Predictors of unknown HIV serostatus at the time of labor and delivery in Kampala, Uganda

Int J Gynaecol Obstet. 2014 Mar;124(3):235-9. doi: 10.1016/j.ijgo.2013.08.011. Epub 2013 Nov 5.

Abstract

Objective: To determine factors associated with an unknown HIV serostatus among pregnant women admitted in labor to Mulago Hospital, Kampala, Uganda.

Methods: In total, 665 pregnant women admitted to Mulago Hospital were interviewed about their sociodemographic characteristics, obstetric history, access to prenatal care, fears regarding HIV testing, and knowledge about modes of mother-to-child-transmission (MTCT). Knowledge of the HIV serostatus was assessed by self-report and verified by prenatal card review.

Results: The prevalence of unknown HIV serostatus at the time of labor was 27.1%. Factors associated with an unknown HIV serostatus included high parity (odds ratio [OR] 1.9; 95% confidence interval [CI], 1.16-3.14), preterm delivery (OR 2.60; 95% CI, 1.06-6.34), prenatal care at a private clinic (OR 12.87; 95% CI, 5.68-29.14), residence more than 5 km from the nearest prenatal clinic (OR 2.86; 95% CI, 1.18-17.9), high knowledge about MTCT (OR 0.25; 95% CI, 0.07-0.86), and fears related to disclosing the test result to the partner (OR 3.60; 95% CI, 1.84-7.06).

Conclusion: The high prevalence of unknown HIV serostatus among women in labor highlights the need to improve accessibility to HIV testing services early during pregnancy to be able to take advantage of antiretroviral therapy.

Keywords: Delivery; Labor; Prevention of mother-to-child transmission; Unknown HIV serostatus.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • AIDS Serodiagnosis / methods*
  • Adolescent
  • Adult
  • Attitude to Health*
  • Cross-Sectional Studies
  • Delivery, Obstetric
  • Female
  • HIV Seropositivity / diagnosis*
  • HIV Seropositivity / psychology
  • Health Services Accessibility
  • Humans
  • Labor, Obstetric
  • Pregnancy
  • Pregnancy Complications, Infectious / diagnosis*
  • Pregnancy Complications, Infectious / virology
  • Prenatal Care / methods
  • Prevalence
  • Uganda
  • Young Adult