Missed Opportunities: barriers to HIV testing during pregnancy from a population based cohort study in rural Uganda.

The aim was to assess population-level HIV-testing uptake among pregnant women, key for access to prevention-of mother to child transmission (PMTCT) services, and to identify risk factors for not being HIV tested,The study was conducted May 2008-May 2010 in the Iganga/Mayuge Health and Demographic S...

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Autores principales:	Elin C Larsson, Anna Ekéus Thorson, George Pariyo, Peter Waiswa, Daniel Kadobera, Gaetano Marrone, Anna Mia Ekström
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2012
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/31fc01aadfb3463ab48270a10efd7e57
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spelling	oai:doaj.org-article:31fc01aadfb3463ab48270a10efd7e572021-11-18T07:08:36ZMissed Opportunities: barriers to HIV testing during pregnancy from a population based cohort study in rural Uganda.1932-620310.1371/journal.pone.0037590https://doaj.org/article/31fc01aadfb3463ab48270a10efd7e572012-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/22916089/?tool=EBIhttps://doaj.org/toc/1932-6203The aim was to assess population-level HIV-testing uptake among pregnant women, key for access to prevention-of mother to child transmission (PMTCT) services, and to identify risk factors for not being HIV tested,The study was conducted May 2008-May 2010 in the Iganga/Mayuge Health and Demographic Surveillance Site (HDSS), Eastern Uganda, during regular surveillance of 68,000 individuals. All women identified to be pregnant May-July 2008 (n=881) were interviewed about pregnancy-related issues and linked to the HDSS database for socio-demographic data. Women were followed-up via antenatal care (ANC) register reviews at the health facilities to collect data related to ANC services received, including HIV testing. Adjusted relative risk (aRR), and 95% confidence intervals (CI) for not being HIV tested were calculated using multivariable binomial regression among the 544 women who remained after record review.Despite high ANC attendance (96%), the coverage of HIV testing was 64%. Only 6% of pregnant women who sought ANC at a facility without HIV testing services were referred for testing and only 20% received counseling regarding HIV. At ANC facilities with HIV testing services, 85% were tested. Only 4% of the women tested had been couple tested for HIV. Living more than three kilometers away from a health facility with HIV testing services was associated with not being tested both among the poorest (aRR,CI; 1.44,1.02-2.04) and the least poor women (aRR,CI;1.72,1.12-2.63).The lack of on site HIV testing services and distant ANC facilities lead to missed opportunities for PMTCT, especially for the poorest women. Referral systems for HIV testing need to be improved and testing should be expanded to lower level health facilities. This is in order to ensure that the policy of HIV testing during pregnancy is implemented more effectively and that testing is accessible for all.Elin C LarssonAnna Ekéus ThorsonGeorge PariyoPeter WaiswaDaniel KadoberaGaetano MarroneAnna Mia EkströmPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 7, Iss 8, p e37590 (2012)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Elin C Larsson Anna Ekéus Thorson George Pariyo Peter Waiswa Daniel Kadobera Gaetano Marrone Anna Mia Ekström Missed Opportunities: barriers to HIV testing during pregnancy from a population based cohort study in rural Uganda.
description	The aim was to assess population-level HIV-testing uptake among pregnant women, key for access to prevention-of mother to child transmission (PMTCT) services, and to identify risk factors for not being HIV tested,The study was conducted May 2008-May 2010 in the Iganga/Mayuge Health and Demographic Surveillance Site (HDSS), Eastern Uganda, during regular surveillance of 68,000 individuals. All women identified to be pregnant May-July 2008 (n=881) were interviewed about pregnancy-related issues and linked to the HDSS database for socio-demographic data. Women were followed-up via antenatal care (ANC) register reviews at the health facilities to collect data related to ANC services received, including HIV testing. Adjusted relative risk (aRR), and 95% confidence intervals (CI) for not being HIV tested were calculated using multivariable binomial regression among the 544 women who remained after record review.Despite high ANC attendance (96%), the coverage of HIV testing was 64%. Only 6% of pregnant women who sought ANC at a facility without HIV testing services were referred for testing and only 20% received counseling regarding HIV. At ANC facilities with HIV testing services, 85% were tested. Only 4% of the women tested had been couple tested for HIV. Living more than three kilometers away from a health facility with HIV testing services was associated with not being tested both among the poorest (aRR,CI; 1.44,1.02-2.04) and the least poor women (aRR,CI;1.72,1.12-2.63).The lack of on site HIV testing services and distant ANC facilities lead to missed opportunities for PMTCT, especially for the poorest women. Referral systems for HIV testing need to be improved and testing should be expanded to lower level health facilities. This is in order to ensure that the policy of HIV testing during pregnancy is implemented more effectively and that testing is accessible for all.
format	article
author	Elin C Larsson Anna Ekéus Thorson George Pariyo Peter Waiswa Daniel Kadobera Gaetano Marrone Anna Mia Ekström
author_facet	Elin C Larsson Anna Ekéus Thorson George Pariyo Peter Waiswa Daniel Kadobera Gaetano Marrone Anna Mia Ekström
author_sort	Elin C Larsson
title	Missed Opportunities: barriers to HIV testing during pregnancy from a population based cohort study in rural Uganda.
title_short	Missed Opportunities: barriers to HIV testing during pregnancy from a population based cohort study in rural Uganda.
title_full	Missed Opportunities: barriers to HIV testing during pregnancy from a population based cohort study in rural Uganda.
title_fullStr	Missed Opportunities: barriers to HIV testing during pregnancy from a population based cohort study in rural Uganda.
title_full_unstemmed	Missed Opportunities: barriers to HIV testing during pregnancy from a population based cohort study in rural Uganda.
title_sort	missed opportunities: barriers to hiv testing during pregnancy from a population based cohort study in rural uganda.
publisher	Public Library of Science (PLoS)
publishDate	2012
url	https://doaj.org/article/31fc01aadfb3463ab48270a10efd7e57
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Missed Opportunities: barriers to HIV testing during pregnancy from a population based cohort study in rural Uganda.

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