Provider Initiated HIV Testing During Antenatal Care and Labour – Knowledge and Acceptability of Patients in a Nigeria Teaching Hospital

Abstract

Aim: This study aimed at accessing the knowledge and acceptance of women receiving Antenatal care (ANC) at the Jos University Teaching Hospital (JUTH) to the concept of Provider Initiated HIV Testing and Counselling (PITC) during antenatal care and in Labour, as a departure from e Client Initiated Counseling and Testing(CICT) or Voluntary Counseling and Testing(VCT). Issues /Background: Nigeria has a huge Prevention of Mother to Child Transmission (PMTCT) gap and strategies need to change to identify and prevent new infections. Since voluntary HIV testing in ANC settings still has a low yield, it is necessary for health workers to initiate HIV testing and expand testing to women in labour and those that delivered. The study was aimed at assessing clients’ acceptability of PITC. Methods: A structured questionnaire was administered to 170 women attending antenatal clinic in JUTH to evaluate their views about PITC. Findings were analyzed with the Epi Info Statistical Package. Results: The age range was 17-46 years, 52.9% were Christians and 47.1% were Moslems; 35.5% were housewives and 24.7% were students. One lady was single, 169 (99.4%) were married. Some 41.8% had tertiary education, 29.4% had secondary; others had primary and informal education. Pregnant women constituted 92.4% while 7.6% were post-natal. About 94.7% were aware of HCT and 87.1% had done the test. Some 93.5% affirmed benefits and 96.5% supported testing. Regarding PITC in labour, 87.9% felt it was beneficial if women had not tested before, others felt she should be left because of pains. About 74.1% indicated babies could benefit from preventive intervention if mothers tested positive in labour, 19.4% didn’t know and 6.5% said the baby could not be helped. Husbands of 98.1% had approved their testing, but three (1.9%) were disallowed. About 90% felt women that previously tested negative should be retested,5% felt that it was unnecessary and 4.1% didn’t know while 68.5% felt test should be discouraged regards causing marital disharmony. A total of 168 (98.5%) encouraged the test while 2 (1.5%) said they discourage people from taking the test. PITC should not be offered women faithful to spouse while 94.1% felt the test should be offered to people who don’t look ill while 3.6% felt it shouldn’t. Conclusion: Awareness of HIV screening in pregnancy and labour is high among our antenatal population, but not all accept HCT. There is need for continuing health education regarding PITC , male involvement and couple counseling.