Knowledge and attitude toward HIV voluntary counseling and testing services among pregnant women attending an antenatal clinic in Sudan

Abstract

Human immunodeficiency virus (HIV) infection and the development of the acquired immunodeficiency syndrome (AIDS) are increasing at an alarming rate especially in the sub-Saharan region. Pregnant women susceptible to HIV and its transmission to the fetus provide a unique opportunity for implementing preventive strategy against HIV infection of newborn babies. During the period of August-December 2005 a cross-sectional study was conducted at the Fath-Elrahman Elbashir antenatal clinic, Khartoum Teaching Hospital, to investigate pregnant women's basic knowledge and attitude toward HIV and mother to child transmission as well as voluntary counseling and testing. Pre-tested structured questionnaires were given to antenatal attendants by professional counselors. Their basic socio-demographic and obstetric characteristics were obtained. Respondents' knowledge about HIV and mother to child transmission were tested. In addition, their willingness toward HIV testing was also reported. Out of the 1,005 women investigated, 79% had basic knowledge about HIV. Those who were resident in Khartoum and whose age was > or =26.1 years and their education level was secondary and above were found to be more knowledgeable about HIV. More than half of respondents were aware of mother to child transmission. Older (> or =26.1 years), educated, and working mothers were found to be more knowledgeable about mother to child transmission. Willingness to undergo the test was demonstrated in 72.8% of respondents. However, only 30.3% had the test done. Older women, primigravidae, and Muslims have higher acceptance of voluntary counseling and testing. There is a need to extend the voluntary counseling and testing program in all antenatal clinics. In addition, there is a need to increase the level of education and raise health awareness about HIV and mother to child transmission.

Women’s willingness to be tested for human immunodeficiency virus during pregnancy: A review

“…Employed pregnant women accepted VCT at higher rates than unemployed married women. Similar results were obtained in a Vietnamese study [54] and in a Sudanese study [41] . The researchers suggested that when women leave the home and are employed, they have greater access to information about VCT compared to unemployed married women who spent most of their time at home [37] .…”

“…Dube and Nkosi [43] found that half of the women in their study felt 50% of respondents expressed willingness to be tested in a Chinese study by Li et al [36] and in an Ethiopian study by Moges and Amberbir [37] ; in contrast, other studies reported higher willingness to be tested (more than 75% of respondents expressed willingness to be tested) [38][39][40] . Some African studies demonstrated significant gaps between the willingness of pregnant women to receive HIV testing and their actual testing rates, as in studies from Sudan [41] and Tanzania [42] . Similarly, a South African study showed that pregnant women had a good level of knowledge and understanding about HIV testing in pregnancy, and their perceptions of HIV testing were positive, but they were not consistent with their behavior.…”

“…Age: In a Sudanese study, women older than 26 years had higher acceptance of VCT [41] . Similarly, in a study conducted in Burkina Faso, the uptake rate of VCT increased linearly with age, being particularly low among adolescents (15-19 years) [67] .…”

“…Most reviewed studies demonstrate that women's willingness to be tested for HIV during pregnancy was influenced by their knowledge about HIV/AIDS and MTCT [36,37,39,41,58,60,[72][73][74] . Other studies found that knowledge was not related to willingness to be tested.…”

“…It has been shown that improving women's access to prenatal care improves PMTCT uptake [81] . Several studies have identified certain obstetric factors, such as bad obstetric history, or being multi gravida vs primigravida, as associated with uptake of VCT [41,63,65,67,82] . It is possible that multigravida women had more contact with prenatal care services and therefore had prior experience of HIV testing, or that they were more aware of the MTCT of HIV.…”