Factors related to HIV counseling of TB personnel working at government hospitals in Thailand

Abstract

Background: HIV/AIDS contributes to a disproportionate burden of maternal deaths in Sub-Saharan Africa. In generalized HIV epidemic settings especially where strong programmes are in place to reduce infant transmission of HIV, antenatal clinics (ANC) provide a good opportunity to link mothers who are HIV infected to HIV care and treatment services. This study assessed the care provided to HIV infected pregnant women attending public sector primary health care (PHC) clinics.Methods: As part of an annual anonymous survey undertaken from October to December 2009 at the 7 PHC clinics in the Vulindlela sub-district, all clinic records were reviewed for coverage of HIV counselling and testing (HCT), compliance with the South African government's requirement for CD4 cell counts and ART provision on all newly diagnosed HIV positive mothers.Results: A total of 410 records were reviewed. Of these 384 (93.6%) received information on HCT services in place at the clinic and 374 (97.4%) agreed to have an HIV test. Of the 10 women declining, 6 (1.6%) had known their HIV test result and 4 were on ART. The prevalence of HIV infection was 37.7% (141/374). Only 88/141 (62.4%) of HIV infected mothers had a CD4 cell count result available, 67% of whom had CD4 cell counts <350 cells/mm3 and by current South African guidelines eligible for ART initiation. However, only 4/88 had been initiated on ART.Conclusion: Missing CD4 cell count results and delays in ART initiation in eligible HIV infected pregnant women represent a huge missed opportunity to impact on maternal morbidity and mortality patterns in these settings.