Factors associated with acceptance of provider-initiated HIV testing and counseling among pregnant women in Ethiopia

Abstract

Introduction: The global human immunodeficiency virus (HIV) epidemic disproportionately affects sub-Saharan African countries, including Ethiopia. Provider-initiated HIV testing and counseling (PITC) is a tool to identify HIV-positive pregnant women and an effective treatment and prevention strategy. However, its success depends upon the willingness of pregnant women to accept HIV testing. Objectives: To describe the level of acceptance of PITC and associated factors among pregnant women attending 8 antenatal care clinics in Adama, Ethiopia. Methods: Trained nursing students and employees from an HIV clinic conducted face-to-face structured interviews in private offices at the clinics from August to September, 2016. Results: Among the 441 respondents, 309 (70.1%) accepted PITC. Women with more antenatal care visits (odds ratio [OR] =2.59, 95% CI: 1.01–6.63), reported better quality of the PITC service (OR =1.91, 95% CI: 1.19–3.08), and higher level of knowledge on mother-to-child transmission (OR =1.82, 95% CI: 1.03–3.20), were more likely to accept PITC, while women who were older in age (OR =0.37, 95% CI: 0.19–0.74) and perceived negative attitudes from their partners toward HIV-positive results (OR =0.31, 95% CI: 0.10–0.94) were less likely to accept the PITC service. Conclusion: About one-third of pregnant women are not willing to accept PITC. When designing intervention program to improve the acceptance of PITC, we should take into consideration the personal factors, HIV-related knowledge, and attitude of women as well as institutional factors.