Acceptance of HIV testing among women attending antenatal care in south-western Uganda: risk factors and reasons for test refusal.
Dahl, Viktor LU ; Mellhammar, L ; Bajunirwe, F and Björkman, Per LU
(2008)
In AIDS Care
20(6).
p.746-752
- Abstract
- A problem commonly encountered in programs for prevention of mother-to-child-transmission (PMTCT) of HIV in sub-Saharan Africa is low rates of HIV test acceptance among pregnant women. In this study, we examined risk factors and reasons for HIV test refusal among 432 women attending three antenatal care clinics offering PMTCT in urban and semi-urban parts of the Mbarara district, Uganda. Structured interviews were performed following pre-test counselling. Three-hundred-eighty women were included in the study, 323 (85%) of whom accepted HIV testing. In multivariate analysis, testing site (Site A: OR = 1.0; Site B: OR = 3.08; 95%CI: 1.12-8.46; Site C: OR = 5.93; 95%CI: 2.94-11.98), age between 30 and 34 years (<20 years: OR = 1.0; 20-24... (More)
- A problem commonly encountered in programs for prevention of mother-to-child-transmission (PMTCT) of HIV in sub-Saharan Africa is low rates of HIV test acceptance among pregnant women. In this study, we examined risk factors and reasons for HIV test refusal among 432 women attending three antenatal care clinics offering PMTCT in urban and semi-urban parts of the Mbarara district, Uganda. Structured interviews were performed following pre-test counselling. Three-hundred-eighty women were included in the study, 323 (85%) of whom accepted HIV testing. In multivariate analysis, testing site (Site A: OR = 1.0; Site B: OR = 3.08; 95%CI: 1.12-8.46; Site C: OR = 5.93; 95%CI: 2.94-11.98), age between 30 and 34 years (<20 years: OR = 1.0; 20-24 years: OR = 1.81; 95%CI: 0.58-5.67; 25-29 years: OR = 2.15; 95%CI: 0.66-6.97; 30-34 years: OR = 3.88; 95%CI: 1.21-13.41), mistrust in reliability of the HIV test (OR = 20.60; 95%CI: 3.24-131.0) and not having been tested for HIV previously (OR = 2.15; 95%CI: 1.02-4.54) were associated with test refusal. Testing sites operating for longer durations had higher rates of acceptance. The most common reasons claimed for test refusal were: lack of access to antiretroviral therapy (ART) for HIV-infected women (88%; n=57), a need to discuss with partner before decision (82%; n=57) and fear of partner's reaction (54%; n=57). Comparison with previous periods showed that the acceptance rate increased with the duration of the program. Our study identified risk factors for HIV test refusal among pregnant women in Uganda and common reasons for not accepting testing. These findings may suggest modifications and improvements in the performance of HIV testing in this and similar populations. (Less)
Please use this url to cite or link to this publication:
https://lup.lub.lu.se/record/1168459
- author
- Dahl, Viktor
LU
; Mellhammar, L
; Bajunirwe, F
and Björkman, Per
LU
- organization
- publishing date
- 2008
- type
- Contribution to journal
- publication status
- published
- subject
- in
- AIDS Care
- volume
- 20
- issue
- 6
- pages
- 746 - 752
- publisher
- Taylor & Francis
- external identifiers
-
- wos:000257114200017
- pmid:18576178
- scopus:46249112404
- pmid:18576178
- ISSN
- 0954-0121
- DOI
- 10.1080/09540120701693990
- language
- English
- LU publication?
- yes
- id
- 88ab10b8-8bf7-4b68-a9ef-287fcfe6e33f (old id 1168459)
- alternative location
- http://www.ncbi.nlm.nih.gov/pubmed/18576178?dopt=Abstract
- date added to LUP
- 2016-04-04 08:11:51
- date last changed
- 2022-03-15 07:52:07
@article{88ab10b8-8bf7-4b68-a9ef-287fcfe6e33f,
abstract = {{A problem commonly encountered in programs for prevention of mother-to-child-transmission (PMTCT) of HIV in sub-Saharan Africa is low rates of HIV test acceptance among pregnant women. In this study, we examined risk factors and reasons for HIV test refusal among 432 women attending three antenatal care clinics offering PMTCT in urban and semi-urban parts of the Mbarara district, Uganda. Structured interviews were performed following pre-test counselling. Three-hundred-eighty women were included in the study, 323 (85%) of whom accepted HIV testing. In multivariate analysis, testing site (Site A: OR = 1.0; Site B: OR = 3.08; 95%CI: 1.12-8.46; Site C: OR = 5.93; 95%CI: 2.94-11.98), age between 30 and 34 years (<20 years: OR = 1.0; 20-24 years: OR = 1.81; 95%CI: 0.58-5.67; 25-29 years: OR = 2.15; 95%CI: 0.66-6.97; 30-34 years: OR = 3.88; 95%CI: 1.21-13.41), mistrust in reliability of the HIV test (OR = 20.60; 95%CI: 3.24-131.0) and not having been tested for HIV previously (OR = 2.15; 95%CI: 1.02-4.54) were associated with test refusal. Testing sites operating for longer durations had higher rates of acceptance. The most common reasons claimed for test refusal were: lack of access to antiretroviral therapy (ART) for HIV-infected women (88%; n=57), a need to discuss with partner before decision (82%; n=57) and fear of partner's reaction (54%; n=57). Comparison with previous periods showed that the acceptance rate increased with the duration of the program. Our study identified risk factors for HIV test refusal among pregnant women in Uganda and common reasons for not accepting testing. These findings may suggest modifications and improvements in the performance of HIV testing in this and similar populations.}},
author = {{Dahl, Viktor and Mellhammar, L and Bajunirwe, F and Björkman, Per}},
issn = {{0954-0121}},
language = {{eng}},
number = {{6}},
pages = {{746--752}},
publisher = {{Taylor & Francis}},
series = {{AIDS Care}},
title = {{Acceptance of HIV testing among women attending antenatal care in south-western Uganda: risk factors and reasons for test refusal.}},
url = {{http://dx.doi.org/10.1080/09540120701693990}},
doi = {{10.1080/09540120701693990}},
volume = {{20}},
year = {{2008}},
}