Determinants of vct uptake among pregnant women attending two ANC clinics in Addis Ababa City: unmatched case control study.
BACKGROUND
With HAART PMTCT interventions can reduce the risk of MTCT below 2%. However, low uptake of VCT is challenging effectiveness of PMTCT programs in sub-Saharan Africa. The aim of this study is to identify factors that determine VCT uptake among pregnant women attending ANC services.


METHODS
A case-control study was conducted from August 30, 2005 - November 30, 2005 among pregnant women attending ANC PMTCT services at Teklehaimanot Health Center and Gandhi memorial Hospital in Addis Ababa City. Cases were pregnant mothers who accepted VCT (n=202) and controls were pregnant mothers who refused VCT (n=200). Data was collected by counselor nurses working at the respective services


RESULTS
Factors that determine VCT acceptance were women's perceived ability to cope with a positive result (OR = 5.5, 95% CI 3.5-8.5, MHOR = 6.3, 95% CI 3.9-10.2); perceived favorable reaction of husband's after sharing positive test result (OR = 2.7 95% CI 1.4-5.1, MHOR = 2.9, 95% CI 1.4-5.7); perceived positive community response (OR = 2.2 95% CI 1.1-4.2, MHOR = 2.6 95% CI 1.3-5.2); perceived ability to get continuous medical care if found out to be positive (OR = 2.0, 95% CI 1.2-3.5, MHOR = 2.4, 95% CI 1.3-4.5).


CONCLUSIONS
Women's perceived ability to cope with a positive result, accesses to medical care, fear of husband's negative reaction and the stigma and discrimination following a positive test result were key determinants of uptake of VCT. Therefore, increasing uptake of VCT/PMTCT services needs policy makers and service providers' effort to promote couple counseling, intensifying the fight against stigma and discrimination and ensuring continuous HIV/AIDS related medical care.
Maedot
Paulos
P
JHPIEGO Ethiopia, P.O Box-2881 Code 12 50, Addis Ababa, Ethiopia.
Haile
Amaha
A
Lulseged
Sileshi
S
Belachew
Ayele
A
D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D023241:Antiretroviral Therapy, Highly Active / Q000523:psychology*; D001294:Attitude to Health; D016022:Case-Control Studies; D005002:Ethiopia; D005260:Female; D015658:HIV Infections / Q000188:drug therapy / Q000517:prevention & control*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control*; D010342:Patient Acceptance of Health Care; D010465:Perception; D011247:Pregnancy; D015995:Prevalence; D011795:Surveys and Questionnaires