Perceived risks and benefits of HIV testing, and predictors of acceptance of HIV counselling and testing among pregnant women in Zimbabwe

Abstract

This project evaluated perceived risks and benefits and determined predictors of acceptance of voluntary HIV counselling and testing (VCT) among pregnant women in Zimbabwe. One hundred and seventy pregnant women attending an urban antenatal clinic were surveyed. Implications of a negative or positive HIV test result and of telling a partner or community members that one is HIV positive were queried. Forty women (23.5%) consented to VCT, and 16 (40%) were HIV positive. Women who saw VCT as lower risk (odds ratio [OR] = 2.3, 95% confidence interval [CI] [1.1-5.0]) and women who had had a stillbirth or child die (OR = 0.4, 95% CI [0.16-0.97]) were more likely to consent. Prenatal HIV VCT offers the best opportunity for prevention of mother-to-child transmission of HIV; however, less than 25% of women consented. If such interventions are to be successful, attention must be directed towards developing culturally appropriate strategies to address women's concerns and improve future acceptance of VCT in Zimbabwe.

A Multilevel Analysis of the Determinants of HIV Testing in Zimbabwe: Evidence from the Demographic and Health Surveys

“…Several studies have found that people are more likely to be tested if they have risky sexual behaviours, such as having multiple sex partners and inconsistent condom use. 20,48,50 In regards to HIV knowledge and awareness, the highest estimates for HIV testing coverage are observed among individuals with medium to higher HIV/AIDS awareness, echoing the results found in the previous studies. 7,13 At community level, community poverty, HIV-related stigma and media exposure were found to be associated with HIV testing.…”

“…Socio-economic challenges may also decrease the likelihood of HIV testing, due to lack of financial resources that would enable individuals to have access to health care services. [18][19][20][21] The effect of HIV/AIDS factors (e.g., stigma and discrimination, risk perception of HIV infection, risky behaviour, HIV awareness, or knowing someone who died of HIV/AIDS) on HIV testing may depend on an individual's predisposing factors such as age, education, marital status, social and economic status. 5,22 These interactions may lead to an increased risk perception of HIV infection which may in turn decrease the willingness to utilise health care services that are linked to HIV.…”

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

“…An important role in the willingness of women to be tested for HIV during pregnancy has been attributed to the male partner, who can be either a barrier or a source of support [31,37,40,42,55,[63][64][65] . Women feel that their spouses' support and approval for HIV testing is a necessary condition for them to agree to receive an HIV test during pregnancy [37,63,[66][67][68] .…”

“…They suggested that knowledge of MTCT and knowing someone who was HIV-positive might increase women's awareness of the possibility of MTCT and the advantages of receiving HIV testing. Indeed, many studies found that high perceived susceptibility to HIV was associated with willingness to receive HIV testing during pregnancy [36,37,42,65,[76][77][78] . Research from multiple countries has shown that many pregnant women did not believe that they were at risk for contracting HIV because they are in monogamous relationships and trust their male partner [37,40,42,79] .…”

“…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.…”