HIV Counselling and Testing (HCT) Service Up-take and the Epidemiology of HIV/AIDS among Women Attending Ante Natal Care (ANC) in High and Low Prevalence States

• Author(s): ONAZI, Moses ; ANIENI James ; DAHUNSI Aisha Ejura
• Paper ID: 1706872
• Page: 325-339
• Published Date: 13-01-2025
• Published In: Iconic Research And Engineering Journals
• Publisher: IRE Journals
• e-ISSN: 2456-8880
• Volume/Issue: Volume 8 Issue 7 January-2025

Abstract

The current study seeks to establish the association between the uptake of HCT services before pregnancy in low and high prevalence states included in the study. The Null hypothesis in the study was the similarity of HCT up-take before pregnancy among women accessing ANC in states reporting high and low HIV prevalence. The study employed a cross-sectional comparative study design to explore the association between the up-take of HCT services and the epidemiology of HIV in study communities. Women attending ANC service in eight selected Global Fund supported health facilities drawn from four states were included in the study. Benue and Akwa-Ibom states were randomly selected from the list of states with very high prevalence rates while Ekiti and Kwara states were selected from the group of states identified with low HIV prevalence in the 2010 National Sentinel Survey. The study assumed uniform prevalence in the study states. Statistical analysis was performed in 2 steps: Step 1: Frequency runs were performed to evaluate each variable in the study. Step 2: Generalized Linear Model (GLM) approach was performed to explore the distribution of respondents’ characteristics and to explain the relationship between HCT up-take and HIV epidemics in the prevalence states. Since the outcome variable in this study has binary outcome (0= High prevalence; 1=Low prevalence), we assumed it had a binomial distribution. This step of analysis was then performed with generalized linear model with a logistic link function. Both uni-variate and multivariate analysis were performed to determine crude and adjusted Odds Ratios. Results reporting p<0.05 level were considered as strong evidence of robust effect. A total of 443 women were sampled in this study. Most respondents were in monogamous 349 (83.7%) marriage relationships and; live together 351 (80.9%) with their spouses in urban locations 306 (69.1%). Only 62 (14.0%) respondents attained graduate or postgraduate level of education. About three-fifths of all respondents were sampled from low prevalence states of Kwara and Ekiti, while the rest were from Benue and Akwa=Ibom states. Those in the upper age bracket of 30 to 49 years of age were more likely to be in low prevalence states (Crude OR=2.777, 95%CI: 1.848, 4.175, p<0.001) compared to those in high prevalence states. The majority of respondents in both low (98.9%) and high (98.3%) prevalence states have heard of HIV/AIDS. Surprisingly however, respondents who know only one or no correct mode of HIV transmission were likely to be in low than high prevalence states in the study, (Crude OR=9.250, 95%CI: 4.289, 19.950, p<0.001). About one tenth of respondents in both low and high prevalence areas did not know any mode of HIV transmission from mother to child; however, the majority of respondents (84.8% vs 90.4%) knew that HIV transmission from mother to child is preventable. Further analysis reveal that age at sexual initiation was significantly delayed beyond 19 years of age in states with low HIV prevalence (Adjusted OR=4.805, 95%CI: 2.883, 8.011, p<0.001) than in states with high prevalence. Results indicate that the probability of the up-take of HCT before current pregnancy in respondents was more likely in low prevalence states (Adjusted OR=2.815, 95%CI: 1.675, 4.731, p<0.001) compared to high prevalence states. The result indicated that a statistically significant association exist between the up-take of HCT among women attending ANC and the epidemiology of HIV in high and low prevalence states. The Null hypothesis of no difference in HCT up-take in the study was thus rejected and the alternate hypothesis of a difference in the up-take of HCT in high and low prevalence states was accepted. Results reveal further that respondents in low prevalence states were more likely to have residences between 5 to 10 minutes walking distances to HCT centers compared to respondents in high prevalence states (Crude OR=7.137, 95%CI:2.337, 21.800. p=0.001) and (Crude OR=2.483, 95%CI: 1.335, 4.616. p=0.004). This study reveals that age at first sexual activity was the most important risk factor for HIV infection in the prevalence states. A delay in the initiation of early sexual activities could prevent new infection in young people and reduce the HIV epidemic even in high risk areas. In addition, association between the HCT up-take before current pregnancy in the prevalence states was statistical significant and could have benefit for women because of its potential to reduce the risk of HIV infection. In this regard we suggest that HCT services should be expanded beyond health facilities to places of worship, schools and other public places to ensure that people have access to services within their reach. Mobile services could also be provided in communities and towns to ensure that everyone has access to service. The campaign to encourage young people to delay the initiation of sexual activity could also be very helpful in the effort to prevent new HIV infections. Additionally, the campaign against HIV/AIDS should be sustained both in urban and rural areas as well as in high and low prevalence states because misconceptions about HIV/AIDS still exist out there. It is important that people, particularly women endeavour to ascertain their HIV status so as to further enhance their ability to protect themselves and the new born from HIV infection.

Keywords

HIV, Prevalence, HCT (HIV Counseling and Testing) and Epidemiology.

Citations

IRE Journals:
ONAZI, Moses , ANIENI James , DAHUNSI Aisha Ejura "HIV Counselling and Testing (HCT) Service Up-take and the Epidemiology of HIV/AIDS among Women Attending Ante Natal Care (ANC) in High and Low Prevalence States" Iconic Research And Engineering Journals Volume 8 Issue 7 2025 Page 325-339

IEEE:
ONAZI, Moses , ANIENI James , DAHUNSI Aisha Ejura "HIV Counselling and Testing (HCT) Service Up-take and the Epidemiology of HIV/AIDS among Women Attending Ante Natal Care (ANC) in High and Low Prevalence States" Iconic Research And Engineering Journals, 8(7)