Predictors of HIV Testing Among Pregnant Women aged 15-49 Years in Nigeria
Main Article Content
Keywords
Antenatal visits, HIV Testiing, Predictors, Pregnant Women, Nigeria
Abstract
Background: The utilization of HIV testing services in Nigeria has not been optimal due to socioeconomic and demographic factors such as educational level, place of residence, and religion. For Nigeria to achieve epidemic control, pregnant women need to know their HIV status through HIV testing, which is the gateway to HIV prevention, care, support, and treatment services. Therefore, the purpose of this study was to determine the predictors of HIV testing among Nigerian pregnant women aged 15-49 years HIV testing during antenatal visits or childbirth.
Methodology: Secondary data analyses of 659 pregnant women randomly selected from the multiple imputation datasets of the 2013 Nigeria Demographic and Health Survey (NDHS)were done using SPSS version 25. Data on socio-demographic characteristics, HIV stigmatizing attitudes, and HIV testing were retrieved from the dataset for the study. Bivariate and multivariate regression analyses were done to determine the predictors of HIV testing.
Results: The prevalence of self-reported HIV testing and receiving results among women of reproductive age was 36.72%. Bivariate model findings showed that educational level, place of residence, and religion were statistically significant predictors of HIV testing among pregnant women. Only educational level and place of residence significantly predicted pregnant women's HIV testing in the parsimonious multivariable regression model. Pregnant women with higher levels of education (Primary Education, AOR, 1.85; 95% CI, 1.07,3.19; Secondary Education, AOR, 3.75; 95% CI:1.93, 7.28; Higher Education, AOR, 11.23; 95% CI: 4.40, 28.68) and those living in urban areas (AOR, 1.60: 95% CI:1.03, 2.47) were more likely to test for HIV than those with no education and those living in the rural areas.
Conclusion: This study identified having a higher level of education and living in urban areas as predictors of HIV testing, therefore, more efforts are needed to have women with lower levels of education and those living in rural areas test for HIV as a strategy for the elimination of mother-to-child transmission of HIV.
References
2. UNAIDS. 90–90–90 - An ambitious treatment target to help end the AIDS epidemic [Internet]. [cited 2021 Aug 30]; Available from: https://www.unaids.org/en/resources/documents/2017/90-90-90
3. Federal Ministry of Health, Nigeria (FMoH). 2019; Nigeria HIV/AIDS Indicator and Impact Survey. Federal Ministry of Health.http://ciheb.org/media/SOM/Microsites/CIHEB/documents /NAIIS-Report-2018.pdf
4. Federal Ministry of Health. Consolidated guidelines on HIV testing services [Internet]. [cited 2021 Dec 23]; Available from: https://www.who.int/publications-detail-redirect/978-92-4-155058-1
5. NPC/Nigeria NPC, International ICF. Nigeria Demographic and Health Survey 2013. 2014 [cited 2021 Dec 5]; Available from: https://dhsprogram.com/publications/publication-fr293-dhs-final-reports.cfm
6. Mohlabane N, Tutshana B, Peltzer K, Mwisongo A. Barriers and facilitators associated with HIV testing uptake in South African health facilities offering HIV Counselling and Testing. Health SA Gesondheid 2016;21(1):86–95.
7. Colombini M, James C, Ndwiga C, Mayhew SH. The risks of partner violence following HIV status disclosure, and health service responses: narratives of women attending reproductive health services in Kenya. J Int AIDS Soc. 2016 Mar 31;19(1):20766. doi: 10.7448/IAS.19.1.20766.
8. Ojikutu BO, Pathak S, Srithanaviboonchai K, Limbada M, Friedman R, Li S, et al. Community Cultural Norms, Stigma and Disclosure to Sexual Partners among Women Living with HIV in Thailand, Brazil and Zambia (HPTN 063). PloS One 2016;11(5):e0153600.
9. Al-Mujtaba M, Cornelius LJ, Galadanci H, Erekaha S, Okundaye JN, Adeyemi OA, et al. Evaluating Religious Influences on the Utilization of Maternal Health Services among Muslim and Christian Women in North-Central Nigeria. BioMed Res Int 2016:1–8.
10. Shodimu MA, Yusuf OB, Akinyemi JO, Fagbamigbe AF, Bamgboye EA, Ngige E, et al. Determinants of perceived stigmatizing and discriminating attitudes towards people living with HIV/AIDS among women of reproductive age in Nigeria. J AIDS HIV Res 2017;9:139–51.
11. Teklehaimanot HD, Teklehaimanot A, Yohannes M, Biratu D. Factors influencing the uptake of voluntary HIV counseling and testing in rural Ethiopia: a cross-sectional study. BMC Public Health 2016;16(1):239.
12. Evangeli M, Pady K, Wroe AL. Which Psychological Factors are Related to HIV Testing? A Quantitative Systematic Review of Global Studies. AIDS Behav 2016;20(4):880–918.
13. Udoh EE, Ushie BA. Determinants of antenatal HIV testing in the opt-out approach in Nigeria: findings from the Nigerian Demographic and Health Survey. Demographic and Health Survey. J Biosoc Sci. 2020 Jul;52(4):473-490. doi: 10.1017/S0021932019000555.
14. Npc NPC, ICF. Nigeria Demographic and Health Survey 2018 - Final Report. 2019 [cited 2021 Dec 5];Available from: https://dhsprogram.com/publications/publication-fr359-dhs-final-reports.cfm
15. Puukko K, Hietajärvi L, Maksniemi E, Alho K, Salmela-Aro K. Social Media Use and Depressive Symptoms—A Longitudinal Study from Early to Late Adolescence. Int J Environ Res Public Health 2020;17(16):5921.
16. Mirzaei A, Carter SR, Patanwala AE, Schneider CR. Missing data in surveys: Key concepts, approaches, and applications. Res Social Adm Pharm. 2022 Feb;18(2):2308-2316.doi: 10.1016/j.sapharm.2021.03.009.
17. Yu L, Liu L, Peace K. Regression multiple imputation for missing data analysis. Stat Methods Med Res. 2020 Sep;29(9):2647-2664. doi: 10.1177/0962280220908613.
18. Muyunda B, Musonda P, Mee P, Todd J, Michelo C. Educational Attainment as a Predictor of HIV Testing Uptake Among Women of Child-Bearing Age: Analysis of 2014 Demographic and Health Survey in Zambia. Front Public Health. 2018 Aug 14;6:192. doi: 10.3389/fpubh.2018.00192.
19. Gunn JK, Asaolu IO, Center KE, Gibson SJ, Wightman P, Ezeanolue EE, et al. Antenatal care and uptake of HIV testing among pregnant women in sub-Saharan Africa: a cross-sectional study. J Int AIDS Soc 2016;19(1):20605.
20. Takarinda KC, Madyira LK, Mhangara M, Makaza V, Maphosa-Mutsaka M, Rusakaniko S, et al. Factors Associated with Ever Being HIV-Tested in Zimbabwe: An Extended Analysis of the Zimbabwe Demographic and Health Survey (2010–2011). PLoS One. 2016 Jan 25;11(1):e0147828.doi: 10.1371/journal.pone.0147828.
21. Muhinda JCPazvakawambwaL. HIV Testing among Women in Namibia: Patterns and Determinants. Biomed J Sci Tech Res 2017;1(3):571–8.
22. Ajayi A, Awopegba O, Owolabi E, Ajala A. Coverage of HIV testing among pregnant women in Nigeria: progress, challenges and opportunities. J Public Health (Oxf). 2021 Apr 12;43(1):e77-e84. doi: 10.1093/pubmed/fdz152.
23. Ejigu Y, Tadesse B. HIV testing during pregnancy for prevention of mother-to-child transmission of HIV in Ethiopia. PloS One 2018;13(8):e0201886.
24. Kirakoya-Samadoulougou F, Jean K, Maheu-Giroux M. Uptake of HIV testing in Burkina Faso: an assessment of individual and community-level determinants. BMC Public Health 2017];17(1):486. https://doi.org/10.1186/s12889-017-4417-2
25. Yaya S, Oladimeji O, Oladimeji KE, Bishwajit G. Determinants of prenatal care use and HIV testing during pregnancy: a population-based, cross-sectional study of 7080 women of reproductive age in Mozambique. BMC Pregnancy Childbirth 2019;19(1): 354.https://doi.org/10.1186/s12884-019-2540-z
26. Meremo A, Mboya B, Ngilangwa D, Dulle R, Tarimo E, Urassa D, et al. Barriers to accessibility and utilization of HIV testing and counseling services in Tanzania: experience from Angaza Zaidi programme. Pan African Medical Journal. 2016;23:189. [doi: 10.11604/pamj.2016.23.189.5683]
27. Ha JH, Lith LMV, Mallalieu EC, Chidassicua J, Pinho MD, Devos P, et al. Gendered relationship between HIV stigma and HIV testing among men and women in Mozambique: a cross-sectional study to inform a stigma reduction and male-targeted HIV testing intervention. BMJ Open 2019;9(10):e029748.
28. Alemu YM, Ambaw F, Wilder-Smith A. Utilization of HIV testing services among pregnant mothers in low-income primary care settings in northern Ethiopia: a cross sectional study. BMC Pregnancy Childbirth 2017;17:199.https://doi.org/10.1186/s12884-017-1389-2
29. Yusuf M, Assegid S, Gezahegn Y. Determinants of HIV test uptake among women of reproductive age group attending to Hargeisa group hospital, Somaliland, Somalia. International Journal of Scientific and Engineering Research 2019;10(5):601-612.
30. Gebremedhin KB, Tian B, Tang C, Zhang X, Yisma E, Wang H. Factors associated with acceptance of provider-initiated HIV testing and counseling among pregnant women in Ethiopia. Patient Prefer Adherence 2018; 12:183–91.
31. Rosenstock IM. Why people use health services. Milbank Mem Fund Q 1966;44(3):Suppl:94-127.
32. Rosenstock IM, Strecher VJ, Becker MH. Social Learning Theory and the Health Belief Model. Health Educ Q 1988;15(2):175–83.
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