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
Anand, A.; Shiraishi, R.W.; Sheikh, A.Ahmed.; Marum, L.H.; Bolu, O.; Mutsotso, W.; Sabin, K.; Ayisi, R.; Diaz, T.
Tropical Medicine and International Health Tm and Ih 14(10): 1215-1219
2009
ISSN/ISBN: 1360-2276 PMID: 19708898 DOI: 10.1111/j.1365-3156.2009.02367.xDocument Number: 208568
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. 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. 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. 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.
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