HIV counselling and testing for prevention of mother – to – child transmission: impact of cost of testing and counselling method

Abstract

Background: Counseling and Testing for HIV has been established as the entry points to HIV care since it enable each person to know his/her HIV status after being informed. Several factors have influenced the attitude of our people to accepting this service including, fear of a positive test, cost of testing, confidentiality and lack of adequate information.

Objective: To determine the impact of free HIV testing and individual counseling on uptake of counseling and testing for HIV infection in an antenatal clinic setting.
Study design and setting: This is a retrospective analysis of the records of antenatal clients involved in the prevention of mother to child transmission (PMTCT) programme at Nnamdi Azikiwe University Teaching Hospital Nnewi. During the first period- March to October 2003 (Period 1), the women paid for their HIV tests (N450 for screening by ELISA and N2000 for
Confirmation by Western Blot: while during the second period- November 2003 to June 2004 (Period 2), the women received free HIV screening and confirmation tests (by Double ELISA) and additional individual pre-test counseling.
Result: 638 women were seen in Period 1, out of which 269 (45.1%) accepted testing: while 656 women were seen in Period 2, and 451 (68.8%) accepted testing (X2=41.01409.df 1. P< 0.001). Similarly, 569(93.4%) women had group counseling alone in Period 1, whereas in Period 2, 656 (100%) had group counseling and 438 (66.7%) had individual counseling in addition (X2=305.47182 df. 1.P<00.1). This difference is significant. The HIV sero-prevalence rates were 7.8% and 11.8% for period 1 and period 2 respectively.
Conclusion: Free HIV testing and individual counseling significantly increased the uptake of counseling and testing for HIV infection in the antenatal clinic. Since counseling and HIV testing serve as entry point into the PMTCT programme, approaches that will increase uptake of testing services like free HIV testing and individual counseling should be emphasized.


Keywords: Counseling, HIV Testing, PMTCT.

Tropical Journal of Medical Research Vol. 11 (1) 2007: pp. 32-34