Site factors may be more important than participant factors in explaining HIV test acceptance in the prevention of mother-to-child HIV transmission programme in Kenya, 2005

Trop Med Int Health. 2009 Oct;14(10):1215-9. doi: 10.1111/j.1365-3156.2009.02367.x. Epub 2009 Aug 25.

Abstract

Objective: To determine the role of participant factors on the acceptance of a Prevention-of-Mother-to-Child (PMTCT) HIV test programme in a situation with an opt-out testing strategy.

Methods: We analysed antenatal clinic (ANC) HIV sentinel surveillance data. All 43 sites in the 2005 round of Kenya's ANC surveillance offered opt-out PMTCT services and recorded if women were offered PMTCT HIV testing and whether they accepted or refused. Logistic regression was used to determine the role of participant-level factors on PMTCT acceptance.

Results: During the period of sentinel surveillance, 13,026 women attended ANC and testing was offered to 12,030 women. Of those offered testing, 9690 (80.5%) accepted, with a large variation in the percent of acceptors by site. Age, residence and educational status were significant determinants of PMTCT acceptance. However, after adjusting for site none of the participant-level factors were significant determinants of PMTCT acceptance.

Conclusions: Participant level factors were not significant determinants of PMTCT HIV test acceptance after adjusting for sites. PMTCT programmes should collect and evaluate the role of site-level (provider and testing service) factors on PMTCT acceptance. Improvement of site-level factors could improve PMTCT uptake.

Publication types

  • Multicenter Study
  • Research Support, U.S. Gov't, Non-P.H.S.
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • AIDS Serodiagnosis / statistics & numerical data*
  • Adolescent
  • Adult
  • Female
  • HIV Infections / transmission*
  • HIV-1*
  • Health Services Accessibility / standards*
  • Humans
  • Infectious Disease Transmission, Vertical / prevention & control*
  • Kenya
  • Logistic Models
  • Middle Aged
  • Patient Acceptance of Health Care / statistics & numerical data*
  • Population Surveillance
  • Pregnancy
  • Prenatal Care / standards*
  • Young Adult