Mandatory HIV testing and uptake of ante-natal services in a primary health care centre in South-South Nigeria

Abstract

Background: The Nigeria\'s national policy on HIV/AIDS did not allow for mandatory HIV testing. But several health institutions in Nigeria insist on an HIV test before certain services are given. Fears have been expressed that such mandatory HIV testing might lead to poorer uptake of associated services.
Aim: To assess the impact of mandatory HIV testing on the uptake of ante-natal services in a primary health centre located in Obrikom - a semi-urban community in south-south Nigeria.
Method: A cross-sectional study was carried out, using the ante-natal records of the primary health centre. The HIV testing procedure of the health centre was clearly established using in-depth interview of staff, and exit interview of women attending the ante-natal clinic. A four-year (October, 2002 to September, 2006) review of the ante-natal records of the health center was then carried out to coincide with the period, two years before, and two years after the introduction of Mandatory HIV testing in the health centre.
Results: The health centre had a total of 281 new antenatal registrations during the study period; out of which, only 75 (26.69%) were registered two years after the introduction of the policy. This is a significant reduction (p-value < 0.001), when compared to the number that registered before the introduction of the policy. There is also a significant decrease in the number of antenatal visits (p-value < 0.05); the number of visits decreased from a total of 840 visits, and an average quarterly visits of 105 (s.d 19.94) before the implementation of the policy, to 394 visits and an average quarterly visits of 44.75 (s.d 15.1).
Conclusion: Mandatory HIV testing can lead to a significant decrease in the uptake of associated health care services. Efforts should be made to discourage it.


Keywords: Mandatory HIV testing, Uptake of services, Ante-natal clinic, Primary health centre, South-south Nigeria

Port Harcourt Medical Journal Vol. 2 (3) 2008: pp. 257-262