered during the first antenatal care (ANC) visit, complementing routine HIV counselling and testing. The goal of Maisha is to promote readiness to initiate and sustain treatment among those who are HIV-positive, and to reduce HIV stigmatizing attitudes among those who test negative. Methods : A pilot randomized control trial (RCT) will assess the feasibility and acceptability of delivering Maisha in a clinical setting, and the potential efficacy of the intervention on HIV care engagement outcomes (for HIV-positive participants) and HIV stigma constructs (for all participants). 1000 women and approximately 700 male partners will be recruited from two study clinics in the Moshi municipality of Tanzania. Participants will be enrolled at their first ANC visit, prior to HIV testing. It is estimated that 50 women (5%) will be identified as HIV-positive. Following consent and a baseline survey, participants will be randomly assigned to either the control (standard of care) or the Maisha intervention. The Maisha intervention includes a video and counseling session prior to HIV testing, and two additional counseling sessions if the participant tests positive for HIV or has an established HIV diagnosis. A sub-set of approximately 500 enrolled participants (all HIV-positive participants, and a random selection of HIV-negative participants who have elevated stigma attitude scores) will complete a follow-up assessment at 3 months. Measures will include health outcomes (care engagement, antiretroviral adherence, depression) and HIV stigma outcomes. Quality assurance data will be collected and the feasibility and acceptability of the intervention will be described. Statistical analysis will examine potential differences between conditions in health outcomes and stigma measures, stratified by HIV status. Discussion : Antenatal care (ANC) provides a unique and important entry point to address HIV stigma. Interventions are needed to improve retention in PMTCT care and to improve community attitudes toward people living with HIV. Results of the Maisha pilot will be used to generate parameter estimates and potential ranges of values to estimate power for a full cluster-randomized trial in PMTCT settings, with extended follow-up and enhanced adherence measurement using a biomarker.

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Prevalence of Malaria with Anaemia and HIV Status in Women of Reproductive Age in Onitsha, Nigeria

Journal of Pharmaceutical Research International ◽

10.9734/jpri/2021/v33i431166 ◽

2021 ◽

pp. 10-19

Author(s):

Vivian Chinenye Ezeoru ◽

Ifeoma Bessie Enweani ◽

Ogochukwu Ochiabuto ◽

Anthonia Chinwe Nwachukwu ◽

Ugoy Sonia Ogbonna ◽

...

Keyword(s):

Pregnant Women ◽

Statistical Significance ◽

Reproductive Age ◽

Hiv Status ◽

Control Groups ◽

Molecular Method ◽

Women Of Reproductive Age ◽

Balanced Diet ◽

Automated Method ◽

Apparently Healthy

The major health problems affecting pregnant women in sub-Saharan African are anaemia, malaria and HIV. A case-control study aimed at determining the prevalence of malaria, anaemia and HIV status among women of reproductive age between 20-49 years attending General Hospital, Onitsha was conducted. Blood samples of three hundred and sixty-two apparently healthy gravid women attending antenatal and 181 non-gravid apparently healthy women in Onitsha were recruited using random sampling method. A structured questionnaire was used for data collection. Haemoglobin was estimated using automated method, Malaria, diagnosed microscopically using gold standard staining method and HIV screened using qualitative immunochromatographic method, confirmed molecularly. Statistical analysis was done using SPSS version 21. Results revealed that out of the 362 pregnant test groups,125 (34.5%) had malaria parasite (mp) in their blood and were anaemic 53(37.6%) though fewer in control groups ;23,14 (12.7%; 16.1%) (p = 0.195; p =0.055). Out of 347 HIV sero-negative pregnant women, 110 (31.7%) tested HIV positive when confirmed by PCR molecular method while only 1(0.6%) sero-negative controls were confirmed positive with molecular method with statistical significance observed in the test and control groups (p = 0.000; p = 0.000). However, as pregnancy affects HIV serology testing, it is necessary to use molecular method to increase its sensitivity and more enlightment programmes on the importance of balanced diet, compliance to Malaria control and routine gynecological drugs intake in pregnant women.

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Acceptability and Preferences among Men and Women for Male Involvement in Antenatal Care

Journal of Pregnancy ◽

10.1155/2017/4758017 ◽

2017 ◽

Vol 2017 ◽

pp. 1-8 ◽

Cited By ~ 13

Author(s):

Nompumelelo Yende ◽

Annelies Van Rie ◽

Nora S. West ◽

Jean Bassett ◽

Sheree R. Schwartz

Keyword(s):

Antenatal Care ◽

Pregnant Women ◽

Hiv Testing ◽

Primary Healthcare ◽

Male Involvement ◽

Sub Saharan Africa ◽

Hiv Status ◽

Sub Saharan ◽

Mother To Child ◽

High Willingness

Introduction. Male involvement in antenatal care (ANC) has been associated with improved prevention of mother-to-child transmission outcomes in Sub-Saharan Africa; yet it remains uncommon. We assess acceptability of male involvement from the male and female perspectives and potential incentives for men to attend ANC. Methods. Adult pregnant women and men attending primary healthcare at Witkoppen Health and Welfare Centre in Johannesburg, South Africa, from October 2013 to January 2014, were recruited using stratified random sampling to ensure equal representation across gender and HIV status. Results. 300/332 individuals (93.8%) offered participation consented. Among the 150 women, 97% had a partner; the majority (92%) preferred partner attendance at ANC, and 14% reported partner attendance during this pregnancy. The 150 men had low knowledge of services rendered at ANC outside of pregnancy monitoring, and few (19%) had previously attended ANC. Blood pressure screening, fatherhood information, and HIV testing were identified by men as incentives for attendance. Women and men expressed high willingness to, respectively, deliver (95%) and respond (97%) to ANC letter invitations. Conclusion. Invitation letters to promote male involvement in ANC are highly acceptable to pregnant women and men. Focusing invitation messages on fatherhood and primary healthcare rather than HIV testing may provide greater motivation for male involvement.

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Improving uptake of prevention of mother-to-child HIV transmission services in Benue State, Nigeria through a faith-based congregational strategy

PLoS ONE ◽

10.1371/journal.pone.0260694 ◽

2021 ◽

Vol 16 (12) ◽

pp. e0260694

Author(s):

Michele Montandon ◽

Timothy Efuntoye ◽

Ijeoma U. Itanyi ◽

Chima A. Onoka ◽

Chukwudi Onwuchekwa ◽

...

Keyword(s):

Pregnant Women ◽

Hiv Testing ◽

Hiv Transmission ◽

Male Partner ◽

Hiv Positive ◽

Linkage Data ◽

Hiv Status ◽

Faith Based ◽

Hiv Test ◽

The Impact

Background Nigeria has low antiretroviral therapy (ART) coverage among HIV-positive pregnant women. In a previous cluster-randomized trial in Nigeria, Baby Shower events resulted in higher HIV testing coverage and linkage of pregnant women to ART; here, we assess outcomes of Baby Shower events in a non-research setting. Methods Baby Shower events, including a prayer ceremony, group education, music, gifting of a “mama pack” with safe delivery supplies, and HIV testing with ART linkage support for HIV-positive pregnant women, were conducted in eighty sites in Benue State, Nigeria. Client questionnaires (including demographics, ANC attendance, and HIV testing history), HIV test results, and reported linkage to ART were analyzed. Descriptive data on HIV testing and ART linkage data for facility-based care at ANC clinics in Benue State were also analyzed for comparison. Results Between July 2016 and October 2017, 10,056 pregnant women and 6,187 male partners participated in Baby Shower events; 61.5% of women attended with a male partner. Nearly half of female participants (n = 4515, 44.9%) were not enrolled in ANC for the current pregnancy, and 22.3% (n = 2,241) of female and 24.8% (n = 1,532) of male participants reported they had never been tested for HIV. Over 99% (n = 16,240) of participants had their HIV status ascertained, with 7.2% of females (n = 724) and 4.0% of males (n = 249) testing HIV-positive, and 2.9% of females (n = 274) and 2.3% of males (n = 138) receiving new HIV-positive diagnoses. The majority of HIV-positive pregnant women (93.0%, 673/724) were linked to ART. By comparison, at health facilities in Benue State during a similar time period, 99.7% of pregnant women had HIV status ascertained, 8.4% had a HIV-positive status, 2.1% were newly diagnosed HIV-positive, and 100% were linked to ART. Conclusion Community-based programs such as the faith-based Baby Shower intervention complement facility-based approaches and can reach individuals who would not otherwise access facility-based care. Future Baby Showers implementation should incorporate enhanced support for ART linkage and retention to maximize the impact of this intervention on vertical HIV transmission.

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Determinan Perilaku Tes Hiv pada Ibu Hamil di Kota Padang Tahun 2019

Jurnal Endurance ◽

10.22216/jen.v5i1.4564 ◽

2020 ◽

Vol 5 (1) ◽

pp. 46

Author(s):

Hamidatul Yuni ◽

Melia Andika

Keyword(s):

Public Health ◽

Health Care ◽

Pregnant Women ◽

Hiv Testing ◽

Reproductive Age ◽

Public Health Care ◽

Hiv Positive ◽

Cross Sectional ◽

Hiv Test ◽

The City

Women are a population prone to contracting and transmitting, the number of women suffering from HIV as much as 36.4%. In 2017 as many as 73 new cases of HIV positive women in the city of Padang, almost half were women of reproductive age, including 2 cases of HIV positive pregnant women. Integrated antenal service for pregnant women, one of which is by carrying out laboratory tests of HIV testing that are required for all pregnant women. Padang City has 20 HIV counseling and testing services and 18 of them are Public Health Care. The purpose of this study was to determine of HIV test behavior in pregnant women viewed from the level of knowledge, patients' perceptions of HIV, social and psychological support of patients. Research with a quantitative approach with cross sectional design, conducted in several Padang city health centers with the lowest coverage of HIV testing in pregnant women in the city of Padang. The sample of the study was 100 pregnant women who visited the Public Health Care in May 2019. The research instrument by the questionnaire method. Data analysis used univariate, bivariate and multivariate. The results showed there was social support is the most dominant variable influencing HIV testing in pregnant women. Perempuan merupakan populasi rawan tertular dan menularkan, jumlah perempuan yang menderita HIV sebanyak 36,4% . Tahun 2017 sebanyak 73 kasus baru wanita positif HIV di Kota Padang, hampir separoh merupakan wanita usia reproduksi, diantaranya 2 kasus ibu hamil positif HIV. Layanan antenal terpadu pada ibu hamil salah satunya dengan melaksanakan pemeriksaan laboratorium tes HIV yang diwajibkan bagi seluruh Ibu hamil. Kota Padang memiliki layanan konseling dan tes HIV sebanyak 20 dan 18 diantaranya adalah puskesmas. Tujuan penelitian ini Untuk mengetahui determinan perilaku tes HIV pada Ibu hamil dilihat dari tingkat pengetahuan, persepsi pasien terhadap HIV, dukungan sosial dan psikologis pasien. Penelitian dengan pendekatan kuantitatif dengan desain cross sectional, yang dilakukan di beberapa puskesmas kota Padang dengan cakupan pemeriksaan HIV terendah pada Ibu hamil di Kota Padang. Sampel penelitian adalah Ibu hamil yang berkunjung ke puskesmas pada bulan Mei 2019 sebanyak 100 orang. Instrumen penelitian dikumpulkan dengan metode angket. Analisis data menggunakan univariat, bivariat dan multivariat. Hasil penelitian menunjukkan Dukungan sosial merupakan variabel yang paling dominan mempengaruhi pemeriksaan HIV pada Ibu hamil.

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