Opt-out HIV testing during antenatal care

Experiences of pregnant women in rural Uganda

Datos Bibliográficos

ID11492037
AutoresElin C Larsson (0000-0002-5189-808X, Karolinska Institutet, autor de correspondencia), Anna Thorson (0000-0002-8703-6561, Heidelberg University), George Pariyo (0000-0002-4411-2309, Heidelberg University), P Conrad (Heidelberg University), Moses Arinaitwe (0000-0001-6340-465X, Heidelberg University), Margaret Kemigisa (Heidelberg University), Jaran Eriksen (0000-0003-1146-5615, Heidelberg University), G Tomson (0000-0001-9222-3604, Heidelberg University), Anna Mia Ekström (0000-0002-3912-1171, Heidelberg University)
Año2012
Volumen27
Número1
Páginas69-75
Fecha de publicación2012-01-01
Peer ReviewedSí
Open AccessSí
TipoARTICLE
RevistaHealth Policy and Planning (JOURNAL)
Identificadores de la revistaISSN: 0268-1080 • E-ISSN: 1460-2237
EditorialOxford University Press (PUBLISHER • GB)
DOI10.1093/heapol/czr009
PMID21292708
OpenAlexW2101558825
IdiomaEN
Citas recibidas14
Referencias citadas25

Two years after the introduction of provider-initiated, opt-out HIV counselling and testing during antenatal care (ANC) in Uganda, HIV testing uptake is still low. This study was carried out to explore pregnant women's experiences of, and views on, the policies for opt-out, and couple HIV testing, and to understand how the policy implementation could be improved in order to increase access to prevention of mother-to-child-transmission (PMTCT) services. The study was conducted at three ANC health facilities at different levels of care in rural eastern Uganda. Data were collected through sit-in observations during ANC and 18 semi-structured interviews with pregnant women receiving ANC, and thereafter analysed using latent content analysis. Pregnant women who received ANC from facilities that provided HIV testing on-site perceived HIV testing as compulsory without actually fully realizing the benefits of HIV testing and PMTCT. No referral for HIV testing or information about testing was given at ANC facilities that lacked HIV testing on-site. A major challenge of couple HIV testing was that pregnant women were made responsible for recruiting their spouses for testing, a precarious dilemma for many women who tried to fulfil health workers' requests without having the power to do so. In order to increase uptake of PMTCT services, the pre-test counselling in groups that precedes the provider-initiated HIV testing should be adjusted to inform women about the benefits of PMTCT. Further, if testing is perceived as compulsory it could potentially deter some women from seeking ANC services. In order to increase HIV testing of male partners new strategies are needed, for example peer-sensitization and male clinics. Moreover, to achieve the desired outcomes of the PMTCT programme, monitoring and evaluation should be built into the programme.

Business · Developing country · Economic growth · Environmental health · Family medicine · Human immunodeficiency virus (HIV) · Opt-out · Population · Prenatal care · Referral · Rural area · Test (biology) · Adolescent Sexual and Reproductive Health · Global Maternal and Child Health · HIV/AIDS Research and Interventions · Medicine · Nursing