Date of Award

Summer 8-11-2020

Degree Type

Thesis

Degree Name

Master of Public Health (MPH)

Department

Public Health

First Advisor

Ike Solomon Okosun, MS, MPH, PhD

Second Advisor

Reynolds Morrison, MPH, PhD

Abstract

INTRODUCTION: In sub-Saharan Africa countries such as Nigeria, the rate of Mother-to-child- transmission (MTCT) of HIV is notably high. Despite the availability of prenatal care services to prevent MTCT of HIV, Nigeria still records a higher rate of new pediatric HIV infections compared to other countries in the region. HIV counseling and testing during antenatal care is necessary as it serves as an entry point for Prevention of Mother-to-child-transmission (PMTCT).

AIM: This study aims to determine factors that are associated with HIV testing uptake during antenatal care (ANC) among women in Nigeria.

METHODS: Cross-sectional data from the 2013 Demographic Health Study on women aged 15-49 years (n=3410), who attended at least one ANC visit was used recruited for this study. The outcome variable was HIV testing during ANC. Predictor variables included various mothers’ level characteristics ( awareness of the mode of transmission, prevention methods of HIV, age, and educational level), demographic characteristics (place of residence, the region of residence, facility for ANC, and workers at ANC), and religious affiliation. Odds ratio from univariate and multivariate logistic regression methods were used to determine the association between the predictor variables and odds of HIV testing during ANC.

RESULTS: Over 50% of the sample were tested for HIV during ANC visits. All the demographic variables, mothers level factors, and sociocultural factors were significantly associated with increased odds of HIV testing uptake. Urban residence participants were 2 times more likely to take the test than the rural residence participants. Christians were 1.3times more likely to be tested than Muslims. Women who received care at government-owned facilities were 1.2 times more likely to be tested for HIV than women who received care at private-owned medical facilities. HIV testing tended to increase with increased levels of education. Women who were 24 - 49 years of age were more likely to be tested for HIV compared to women who were younger than 24 years of age. Compared to women who had no comprehensive knowledge of HIV transmission, women who knew about transmission during delivery (AOR =1.31; 95%CI:1.08 - 1.59), and drugs for PMTCT (AOR=2.28; 95%CI:1.89 - 2.68) were more likely to be tested for HIV during ANC. Women who were attended to by skilled workers were more likely to be tested than women attended to by unskilled workers(AOR=2.11; 95%CL:1.63 – 2.71).

CONCLUSION: In this study, factors driving HIV uptake during ANC was found to be rooted in demographic characteristics, mothers’ level characteristics, and socio-cultural factors. Thus, addressing modifiable factors such as availability of government health facilities, and skilled workers may lead to a higher uptake of HIV testing during ANC among women. This will contribute to a notable reduction in the incidence of MTCT HIV infections in Nigeria

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