HIV testing during pregnancy in sub-Saharan Africa

Kongnyuy, Eugene J

doi:10.1586/eog.09.19

Cited by 3 publications

(2 citation statements)

References 18 publications

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“…Numerous sub-Saharan countries have adopted HIV-specific laws and policies which have addressed, inter alia, HIV testing. For instance, twenty-six sub-Saharan countries have implemented HIV-specific laws and policies that forbid compulsory HIV testing, including for pregnant women, thereby establishing informed consent as a condition for such testing (Kongnyuy 2009 ; Eba 2015 ). This requirement also applies to laws and policies on HIV testing in Zambia ( Kingaipe and Chookole v Attorney-General 2010 ; Kasoka 2018 ).…”

Section: Our Contributionmentioning

confidence: 99%

HIV Testing Autonomy: The Importance of Relationship Factors in HIV Testing to People in Lusaka and Chongwe, Zambia

Kasoka

Weait

2022

Bioethical Inquiry

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In recent times, informed consent has been adopted worldwide as a cornerstone to ensure autonomy during HIV testing. However, there are still ongoing debates on whether the edifice on which informed consent requirements are grounded, that is, personal autonomy, is philosophically, morally, and practically sound, especially in countries where HIV is an epidemic and/or may have a different ontological perspective or lived reality. This study explores the views of participants from Zambia. In-depth and focus group discussions were conducted at various locations in Lusaka and Chongwe, Zambia. Participants came from various demographics, including people living with HIV (PLHIV), healthcare professionals and workers, policymakers, pregnant women, churchgoers, teachers, rural-based persons, and police officers. Data were manually analysed by conducting inductive and deductive thematic analyses. Results show that participants were not in favour of HIV policies that promote personal autonomy at the expense of pursuit of the common good. Participants viewed interdependence, not autonomy, as an essential characteristic of being human. The participants’ views have a realistic potential to provide a contextual and appropriate ethical, respectful, and realistic foundation for HIV testing policies.

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Section: Our Contributionmentioning

confidence: 99%

HIV Testing Autonomy: The Importance of Relationship Factors in HIV Testing to People in Lusaka and Chongwe, Zambia

Kasoka

Weait

2022

Bioethical Inquiry

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“…HIV testing services in SSA started with voluntary counselling and testing in standalone sites. With the expansion of antiretroviral therapy, provider-initiated testing and counselling emerged, and testing services were integrated into antenatal care, increasing coverage among pregnant and postpartum women [ 8 , 9 ]. The joint United Nations Programme on HIV/AIDS has released a new set of goals to increase HIV testing and reduce new infections by 95% by 2030 [ 10 ].…”

Section: Introductionmentioning

confidence: 99%

Socioeconomic inequalities in uptake of HIV testing during antenatal care: evidence from Sub-Saharan Africa

Dadzie,

Gebremedhin,

Salihu

et al. 2024

Int J Equity Health

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Background Measuring socioeconomic inequalities in healthcare usage represents a critical step towards promoting health equity, in alignment with the principles of universal health coverage and the United Nations’ Sustainable Development Goals. In this study, we assessed the socioeconomic inequalities in HIV testing during antenatal care (ANC) in sub-Saharan Africa. Methods Sub-Saharan Africa was the focus of this study. Benin, Burundi, Cameroon, Ethiopia, Gambia, Guinea, Liberia, Malawi, Mali, Mauritania, Mozambique, Rwanda, Sierra Leone, Uganda, Zambia, and Zimbabwe were the countries included in the study. This study used current Demographic and Health Surveys data spanning from 2015 to 2022. A total of 70,028 women who tested for HIV as part of antenatal contacts formed the sample for analysis. We utilized the standard concentration index and curve to understand the socioeconomic inequalities in HIV testing during antenatal care among women. Additionally, a decomposition analysis of the concentration index was ran to ascertain the contributions of each factor to the inequality. Results Overall, 73.9% of women in sub-Saharan Africa tested for HIV during ANC. The countries with the highest proportions were Malawi, Rwanda, Zambia, and Zimbabwe. Mali Benin, Guinea, Mali, and Mauritania were the countries with the lowest proportions of HIV testing. Being among the richer [AOR 1.10, 95% CI: 1.02,1.18] and richest [AOR 1.41, 95% CI:1.30, 1.54] wealth quintiles increased the odds of HIV testing during ANC. The concentration value of 0.03 and the curve show that HIV testing is more concentrated among women in the highest wealth quintile. Hence, wealthy women are advantaged in terms of HIV testing. As the model’s residual value is negative (-0.057), the model overestimates the level of inequality in the outcome variable (HIV during ANC), which means that the model’s explanatory factors can account for higher concentration than is the case. Conclusion We found that there is substantial wealth index-related inequalities in HIV testing, with women of the poorest wealth index disadvantaged in relation to the HIV testing. This emphasizes the necessity for sub-Saharan Africa public health programs to think about concentrating their limited resources on focused initiatives to grasp women from these socioeconomic circumstances. To increase women’s access to HIV testing, maternal and child health programs in sub-Saharan Africa should attempt to minimize female illiteracy and poverty. Consequently, health education may be required to provide women with comprehensive HIV knowledge and decrease the number of lost opportunities for women to get tested for HIV. Given the link between knowledge of HIV and HIV testing, it is important to focus on community education and sensitization about HIV and the need to know one’s status.

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Coverage of HIV testing among pregnant women in Nigeria: progress, challenges and opportunities

Ajayi

Awopegba²,

Owolabi

et al. 2019

Journal of Public Health

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Objective This study assessed the progress, opportunities and challenges in scaling up of HIV testing for pregnant women in Nigeria. Methods Data were retrieved from the 2016–2017 fifth multiple cluster survey. Adjusted and unadjusted logistic regression models were used to examine demographic factors associated with HIV testing while controlling for geopolitical zones. Results At the population level, the coverage of HIV testing among pregnant women increased by 10% points from 32.8 to 42.7% between 2013 and 2017. Also, the coverage of antenatal HIV testing grew by 20 points, from 50.1 to 70.5% over the period. However, women were still more likely to be tested for HIV during pregnancy if they were older than 24 years [adjusted odds ratio (AOR) 1.33, 95% CI 1.04–1.69], had higher education [AOR 6.94, 95% CI 5.07–9.49], resided in urban areas [AOR 1.26, 95% CI 1.07, 1.50] and belong to richest wealth quintile [AOR 7.43, 95% CI 5.72–9.66]. Conclusion Our findings suggest that progress has been made in scaling up of antenatal coverage of HIV testing. However, the level of HIV testing during pregnancy remains low and far below the 95% national target. Appropriate interventions are needed in resource-poor communities where antenatal care utilization is very low.

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HIV testing during pregnancy in sub-Saharan Africa

Cited by 3 publications

References 18 publications

HIV Testing Autonomy: The Importance of Relationship Factors in HIV Testing to People in Lusaka and Chongwe, Zambia

HIV Testing Autonomy: The Importance of Relationship Factors in HIV Testing to People in Lusaka and Chongwe, Zambia

Socioeconomic inequalities in uptake of HIV testing during antenatal care: evidence from Sub-Saharan Africa

Coverage of HIV testing among pregnant women in Nigeria: progress, challenges and opportunities

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