Prevalence and Associated Factors of HIV Testing Among Pregnant Women: A Multilevel Analysis Using the Recent Demographic and Health Survey Data from 11 East African Countries

Abstract

In developing countries, particularly in sub-Saharan Africa, the burden of mother to child transmission (MTCT) of HIV is higher. Although the Joint United Nations Programme on HIV/AIDS (UNAIDS) and other organizations are working to eliminate MTCT, a large number of pregnant women are not screened for HIV in most African countries. Methods: The demographic health survey (DHS) used two-stage stratified sampling technique to select the study participants and we appended the most recent DHS done in the 11 East African countries. A weighted sample of 53, 420 women were included. A multilevel logistic regression analysis was used due to the hierarchical structure of the DHS data. To determine whether or not there was a clustering, the Interclass Correlation Coefficient (ICC) and Median Odds Ratio (MOR) were determined. Model comparison was conducted using deviance (−2LL). Results: The prevalence of HIV testing among pregnant women was 77.56% [95% CI= 77.20%, 77.91%]. In the Multivariable multi-level analysis, variables such as respondent age, wealth index, marital status, educational level, HIV knowledge, HIV stigma indicator, risky sexual activity, women visiting health care facilities, multiple sexual partnership, early sexual initiation, and awareness about MTCT were the individual-level factors that were associated with HIV testing among pregnant women. While residence and community-level education were the community-level factors that were significantly associated with HIV testing. Conclusion: The prevalence of HIV testing and counseling among pregnant women was higher compared to the previous report. Respondent age, wealth index, marital status, educational level, HIV knowledge, HIV stigma indicator, risky sexual activity, women visiting health care facilities, multiple sexual partnership, early sexual initiation, residence, community-level education and awareness about MTCT were the significant determinant of HIV testing.

Socioeconomic inequalities in the HIV testing during antenatal care: evidence from Indian demographic health survey, 2015–16

“…Regular exposure of mass media and comprehensive knowledge of HIV/AIDS played as an important catalyst to have HIV testing during ANC among mothers. This finding was coupled with the other studies conducted in developing countries [ 19 , 46 , 47 ]. The findings of the study also revealed a large gap in the uptake of HIV testing during ANC between urban (46%) and rural areas (23%), as the HIV testing prevalence was almost twice in urban areas than the rural.…”

“…Several studies have documented that there is a significant association between sociodemographic characteristics and HIV testing during pregnancy among women [ 14 , 17 , 19 , 40 ]. We found that HIV testing during antenatal care increases with increasing level of education.…”

“…Our findings are consistent with previous studies conducted in many developing countries such as Asian and African countries [ 5 , 14 , 41 – 43 ]. It may be due to the reason that education might enhance HIV-related awareness and earnings among women, which leads to increased use of maternal health care services [ 19 , 44 ]. Furthermore, educated women may be more exposed to HIV/AIDS-related facts, have a better understanding of the benefits of HIV treatment, and be better able to make informed decisions about whether or not to get tested [ 45 ].…”

The Optimization of HIV Testing in Eastern Indonesia: Findings from the 2017 Indonesian Demographic and Health Survey

“…The low level of health-seeking behaviors in males to pursue HIV testing services in other relevant clinical settings could explain why fewer males were accessing HIV testing and treatment [ 40 ]. It has been reported that the most significant contributor to the higher percentage of female than male participants taking HIV tests at the PHCs is because women were undergoing HIV testing during pregnancy [ 41 ]. The global screening of pregnant women is essential to prevent the mother-to-child transmission (MTCT) of HIV through provider-initiated routine testing and antiretroviral therapy (ART) in antenatal clinics [ 10 , 42 , 43 ].…”

“…In line with the previous studies, the results reported that women had a higher percentage of undergoing HIV tests in the last 12 months in five out of sixteen countries [ 40 , 44 ]. However, many women have still not yet been tested for HIV/AIDS [ 41 ]. It was noted that not all accepted the screening.…”