HIV Insight: HIV Prevalence and Antenatal Care Attendance among Pregnant Women in a Large Home-Based HIV Counseling and Testing Program in Western Kenya

OBJECTIVE:

To describe the uptake of and factors associated with HIV prevalence among pregnant women in a large-scale home-based HIV counseling and testing (HBCT) program in western Kenya.

METHODS:

In 2007, the Academic Model Providing Access to Healthcare Program (AMPATH) initiated HBCT to all individuals aged ≥13 years and high-risk children <13 years. Included in this analysis were females aged 13-50 years, from 6 catchment areas (11/08-01/12). We used descriptive statistics and logistic regression to describe factors associated with HIV prevalence.

RESULTS:

There were 119,678 women eligible for analysis; median age 25 (interquartile range, IQR: 18-34) years. Of these, 7,396 (6.2%) were pregnant at the time of HBCT; 4,599 (62%) had ever previously tested for HIV and 2,995 (40.5%) had not yet attended ANC for their current pregnancy. Testing uptake among pregnant women was high (97%). HBCT newly identified 241 (3.3%) pregnant HIV-positive women and overall HIV prevalence among all pregnant women was 6.9%. HIV prevalence among those who had attended ANC in this pregnancy was 5.4% compared to 9.0% among those who had not. Pregnant women were more likely to newly test HIV-positive in HBCT if they had not attended ANC in the current pregnancy (AOR: 6.85, 95% CI: 4.49-10.44).

CONCLUSIONS:

Pregnant women who had never attended ANC were about 6 times more likely to newly test HIV-positive compared to those who had attended ANC, suggesting that the cascade of services for prevention of mother-to-child HIV transmission should optimally begin at the home and village level if elimination of perinatal HIV transmission is to be achieved.

Full article at: http://goo.gl/pRbjCk

By: Ndege S1,2, Washington S3, Kaaria A1,4, Prudhomme-O'Meara W1,2,5, Were E1,6, Nyambura M1, Keter AK1, Wachira J1,6, Braitstein P1,6,7,8,9.

1Academic Model Providing Access to Healthcare (AMPATH) Program, Eldoret, Kenya.
2Moi University, College of Health Sciences, School of Public Health, Eldoret, Kenya.
3Indiana University, School of Medicine, Indianapolis, Indiana, United States of America.
4Moi Teaching and Referral Hospital, Eldoret, Kenya.
5Duke University, School of Medicine and Duke Global Health Institute, Durham, North Carolina, United States of America.
6Moi University, College of Health Sciences, School of Medicine, Eldoret, Kenya.
7University of Toronto, Dalla Lana School of Public Health, Toronto, Canada.
8Indiana University, Fairbanks School of Public Health, Indianapolis, Indiana, United States of America.
9Regenstrief Institute, Inc. Indianapolis, Indiana, United States of America.
PLoS One. 2016 Jan 19;11(1):e0144618. doi: 10.1371/journal.pone.0144618. eCollection 2016.