Determinants of antenatal HIV testing in the opt-out approach in Nigeria: findings from the Nigerian Demographic and Health Survey

2019 ◽  
Vol 52 (4) ◽  
pp. 473-490 ◽  
Author(s):  
Ekerette Emmanuel Udoh ◽  
Boniface Ayanbekongshie Ushie
Keyword(s):  
Antenatal Care ◽  
Hiv Testing ◽  
Health Survey ◽  
Rural Women ◽  
Multivariate Regression Analysis ◽  
Lower Probability ◽  
Antenatal Visit ◽  
Opting Out ◽  
Opt Out ◽  
Nationally Representative

AbstractChildren in Nigeria are frequently born with HIV, despite available services to prevent mother-to-child transmission (MTCT). Not offering, or non-acceptance of, HIV testing during antenatal care (ANC) delays anti-retroviral commencement for infected women, thereby increasing the risk of MTCT. This study assessed the determinants of HIV testing during antenatal care in Nigeria using nationally representative data from the 2013 Nigerian Demographic Health Survey. This study included 13,352 women aged 15–49 years who reported having at least one antenatal visit. The outcome variables were HIV testing during ANC and during labour, while socio-demographic and maternal factors, including number of ANC visits, offer of HIV testing during ANC and labour, place of delivery and knowledge and counselling on MTCT, were among the independent variables. Multivariate regression analysis was used to predict HIV testing during ANC and labour. About half (53%) of the women were tested for HIV during antenatal care with 85% of those tested receiving their test results. Only 6% had HIV tests during labour. There was a 33% excess probability of urban women testing during ANC compared with rural women. Never having a previous pregnancy terminated was associated with lower odds of testing during ANC. No counselling on MTCT and no counselling to get tested were associated with a lower probability of testing during ANC. Counselling on the prevention of MTCT is crucial for women’s willingness to be tested, and acceptance of testing. More effort is needed to ensure that providers in Nigeria offer these services to all women, educate women on the dangers of opting out and ensure the earliest commencement of ARV enrolment for those infected.

scholarly journals 964. Opt-Out HIV- Hepatitis C (HCV) Testing at a Primary Care Resident Clinic in Columbia, SC: Who Gets Tested and Who Opts Out of Testing?

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S512-S512
Author(s):  
Jodian Pinkney ◽  
Divya Ahuja ◽  
Caroline Derrick ◽  
Martin Durkin
Keyword(s):  
Primary Care ◽  
Hiv Testing ◽  
Demographic Variables ◽  
Demographic Characteristics ◽  
Categorical Variables ◽  
Newly Diagnosed ◽  
Opting Out ◽  
Opt Out ◽  
Primary Care Resident ◽  
Hcv Testing

Abstract Background South Carolina (SC) remains one of the most heavily affected states for both HIV and HCV infections. Males account for the majority of cases. Implementation of universal opt-out testing has improved screening rates but not much has been published describing the characteristics of those who opt out of testing. This becomes important as 10-50% of patients have opted out in previous studies. Methods Between February and August 2019, we conducted a quality improvement (QI) project which implemented opt- out HIV-HCV testing at a single primary care resident clinic in SC with the primary aim of increasing screening rates for HIV-HCV by 50%. Secondary aims included describing the demographic characteristics of the opt-out population. Persons were considered eligible for testing if they were between the ages of 18-65 years for HIV and 18-74 years for HCV. This was prior to the USPSTF 2020 guidelines which recommend HCV screening for adults aged 18-79 years. A retrospective chart review was used to obtain screening rates, opt status and demographic data. Logistic regression and the firth model were used to determine linkages between categorical variables. We present 3-month data. Results 1253 patients were seen between May 1, 2019- July 31, 2019 (See Table 1). 985 (78%) were eligible for HIV testing. 482 (49%) were tested for HIV as a result of our QI project and all tests were negative. 212 (22%) of eligible patients opted out of HIV testing. Males were 1.59 times more likely to opt out (p=0.008). (see Table 2,3) Regarding HCV, 1136 (90.7%) were deemed eligible for testing. 503 (44%) were tested for HCV as a result of our QI project. 12 (2.4%) were HCV antibody positive with viremia. 11 (90%) of antibody positive with viremia cases were in the 1945-1965 birth cohort (see Table 4). 244 (21%) opted out of HCV testing. Males and persons without a genitourinary chief complaint were more likely to opt out (p=0.02). Table 1: Demographic characteristics of the population seen at the internal medicine resident clinic between May- July 2019 Table 2: Relationship between demographic variables and the odds of being tested for HIV or HCV within the last 12 months. Logistic Model. Table 3: Relationship between demographic variables and the odds of opting out of testing for HIV or HCV. Firth Model. Conclusion Although implementation of routine HIV-HCV opt-out testing led to increased screening rates for both HIV and HCV, roughly 1 in 5 eligible patients chose to opt out of testing. Males were more likely to opt out despite accounting for the majority of newly diagnosed HCV cases. Future studies investigating drivers for opting-out in the male population could improve testing and assist with early diagnosis. Table 4: Characteristics of patients newly diagnosed with HCV positive with viremia. Disclosures All Authors: No reported disclosures

scholarly journals Utilization of HIV Testing and Counselling Services By Women With Disabilities During Antenatal Care in Uganda: Analysis of 2016 Demographic and Health Survey

2021 ◽  
Author(s):  
Hussaini Zandam ◽  
Ilhom Akobirshoev ◽  
Allyala Nandakumar ◽  
Monika Mitra
Keyword(s):  
Antenatal Care ◽  
Hiv Testing ◽  
Health Survey ◽  
Women With Disabilities ◽  
Counselling Services ◽  
Hiv Test ◽  
Post Test ◽  
Hiv Testing And Counselling ◽  
To Receive ◽  
Test Result

Abstract Background: HIV testing and counselling during antenatal care (ANC) is critical for eliminating mother-to-child transmission of HIV. We investigated disparity in utilization of HIV testing and counselling services (HTC) between women with and without disabilities in Uganda.Methods: We conducted a retrospective study using the nationally representative 2016 Uganda Demographic and Health Survey. The study sampled 10,073 women between age 15-49 who had a live birth in the last 5 years. We estimated unadjusted and adjusted odds ratio for receiving pre-test HIV counselling, obtaining an HIV test result, and post-test HIV counselling by disability status using logistic regressions.Results: We found that women with disabilities were less likely to receive pre-test HIV counselling (59.6 vs 52.4), obtain an HIV test result (68.2 vs 61.4), receive post-test HIV counselling (55.5 vs 51.6), and all HTC services (49.2 vs 43.5). From the regression analysis, women with disabilities were less likely to receive pre-test counselling [AOR = 0.83; CI = 0.74, 0.93] and obtain an HIV test result [AOR = 0.88; CI = 0.78, 0.99].Conclusions: Our findings revealed that women with disabilities are less likely to receive HTC service during ANC and highlighted the need for disability-inclusive HIV and reproductive health services. Government, non-governmental organizations, and other stakeholders should consider funding inclusive campaigns and identifying other mechanisms for disseminating health information and behavioral interventions to women with disabilities.

scholarly journals Opt-out HIV testing during antenatal care: experiences of pregnant women in rural Uganda

2011 ◽  
Vol 27 (1) ◽  
pp. 69-75 ◽  
Author(s):  
E. C. Larsson ◽  
A. Thorson ◽  
G. Pariyo ◽  
P. Conrad ◽  
M. Arinaitwe ◽  
...  
Keyword(s):  
Antenatal Care ◽  
Pregnant Women ◽  
Hiv Testing ◽  
Opt Out

Successful Introduction of Routine Opt-Out HIV Testing in Antenatal Care in Botswana

2007 ◽  
Vol 45 (1) ◽  
pp. 102-107 ◽  
Author(s):  
Tracy L Creek ◽  
Raphael Ntumy ◽  
Khumo Seipone ◽  
Monica Smith ◽  
Mpho Mogodi ◽  
...  
Keyword(s):  
Antenatal Care ◽  
Hiv Testing ◽  
Opt Out

scholarly journals Attendance of fourth Antenatal Care Visit in Ethiopia: Analysis from 2016 Ethiopian Demographic Health Survey

2019 ◽  
Author(s):  
Mulugeta Abrha Woldu ◽  
Brhane Gebrekidan Ayele ◽  
Haftom Weldearegay Gebrehiwot ◽  
Araya Medhanyie Abrha
Keyword(s):  
Antenatal Care ◽  
Health Care Providers ◽  
Health Survey ◽  
Wealth Index ◽  
Antenatal Visit ◽  
Birth Preparedness ◽  
Care Providers ◽  
Complication Readiness ◽  
Antenatal Care Visit ◽  
Care Visit

Abstract Background: Globally, approximately 830 women have been reported to die every day due to complications of pregnancy and childbirth. Almost all of these deaths occurred during the third trimester of pregnancy. This could have been reduced by having adequate Antenatal care visits. However, little is known about the determinants of fourth Antenatal care visit. This study is therefore conducted to identify determinants of attendance of fourth Antenatal visits in Ethiopia.Method: This study was an analysis of data collected by the 2016 Ethiopian Demographic and Health Survey which used a stratified, two-stage cluster sampling design. Bivariate and multivariable regression analysis was done to declare association between independent predictors and attendance of fourth Antenatal care visit.Result: The independent factors affecting fourth Antenatal visit were highest wealth index (Adjusted Odds Ratio(AOR) = 1.85; 95% Confidence interval (CI) (1.41, 2.44), watching television less than once in a week (AOR= 0.64; 95%CI (0.46, 0.88) , not informed about pregnancy complications during previous visit (AOR= 0.59; 95%CI (0.51, 0.70) and women who were not given or who did not buy iron tablets/syrup (AOR= 0.64; 95%CI (0.55, 0.75).Conclusion: In this study wealth index, frequencies of watching television, information about pregnancy complication, given or bought iron tablets/syrup were the predictors. Therefore integrated service of proper counseling on birth preparedness and complication readiness, Iron folic acid provision by health care providers and other integrated multi-sectoral collaborations are also highly important to improve the wealth index and health literacy of mothers.

scholarly journals Determinants of prenatal care use and HIV testing during pregnancy: a population-based, cross-sectional study of 7080 women of reproductive age in Mozambique

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Sanni Yaya ◽  
Olanrewaju Oladimeji ◽  
Kelechi Elizabeth Oladimeji ◽  
Ghose Bishwajit
Keyword(s):  
Antenatal Care ◽  
Rural Women ◽  
Rural Areas ◽  
Urban Areas ◽  
Wealth Quintile ◽  
Household Wealth ◽  
Antenatal Visit ◽  
Cross Sectional ◽  
Research Attention ◽  
Hiv Test

Abstract Background In low-income countries with poor coverage of healthcare services such as Mozambique, antenatal care serves as a vital tool for providing life-saving and cost-effective services for pregnant mothers. Nonetheless, many countries in Africa, including Mozambique, are struggling to attain an optimum level of antenatal care (at least 4 visits) utilisation among pregnant women. In the present study, we aimed to assess the sociodemographic and economic factors associated with antenatal care use in Mozambique. Methods Cross-sectional data from the latest round of Mozambique Demographic and Health Survey (2011) on women aged 15–49 years (n = 7080) were analysed. The outcome measures were early and adequate antenatal visit and HIV tests during the last pregnancy. Data were analysed using descriptive and multivariate regression methods. The predictor variables included various demographic (e.g. age, parity), empowerment (e.g. type of employment, household wealth status) and sociocultural factors (e.g. ethnicity, religion). Results Of the 7080 women whose data was analyzed, 15.3 and 60.1% had early and adequate ANC visits respectively while 75.4% received HIV test during ANC visits. The odds of early ANC visits were higher [OR = 1.300, 95%CI = 1.062,1.592] among women in the rural areas compared with those in the urban areas. However, participants in rural areas had lower odds [OR = 0.788, 0.687,0.902] of receiving HIV tests during ANC visits. Women in the urban areas with secondary [OR = 1.296, 95%CI = 1.007,1.666] and higher [OR = 1.663, 95%CI = 1.052,2.628] education had higher odds of having early ANC visit. Those in the higher wealth quintiles also had significantly increased odds of using all three types of ANC indicators, particularly for rural women in the highest wealth quintile [OR = 4.776, 95%CI = 1.250,18.24]. Being within the higher wealth quintiles was found to significantly increase the odds of using all three types of ANC indicators, particularly women from rural areas with highest wealth quintile [OR = 4.776, 95%CI = 1.250,18.24]. Conclusion About two-fifth of the women in Mozambique are not using adequate antenatal care and about and a quarter do not take HIV tests during pregnancy. The sources of low and unequal use of these vital health services might be rooted in women’s socioeconomic status and cultural issues that require special policy and research attention.

scholarly journals Attendance of fourth Antenatal Care Visit in Ethiopia: Analysis from 2016 Ethiopian Demographic Health Survey

2020 ◽  
Author(s):  
Mulugeta Woldu Abrha ◽  
Brhane Ayele Gebrekidan ◽  
Haftom Gebrehiwot Weldearegay ◽  
Araya Abrha Medhanyie
Keyword(s):  
Antenatal Care ◽  
Health Care Providers ◽  
Health Survey ◽  
Wealth Index ◽  
Antenatal Visit ◽  
Birth Preparedness ◽  
Care Providers ◽  
Complication Readiness ◽  
Antenatal Care Visit ◽  
Care Visit

Abstract Background Globally, approximately 830 women have been reported to die every day due to complications of pregnancy and childbirth. Almost all of these deaths occurred during the third trimester of pregnancy. This could have been reduced by having adequate Antenatal care visits. However, little is known about the determinants of fourth Antenatal care visit. This study is therefore conducted to identify determinants of attendance of fourth Antenatal visits in Ethiopia. Method This study was an analysis of data collected by the 2016 Ethiopian Demographic and Health Survey which used a stratified, two-stage cluster sampling design. Bivariate and multivariable regression analysis was done to declare association between independent predictors and attendance of fourth Antenatal care visit. Result The independent factors affecting fourth Antenatal visit were highest wealth index (Adjusted Odds Ratio(AOR) = 1.85; 95% Confidence interval (CI) (1.41, 2.44), watching television less than once in a week (AOR= 0.64; 95%CI (0.46, 0.88), not informed about pregnancy complications during previous visit (AOR= 0.59; 95%CI (0.51, 0.70) and women who were not given or who did not buy iron tablets/syrup (AOR= 0.64; 95%CI (0.55, 0.75). Conclusion In this study wealth index, frequencies of watching television, information about pregnancy complication, given or bought iron tablets/syrup were the predictors. Therefore integrated service of proper counseling on birth preparedness and complication readiness, Iron folic acid provision by health care providers and other integrated multi-sectoral collaborations are also highly important to improve the wealth index and health literacy of mothers.

scholarly journals Determinants of Optimal Antenatal Care Visit Among Pregnant Women in Ethiopia: a Multilevel Analysis of Ethiopian Mini Demographic Health Survey 2019 Data

2021 ◽  
Author(s):  
Delelegn Emwodew Yehualashet ◽  
Binyam Tariku Seboka ◽  
Getanew Aschalew Tesfa ◽  
Tizalegn Tesfaye Mamo ◽  
Elias Seid
Keyword(s):  
Antenatal Care ◽  
Pregnant Women ◽  
Health Survey ◽  
Rural Women ◽  
Urban Areas ◽  
Formal Education ◽  
Educational Interventions ◽  
World Health ◽  
Wealth Status ◽  
Factors Associated

Abstract Background: Optimal antenatal care (ANC4 +) needs to be used throughout pregnancy to reduce pregnancy complications and maternal mortality. The World Health Organization (WHO) recommends eight ANC contacts, while Ethiopia has the lowest coverage of at least four ANC visits. Therefore, this study aimed to identify factors associated with optimal ANC visits among pregnant women in Ethiopia. Methods: This study is a secondary data analysis of the 2019 Ethiopian Mini Demographic and Health Survey (EMDHS). A multilevel logistic regression model is set up to identify factors associated with optimal ANC visits. Adjusted odds ratios (AOR) with 95% confidence intervals (CI) were calculated to estimate the strength of the association between the outcome and the predictor variables. Results: Overall, 43% of women had optimal ANC visits during their last pregnancy. Higher educated women are 3.99 times more likely (AOR = 3.99; 95% CI: 2.62-6.02) to have optimal ANC visits than women with no formal education. The wealthiest women are 2.09 times more likely (AOR = 2.09; 95% CI: 1.56-2.82) to have optimal ANC visits than women in the poorest quintile. The odds of optimal ANC visit is 42 percent lower in rural women (AOR = 0.58, 95% CI: 0.41-0.83) compared to women living in urban areas. Conclusion: Women's educational status, wealth status, mass media exposure, place of residence and region are factors that are significantly associated with optimal ANC visit. These findings help health care programmers and policymakers to introduce appropriate policies and programs to ensure optimal ANC coverage. Priority should be given to addressing economic and educational interventions.

scholarly journals Utilization of HIV testing and counselling services by women with disabilities during antenatal care in Uganda: analysis of 2016 demographic and health survey

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hussaini Zandam ◽  
Ilhom Akobirshoev ◽  
Allyala Nandakumar ◽  
Monika Mitra
Keyword(s):  
Antenatal Care ◽  
Hiv Testing ◽  
Health Survey ◽  
Women With Disabilities ◽  
Counselling Services ◽  
Hiv Test ◽  
Post Test ◽  
Hiv Testing And Counselling ◽  
To Receive ◽  
Test Result

Abstract Background HIV testing and counselling during antenatal care (ANC) is critical for eliminating mother-to-child transmission of HIV. We investigated disparity in utilization of HIV testing and counselling services (HTC) between women with and without disabilities in Uganda. Methods We conducted a retrospective study using the nationally representative 2016 Uganda Demographic and Health Survey. The study sampled 10,073 women between age 15–49 who had a live birth in the last 5 years. We estimated unadjusted and adjusted odds ratio for receiving pre-test HIV counselling, obtaining an HIV test result, and post-test HIV counselling by disability status using logistic regressions. Results We found that women with disabilities were less likely to receive pre-test HIV counselling (59.6 vs 52.4), obtain an HIV test result (68.2 vs 61.4), receive post-test HIV counselling (55.5 vs 51.6), and all HTC services (49.2 vs 43.5). From the regression analysis, women with disabilities were less likely to receive pre-test counselling [AOR = 0.83; CI = 0.74, 0.93] and obtain an HIV test result [AOR = 0.88; CI = 0.78, 0.99]. Conclusions Our findings revealed that women with disabilities are less likely to receive HTC service during ANC and highlighted the need for disability-inclusive HIV and reproductive health services. Government, non-governmental organizations, and other stakeholders should consider funding inclusive campaigns and identifying other mechanisms for disseminating health information and behavioral interventions to women with disabilities.

scholarly journals Sociodemographic correlates of antenatal care visits in Nepal: Results from Nepal Demographic and Health Survey 2016

2020 ◽  
Author(s):  
Mukesh Adhikari ◽  
Binaya Chalise ◽  
Bihungum Bista ◽  
Achyut Raj Pandey ◽  
Dipak Prasad Upadhyaya
Keyword(s):  
Antenatal Care ◽  
Health Survey ◽  
Wealth Index ◽  
Targeted Interventions ◽  
Representative Data ◽  
Sociodemographic Correlates ◽  
Nationally Representative ◽  
To Receive ◽  
Antenatal Visits

Abstract Background: Good quality antenatal care visits are crucial to reduce maternal mortality and improve overall maternal and neonatal health outcomes. A previous study on antenatal care visits analyzed the nationally representative data of 2011; however, no studies have been conducted recently in Nepal. Therefore, we analyzed the sociodemographic correlates of the frequency and quality of antenatal care among Nepalese women from the nationally representative data of 2016.Methods: We analyzed data obtained from the Nepal Demography Health Survey (2016) on antenatal care for 2761 women who had one or more births in the past three years. Our study defined 'good quality antenatal care' as at least a 75% score on a composite metric which was obtained by adding the weighted scores assigned to the twelve recommended components of antenatal care. We analyzed the factors associated with the frequency and quality of antenatal care by using multiple Poisson regression and multiple logistic regression.Results: While 70 % of the Nepalese women surveyed had at least four antenatal care visits, only 21 % of these women received good-quality antenatal care. We found that the educated women (APR: 1.12; CI: 1.05-1.19) and the women of rich wealth index (APR: 1.27; CI: 1.18-1.37) were more likely to receive a higher number of antenatal visits. In contrast, women living in rural areas (APR: 0.92; CI: 0.87-0.98), and those who had more than two children (APR: 0.88; CI: 0.83-0.93) were less likely to receive a higher number of antenatal visits. Regarding the quality of antenatal care, educated women (AOR: 1.51; CI: 1.09-2.08), women who had educated husbands (AOR: 2.11; CI: 1.38-3.22), women of rich wealth index (AOR: 1.58; CI: 1.13-2.20) and women who had intended pregnancy (APR: 1.69; CI: 1.23-2.34), were more likely to receive good-quality antenatal care.Conclusion: Due to a wide variation in the coverage of different components of antenatal care, concerned stakeholders could tailor the interventions by focusing on components with lower use. Because we found an association of myriad sociodemographic factors with the frequency and quality of antenatal care, targeted interventions are necessary.

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