Awareness of Repeat Antenatal HIV Testing in Mothers Six Weeks Postnatal in Lusaka, Zambia

Abstract

Zambia national guidelines on the Prevention of Mother to Child Transmission (PMTCT) recommend that all pregnant women and breastfeeding mothers must have HIV tests every 3 months. However, less than 10% of pregnant women in Lusaka District get retested. Repeat HIV testing identifies women who seroconvert after the first test and allows measures to reduce mother to child transmission to be instituted.

Objectives: This cross-sectional survey aimed at investigating the effect of awareness of repeat testing on actual retesting in women attending the 6^th week postnatal clinic at Chilenje Health Centre in Lusaka. The objectives of the study were to determine the proportion of women that were aware of the repeat antenatal HIV testing, the number of women that were retested later in pregnancy or labour, and the number of postnatal mothers who seroconverted during the study.

Methods: Questionnaires were used to assess awareness and mothers eligible for a repeat test were offered a repeat test. 404 mothers at the sixth week postnatal visit were recruited by convenient sampling. Only women that had proof of a negative HIV test result in pregnancy were included in the study. Data was stored on Epidata and analysed using stata. Chi squares were used to make associations between the categorical variables and the primary outcome, repeat testing. Multivariate logistic regressions were used to adjust for confounders.

Results: Seventy two percent of the women were aware of the importance of repeat testing but only 36% received a repeat test. None of the women seroconverted during the study. Awareness was significantly associated with repeat testing (Odds ratio 3.8; 95% CI 2.9 – 6.9).

Conclusion: Women that are aware of repeat antenatal HIV testing are four times more likely to receive a repeat test than those that are not. Booking in the first trimester increases the chance of being retested two fold. Women that have 5 or more ANC visits have a three-fold chance of being retested than those with fewer visits.