Facilitators and barriers for HIV-testing in Zambia: A systematic review of multi-level factors

Qiao, Shan; Zhang, Yao; Li, Xiaoming; Menon, J. Anitha

doi:10.1371/journal.pone.0192327

Cited by 67 publications

(70 citation statements)

References 48 publications

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“…Education and awareness of women about MTCT during pregnancy were independently and positively associated with HIV testing. Our findings are consistent with previous studies conducted in Ethiopia [ 17 ], other African countries [ 33 , 34 ]. Similarly, uptake of HIV testing during pregnancy was higher among wealthiest categories although HIV testing is provided free of charge in public health facilities.…”

Section: Discussionsupporting

confidence: 94%

HIV testing during pregnancy for prevention of mother-to-child transmission of HIV in Ethiopia

Ejigu

Tadesse

2018

PLoS ONE

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IntroductionHIV testing during pregnancy provides an entry point to prevention of mother-to-child transmission of HIV and to access treatment for HIV positive women. The study aimed to assess the uptake of HIV testing during pregnancy and associated factors among Ethiopian women.MethodsWe analyzed the 2016 Ethiopian Demographic and Health Survey dataset. Women who gave birth within one year prior to the survey were included in the analysis. Uptake of HIV testing during pregnancy is defined as receiving HIV testing service during pregnancy and/or at the time of delivery and knew the test results. Adjusted odds ratios (AORs) and 95% confidence intervals (95% CIs) were calculated by using step-wise backward logistic regression analyses to identify factors associated with HIV testing during pregnancy.ResultsA total of 2114 women who were pregnant in the last one year prior to the survey were included in the analysis. Of these, only 35.1% were tested for HIV and received the test results during pregnancy. About one third of women who had antenatal care follow-up missed the opportunity to be tested for HIV. Compared to women who had no formal education, those who had primary level education (AOR = 1.55; 95% CI: 1.12–2.15), secondary level education (AOR = 2.56 95%CI: 1.36–3.82), or higher education (AOR = 3.95, 95%CI: 1.31–11.95) were more likely to be tested for HIV during pregnancy. Similarly, having awareness about mother-to-child transmission of HIV (AOR = 2.03, 95%CI: 1.48–2.78), and living in urban areas (AOR = 3.30, 95%CI: 1.39–7.85) were positively and independently associated with uptake of HIV during pregnancy. Women who have stigmatizing attitude towards HIV positive people were less likely to be tested for HIV (AOR = 0.57, 95%CI: 0.40–0.79).ConclusionUptake of HIV testing during pregnancy is low. Missed opportunity among women who had antenatal care visits was very high. Integrating HIV testing with antenatal care services, improving HIV testing service quality and access are essential to increase uptake of HIV testing during pregnancy and reach the goal of eliminating MTCT.

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Section: Discussionsupporting

confidence: 94%

HIV testing during pregnancy for prevention of mother-to-child transmission of HIV in Ethiopia

Ejigu

Tadesse

2018

PLoS ONE

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“…Women living with HIV are even more likely to experience violence [20]. A systematic review revealed that higher education is a common facilitator of HIV testing and, patient's decision-making towards HIV screening can be influenced by marital dynamics, partner relationship and relationship with the health care services [18]. Those findings though not investigated in our study, probably also apply in our study population.…”

Section: Discussionmentioning

confidence: 67%

“…Evaluation of obstetrical characteristics and exposed child outcome. 18], sometimes leading to cases of refusal to provide care to people with HIV reported in the western world [19]. Women living with HIV are even more likely to experience violence [20].…”

Section: Discussionmentioning

confidence: 99%

Mother to Child Transmission of HIV after Option B+ in Low Income Environment

Valère¹,

Kamgaing²,

Mefo³

et al. 2018

OJOG

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Background: In Cameroon, the prevalence of HIV in pregnant women was 7.8% in 2012, and they were 8500 HIV positive newborns in 2013. Option B+ is the first highly active antiretroviral therapy (HAART) preventive protocol. The objective was to evaluate the rate of HIV transmission on children born from mothers who were on Option B+ during pregnancy, in three university teaching hospitals of the University of Yaoundé I. Methods: It was a retrospective, cross-sectional study over a period of four years (2013-2017). We included HIV positive mothers not on previous antiretroviral treatment and who received a single tablet daily of combined tenofovir (300 mg) + Lamivudine (300 mg) + Efavirenz (600 mg) started at any time during pregnancy. Newborn received nevirapine syrup according to WHO option B+ protocol. Results: 179 women were included. The average age was 33.5 ± 2.92 years, all ages were represented. Blood donation was the most frequent HIV positive screening opportunity, voluntary testing rate was 29% (29/179), and adherence rate was 98.9%. Few male partners were involved (58/179). Premature deliveries and low birth weight were rare (5/179; 10/179)), the indication of mode of delivery was strictly obstetrical, newborn feeding choice didn't affect the transmission outcome, and the mother to child transmission rate was 2.2% (4/179). Conclusion: Option B+ could achieve the lowest mother to child transmission ever in Cameroon and should be generalized in high endemicity low resources settings.

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“…Studies in Botswana and Zimbabwe suggested that risky sexual behavior among married and cohabiting women occurs because of the belief that they are protected against STIs. Mixed results have been reported on association between marital status and HIV testing [13]. As expected, condom use was associated with such risk perception.…”

Section: Discussionmentioning

confidence: 79%

Perceptions of Risk of Contracting HIV among Married Men and Women in Zambia

Kusanthan

Mwaba

Menon

2020

IJTDH

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This study explored the perceived risk of contracting HIV among the currently married men and women in Zambia. The analysis was carried out on data from the latest Zambia Demographic Health Survey (2014). Results indicated that 48% of the currently married women, and 61% of the currently married men reported low perceived risk for contracting HIV. The results also indicate that age, place of residence, wealth status, having had sex with three or more partners for the last 12 months, drinking alcohol and condom use were associated with high risk perception of contracting HIV for men. Women who had three or more sexual partners during the last 12 months were 1.5 times more likely to perceive high risk for contracting HIV than those who had less than three partners. Among the males, those who had sex with three or more sexual partners were 1.7 times more likely to perceive being at high risk for contracting HIV than those who had sex with less than three partners. Respondents from the higher socio-economic group were 1.3 times more likely to report low risk of contracting HIV as compared to those from middle and lower socio-economic group. These findings suggest that behaviour change campaigns encouraging married men and women to accurately assess their personal risk of contracting HIV should be complemented with targeted awareness messages emphasizing the positive attributes of using condom.

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Facilitators and barriers for HIV-testing in Zambia: A systematic review of multi-level factors

Cited by 67 publications

References 48 publications

HIV testing during pregnancy for prevention of mother-to-child transmission of HIV in Ethiopia

HIV testing during pregnancy for prevention of mother-to-child transmission of HIV in Ethiopia

Mother to Child Transmission of HIV after Option B+ in Low Income Environment

Perceptions of Risk of Contracting HIV among Married Men and Women in Zambia

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