Health service barriers to HIV testing and counseling among pregnant women attending Antenatal Clinic; a cross-sectional study
Identifieur interne : 000480 ( Main/Exploration ); précédent : 000479; suivant : 000481Health service barriers to HIV testing and counseling among pregnant women attending Antenatal Clinic; a cross-sectional study
Auteurs : Golda Dokuaa Kwapong [Ghana] ; Daniel Boateng [Ghana] ; Peter Agyei-Baffour [Ghana] ; Ernestina A. Addy [Ghana]Source :
- BMC Health Services Research [ 1472-6963 ] ; 2014.
Descripteurs français
- KwdFr :
- Accessibilité des services de santé, Adolescent, Adulte, Adulte d'âge moyen, Assistance, Complications de la grossesse et maladies infectieuses (), Dépistage systématique (utilisation), Femelle, Ghana, Grossesse, Humains, Infections à VIH (), Infections à VIH (diagnostic), Jeune adulte, Prise en charge prénatale, Établissements de soins ambulatoires (organisation et administration), Études transversales.
- MESH :
- diagnostic : Infections à VIH.
- organisation et administration : Établissements de soins ambulatoires.
- utilisation : Dépistage systématique.
- Accessibilité des services de santé, Adolescent, Adulte, Adulte d'âge moyen, Assistance, Complications de la grossesse et maladies infectieuses, Femelle, Ghana, Grossesse, Humains, Infections à VIH, Jeune adulte, Prise en charge prénatale, Études transversales.
- Wicri :
- geographic : Ghana.
English descriptors
- KwdEn :
- Adolescent, Adult, Ambulatory Care Facilities (organization & administration), Counseling, Cross-Sectional Studies, Female, Ghana, HIV Infections (diagnosis), HIV Infections (prevention & control), Health Services Accessibility, Humans, Mass Screening (utilization), Middle Aged, Pregnancy, Pregnancy Complications, Infectious (prevention & control), Prenatal Care, Young Adult.
- MESH :
- geographic : Ghana.
- diagnosis : HIV Infections.
- organization & administration : Ambulatory Care Facilities.
- prevention & control : HIV Infections, Pregnancy Complications, Infectious.
- utilization : Mass Screening.
- Adolescent, Adult, Counseling, Cross-Sectional Studies, Female, Health Services Accessibility, Humans, Middle Aged, Pregnancy, Prenatal Care, Young Adult.
Abstract
HIV testing and counseling (HTC) remains critical in the global efforts to reach a goal of universal access to prevention and timely human immunodeficiency virus (HIV) treatment and health care. Routine HIV testing has been shown to be cost-effective and life-saving by prolonging the life expectancy of HIV patients and reducing the annual HIV transmission rate. However, these benefits of routine HIV testing may not be seen among pregnant women attending antenatal clinic (ANC) due to health facility related factors. This paper presents the influence of health facility related factors on HTC to inform HTC implementation.
The study was cross-sectional in design and used structured questionnaire and interview guides to gather information from 300 pregnant women aged 18 to 49 years and had attended ANC for more than twice at the time of the study. Twelve health workers were interviewed as key informants. Respondents were selected from the five sub metro health facilities in the Kumasi Metropolis through systematic random sampling from August to November 2011. Pregnant women who had not tested after two or more ANC visits were classified as not utilizing HTC. Data was analyzed with STATA 11. Logistic regression was run to assess the odds ratios at 95% confidence level.
Twenty-four percent of the pregnant women had not undergone HTC, with “never been told” emerging as the most cited reason as reported by 29.5% of respondents. Decisions by pregnant women to take up HTC were mostly influenced by factors such as lack of information, perceptions of privacy and confidentiality, waiting time, poor relationship with health staff and fear of being positive.
Access to HTC health facility alone does not translate into utilization of HTC service. Improving health facility related factors such as health education and information, confidentiality, health staff turnaround time and health staff-client relationship related to HTC will improve implementation.
Url:
DOI: 10.1186/1472-6963-14-267
PubMed: 24942820
PubMed Central: 4067520
Affiliations:
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Addy</name><affiliation wicri:level="1"><nlm:aff id="I2">Department of community Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana</nlm:aff><country xml:lang="fr">Ghana</country><wicri:regionArea>Department of community Health, Kwame Nkrumah University of Science and Technology, Kumasi</wicri:regionArea><wicri:noRegion>Kumasi</wicri:noRegion></affiliation></author></analytic><series><title level="j">BMC Health Services Research</title><idno type="eISSN">1472-6963</idno><imprint><date when="2014">2014</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adolescent</term><term>Adult</term><term>Ambulatory Care Facilities (organization & administration)</term><term>Counseling</term><term>Cross-Sectional Studies</term><term>Female</term><term>Ghana</term><term>HIV Infections (diagnosis)</term><term>HIV Infections (prevention & control)</term><term>Health Services Accessibility</term><term>Humans</term><term>Mass Screening (utilization)</term><term>Middle Aged</term><term>Pregnancy</term><term>Pregnancy Complications, Infectious (prevention & control)</term><term>Prenatal Care</term><term>Young Adult</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Accessibilité des services de santé</term><term>Adolescent</term><term>Adulte</term><term>Adulte d'âge moyen</term><term>Assistance</term><term>Complications de la grossesse et maladies infectieuses ()</term><term>Dépistage systématique (utilisation)</term><term>Femelle</term><term>Ghana</term><term>Grossesse</term><term>Humains</term><term>Infections à VIH ()</term><term>Infections à VIH (diagnostic)</term><term>Jeune adulte</term><term>Prise en charge prénatale</term><term>Établissements de soins ambulatoires (organisation et administration)</term><term>Études transversales</term></keywords><keywords scheme="MESH" type="geographic" xml:lang="en"><term>Ghana</term></keywords><keywords scheme="MESH" qualifier="diagnosis" xml:lang="en"><term>HIV Infections</term></keywords><keywords scheme="MESH" qualifier="diagnostic" xml:lang="fr"><term>Infections à VIH</term></keywords><keywords scheme="MESH" qualifier="organisation et administration" xml:lang="fr"><term>Établissements de soins ambulatoires</term></keywords><keywords scheme="MESH" qualifier="organization & administration" xml:lang="en"><term>Ambulatory Care Facilities</term></keywords><keywords scheme="MESH" qualifier="prevention & control" xml:lang="en"><term>HIV Infections</term><term>Pregnancy Complications, Infectious</term></keywords><keywords scheme="MESH" qualifier="utilisation" xml:lang="fr"><term>Dépistage systématique</term></keywords><keywords scheme="MESH" qualifier="utilization" xml:lang="en"><term>Mass Screening</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adolescent</term><term>Adult</term><term>Counseling</term><term>Cross-Sectional Studies</term><term>Female</term><term>Health Services Accessibility</term><term>Humans</term><term>Middle Aged</term><term>Pregnancy</term><term>Prenatal Care</term><term>Young Adult</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Accessibilité des services de santé</term><term>Adolescent</term><term>Adulte</term><term>Adulte d'âge moyen</term><term>Assistance</term><term>Complications de la grossesse et maladies infectieuses</term><term>Femelle</term><term>Ghana</term><term>Grossesse</term><term>Humains</term><term>Infections à VIH</term><term>Jeune adulte</term><term>Prise en charge prénatale</term><term>Études transversales</term></keywords><keywords scheme="Wicri" type="geographic" xml:lang="fr"><term>Ghana</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Background</title><p>HIV testing and counseling (HTC) remains critical in the global efforts to reach a goal of universal access to prevention and timely human immunodeficiency virus (HIV) treatment and health care. Routine HIV testing has been shown to be cost-effective and life-saving by prolonging the life expectancy of HIV patients and reducing the annual HIV transmission rate. However, these benefits of routine HIV testing may not be seen among pregnant women attending antenatal clinic (ANC) due to health facility related factors. This paper presents the influence of health facility related factors on HTC to inform HTC implementation.</p></sec><sec><title>Methods</title><p>The study was cross-sectional in design and used structured questionnaire and interview guides to gather information from 300 pregnant women aged 18 to 49 years and had attended ANC for more than twice at the time of the study. Twelve health workers were interviewed as key informants. Respondents were selected from the five sub metro health facilities in the Kumasi Metropolis through systematic random sampling from August to November 2011. Pregnant women who had not tested after two or more ANC visits were classified as not utilizing HTC. Data was analyzed with STATA 11. Logistic regression was run to assess the odds ratios at 95% confidence level.</p></sec><sec><title>Results</title><p>Twenty-four percent of the pregnant women had not undergone HTC, with “never been told” emerging as the most cited reason as reported by 29.5% of respondents. Decisions by pregnant women to take up HTC were mostly influenced by factors such as lack of information, perceptions of privacy and confidentiality, waiting time, poor relationship with health staff and fear of being positive.</p></sec><sec><title>Conclusions</title><p>Access to HTC health facility alone does not translate into utilization of HTC service. Improving health facility related factors such as health education and information, confidentiality, health staff turnaround time and health staff-client relationship related to HTC will improve implementation.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Walensky, Rp" uniqKey="Walensky R">RP Walensky</name></author><author><name sortKey="Weinstein, Mc" uniqKey="Weinstein M">MC Weinstein</name></author><author><name sortKey="Kimmel, Ad" uniqKey="Kimmel A">AD Kimmel</name></author><author><name sortKey="Seage, Gr" uniqKey="Seage G">GR Seage</name></author><author><name sortKey="Losina, E" uniqKey="Losina E">E Losina</name></author><author><name sortKey="Sax, Pe" uniqKey="Sax P">PE Sax</name></author><author><name sortKey="Zhang, H" uniqKey="Zhang H">H Zhang</name></author><author><name 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sortKey="Schilsky, Am" uniqKey="Schilsky A">AM Schilsky</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Chi, Bh" uniqKey="Chi B">BH Chi</name></author><author><name sortKey="Chansa, K" uniqKey="Chansa K">K Chansa</name></author><author><name sortKey="Gardner, Mo" uniqKey="Gardner M">MO Gardner</name></author><author><name sortKey="Sangi Haghpeykar, H" uniqKey="Sangi Haghpeykar H">H Sangi-Haghpeykar</name></author><author><name sortKey="Goldenberg, Rl" uniqKey="Goldenberg R">RL Goldenberg</name></author><author><name sortKey="Sinkala, M" uniqKey="Sinkala M">M Sinkala</name></author><author><name sortKey="Muchimba, M" uniqKey="Muchimba M">M Muchimba</name></author><author><name sortKey="Stringer, Js" uniqKey="Stringer J">JS Stringer</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Brouwer, Cn" uniqKey="Brouwer C">CN Brouwer</name></author><author><name sortKey="Lok, Cl" uniqKey="Lok C">CL Lok</name></author><author><name sortKey="Wolffers, I" uniqKey="Wolffers I">I Wolffers</name></author><author><name sortKey="Sebagalls, S" uniqKey="Sebagalls S">S Sebagalls</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="De Paoli, Mm" uniqKey="De Paoli M">MM De Paoli</name></author><author><name sortKey="Manongi, R" uniqKey="Manongi R">R Manongi</name></author><author><name sortKey="Klepp, Ki" uniqKey="Klepp K">KI Klepp</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Worthington, C" uniqKey="Worthington C">C Worthington</name></author><author><name sortKey="Myers, T" uniqKey="Myers T">T Myers</name></author></analytic></biblStruct></listBibl></div1></back></TEI><affiliations><list><country><li>Ghana</li></country><region><li>Région du Grand Accra</li></region><settlement><li>Accra</li></settlement></list><tree><country name="Ghana"><region name="Région du Grand Accra"><name sortKey="Kwapong, Golda Dokuaa" sort="Kwapong, Golda Dokuaa" uniqKey="Kwapong G" first="Golda Dokuaa" last="Kwapong">Golda Dokuaa Kwapong</name></region><name sortKey="Addy, Ernestina A" sort="Addy, Ernestina A" uniqKey="Addy E" first="Ernestina A" last="Addy">Ernestina A. Addy</name><name sortKey="Agyei Baffour, Peter" sort="Agyei Baffour, Peter" uniqKey="Agyei Baffour P" first="Peter" last="Agyei-Baffour">Peter Agyei-Baffour</name><name sortKey="Boateng, Daniel" sort="Boateng, Daniel" uniqKey="Boateng D" first="Daniel" last="Boateng">Daniel Boateng</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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