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Rapid testing may not improve uptake of HIV testing and same day results in a rural South African community: a cohort study of 12,000 women.

Mkwanazi NB, Patel D, Newell ML, Rollins NC, Coutsoudis A, Coovadia HM, Bland RM - PLoS ONE (2008)

Bottom Line: Women with secondary school education were less likely to agree to testing than those with no education (AOR 0.648, p<0.001), as were women aged 21-35 (AOR 0.762, p<0.001) and >35 years (AOR 0.756, p<0.01) compared to those <20 years.Contrary to other reports, few women who had rapid tests accepted their HIV results the same day.Finding strategies to increase the proportion of pregnant women knowing their HIV results is critical so that appropriate care can be given.

View Article: PubMed Central - PubMed

Affiliation: Africa Centre for Health and Population Studies, University of KwaZulu-Natal, Durban, South Africa.

ABSTRACT

Background: Rapid testing of pregnant women aims to increase uptake of HIV testing and results and thus optimize care. We report on the acceptability of HIV counselling and testing, and uptake of results, before and after the introduction of rapid testing in this area.

Methods and principal findings: HIV counsellors offered counselling and testing to women attending 8 antenatal clinics, prior to enrolment into a study examining infant feeding and postnatal HIV transmission. From August 2001 to April 2003, blood was sent for HIV ELISA testing in line with the Prevention of Mother-to-Child Transmission (PMTCT) programme in the district. From May 2003 to September 2004 women were offered a rapid HIV test as part of the PMTCT programme, but also continued to have ELISA testing for study purposes. Of 12,323 women counselled, 5,879 attended clinic prior to May 2003, and 6,444 after May 2003 when rapid testing was introduced; of whom 4,324 (74.6%) and 4,810 (74.6%) agreed to have an HIV test respectively. Of the 4,810 women who had a rapid HIV test, only 166 (3.4%) requested to receive their results on the same day as testing, the remainder opted to return for results at a later appointment. Women with secondary school education were less likely to agree to testing than those with no education (AOR 0.648, p<0.001), as were women aged 21-35 (AOR 0.762, p<0.001) and >35 years (AOR 0.756, p<0.01) compared to those <20 years.

Conclusions: Contrary to other reports, few women who had rapid tests accepted their HIV results the same day. Finding strategies to increase the proportion of pregnant women knowing their HIV results is critical so that appropriate care can be given.

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Related in: MedlinePlus

Proportion of women accepting HIV counselling and their HIV results.
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pone-0003501-g001: Proportion of women accepting HIV counselling and their HIV results.

Mentions: Overall, 12,323 pregnant women received HIV counselling; their socio-demographic characteristics are shown in Table 1. Figure 1 shows the proportion of women who accepted testing and those who returned for results. Overall 74% (9,134/12,323) of women accepted testing, of whom 9 did not want their results. In a logistic regression model including maternal education, age and parity, women with secondary school education were less likely to accept testing than those with no education (AOR 0.648; 95% CI 0.54–0.79; p<0.001). Compared to women below 20 years, those aged 21–35 years were less likely to accept testing (AOR 0.762; 95% CI 0.68–0.85; p<0.001); as were those above 35 years (AOR 0.756; 95% CI 0.62–0.93; p<0.01) (Table 2).


Rapid testing may not improve uptake of HIV testing and same day results in a rural South African community: a cohort study of 12,000 women.

Mkwanazi NB, Patel D, Newell ML, Rollins NC, Coutsoudis A, Coovadia HM, Bland RM - PLoS ONE (2008)

Proportion of women accepting HIV counselling and their HIV results.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC2567429&req=5

pone-0003501-g001: Proportion of women accepting HIV counselling and their HIV results.
Mentions: Overall, 12,323 pregnant women received HIV counselling; their socio-demographic characteristics are shown in Table 1. Figure 1 shows the proportion of women who accepted testing and those who returned for results. Overall 74% (9,134/12,323) of women accepted testing, of whom 9 did not want their results. In a logistic regression model including maternal education, age and parity, women with secondary school education were less likely to accept testing than those with no education (AOR 0.648; 95% CI 0.54–0.79; p<0.001). Compared to women below 20 years, those aged 21–35 years were less likely to accept testing (AOR 0.762; 95% CI 0.68–0.85; p<0.001); as were those above 35 years (AOR 0.756; 95% CI 0.62–0.93; p<0.01) (Table 2).

Bottom Line: Women with secondary school education were less likely to agree to testing than those with no education (AOR 0.648, p<0.001), as were women aged 21-35 (AOR 0.762, p<0.001) and >35 years (AOR 0.756, p<0.01) compared to those <20 years.Contrary to other reports, few women who had rapid tests accepted their HIV results the same day.Finding strategies to increase the proportion of pregnant women knowing their HIV results is critical so that appropriate care can be given.

View Article: PubMed Central - PubMed

Affiliation: Africa Centre for Health and Population Studies, University of KwaZulu-Natal, Durban, South Africa.

ABSTRACT

Background: Rapid testing of pregnant women aims to increase uptake of HIV testing and results and thus optimize care. We report on the acceptability of HIV counselling and testing, and uptake of results, before and after the introduction of rapid testing in this area.

Methods and principal findings: HIV counsellors offered counselling and testing to women attending 8 antenatal clinics, prior to enrolment into a study examining infant feeding and postnatal HIV transmission. From August 2001 to April 2003, blood was sent for HIV ELISA testing in line with the Prevention of Mother-to-Child Transmission (PMTCT) programme in the district. From May 2003 to September 2004 women were offered a rapid HIV test as part of the PMTCT programme, but also continued to have ELISA testing for study purposes. Of 12,323 women counselled, 5,879 attended clinic prior to May 2003, and 6,444 after May 2003 when rapid testing was introduced; of whom 4,324 (74.6%) and 4,810 (74.6%) agreed to have an HIV test respectively. Of the 4,810 women who had a rapid HIV test, only 166 (3.4%) requested to receive their results on the same day as testing, the remainder opted to return for results at a later appointment. Women with secondary school education were less likely to agree to testing than those with no education (AOR 0.648, p<0.001), as were women aged 21-35 (AOR 0.762, p<0.001) and >35 years (AOR 0.756, p<0.01) compared to those <20 years.

Conclusions: Contrary to other reports, few women who had rapid tests accepted their HIV results the same day. Finding strategies to increase the proportion of pregnant women knowing their HIV results is critical so that appropriate care can be given.

Show MeSH
Related in: MedlinePlus