title: Site factors may be more important than participant factors in explaining HIV test acceptance in the prevention of mother-to-child HIV transmission programme in Kenya, 2005.
abstract: OBJECTIVE
  To determine the role of participant factors on the acceptance of a Prevention-of-Mother-to-Child (PMTCT) HIV test programme in a situation with an opt-out testing strategy.
  
  
  METHODS
  We analysed antenatal clinic (ANC) HIV sentinel surveillance data. All 43 sites in the 2005 round of Kenya's ANC surveillance offered opt-out PMTCT services and recorded if women were offered PMTCT HIV testing and whether they accepted or refused. Logistic regression was used to determine the role of participant-level factors on PMTCT acceptance.
  
  
  RESULTS
  During the period of sentinel surveillance, 13,026 women attended ANC and testing was offered to 12,030 women. Of those offered testing, 9690 (80.5%) accepted, with a large variation in the percent of acceptors by site. Age, residence and educational status were significant determinants of PMTCT acceptance. However, after adjusting for site none of the participant-level factors were significant determinants of PMTCT acceptance.
  
  
  CONCLUSIONS
  Participant level factors were not significant determinants of PMTCT HIV test acceptance after adjusting for sites. PMTCT programmes should collect and evaluate the role of site-level (provider and testing service) factors on PMTCT acceptance. Improvement of site-level factors could improve PMTCT uptake.
authors.affiliation: Epidemic Intelligence Service, Office of Workforce and Career Development, Centers for Disease Control and Prevention (CDC), Atlanta, GA 30333, USA. aanand@cdc.gov
authors.forename: Abhijeet
authors.initials: A
authors.lastname: Anand
authors.forename: Ray W
authors.initials: RW
authors.lastname: Shiraishi
authors.forename: Abdullahi Ahmed
authors.initials: AA
authors.lastname: Sheikh
authors.forename: Lawrence H
authors.initials: LH
authors.lastname: Marum
authors.forename: Omotayo
authors.initials: O
authors.lastname: Bolu
authors.forename: Winfred
authors.initials: W
authors.lastname: Mutsotso
authors.forename: Keith
authors.initials: K
authors.lastname: Sabin
authors.forename: Robert
authors.initials: R
authors.lastname: Ayisi
authors.forename: Theresa
authors.initials: T
authors.lastname: Diaz
mesh_terms: D015492:AIDS Serodiagnosis / Q000706:statistics & numerical data*; D000293:Adolescent; D000328:Adult; D005260:Female; D015658:HIV Infections / Q000635:transmission*; D015497:HIV-1; D006297:Health Services Accessibility / Q000592:standards*; D006801:Humans; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control*; D007630:Kenya; D016015:Logistic Models; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D011159:Population Surveillance; D011247:Pregnancy; D011295:Prenatal Care / Q000592:standards*; D055815:Young Adult