Unknown HIV status among women delivering in Mulago Hospital

Abstract

Mother to Child Transmission of HIV accounts for more than 90% of all paediatric HIV infections. HIV testing among pregnant women is the first step to receiving interventions that prevent Mother to Child transmission. Provider Initiated Counselling and Testing has greatly improved uptake of HIV testing during antenatal care but at a population level, only 66% of pregnant women are tested during pregnancy in Uganda. The objective of this study was to determine the prevalence and factors associated with unknown HIV status among women delivering in Mulago Hospital. Methods: This was a cross sectional study of women who had delivered and admitted on the postnatal ward in Mulago Hospital. Participants were chosen at random and had a questionnaire administered. Information regarding mothers’ demographic characteristics, partner support, health seeking behaviour, Health system related factors and knowledge on PMTCT was collected. Unknown HIV status was determined by self report. Fisher’s exact test and Wilcoxon rank sum tests were used for bivariate analysis. Logistic regression was used for multivariate analysis. Results: The prevalence of unknown HIV status was 2.6% (10/382). This was 90% less than the prevalence in 2006. Being married (OR=0.2, 95%CI 0.0-0.9), attending ANC at higher level facilities (OR =0.1 95%CI 0.0 – 0.5) and having been counselled for HIV testing during ANC(OR=0.1,95%CI 0.0-0.5) were negatively associated with having an unknown HIV status at labour. “Opting out” of HIV testing during ANC was the main reason (5/6) for not testing among women who had unknown HIV at labour and had attended ANC in structured health facilities while lack of HIV counselling was the main reason for having unknown HIV status (3/4) among those who attended ANC in private clinics. All the women who presented in labour with unknown HIV status accepted to be tested.