title: Acceptability of counselling and testing for HIV infection in women in labour at the University College Hospital, Ibadan, Nigeria.
abstract: BACKGROUND
  Many patients are referred to labour ward as emergencies, and therefore do not benefit from the antenatal HIV counselling and testing and treatment offered to registered patients.
  
  
  OBJECTIVE
  To assess the acceptability and suitability of offering HIV counselling and testing to women of unknown HIV status presenting in labour.
  
  
  METHODS
  A cross-sectional study comprising counselling and obtaining consent for HIV testing among 104 unregistered patients who presented in labour over a 3-month period. Rapid and enzyme-linked immunosorbent assay screening was performed for 90 consenting respondents. Reactive results were confirmed by Western blot. Appropriate therapy was instituted.
  
  
  RESULTS
  Acceptance rate for HIV testing was 86.5%, prevalence of HIV was 6.7%. Women of lower educational status were more likely to accept testing in labour (OR: 0.3; 95% CI: 0.1-0.7; p=0.01); age, parity, occupation and knowledge of HIV had no influence. Most women (66.3%) had satisfactory knowledge of HIV. No one admitted to feeling coerced to test in fear of being denied care. Most refusals for screening were to avoid needle pricks (28.6%). Compared to ELISA screening test, specificity of the rapid test was 100%, sensitivity 85.7%, positive predictive value 100% and negative predictive value 98.8%. Attitude to testing was maintained on post-partum re-evaluation.
  
  
  CONCLUSIONS
  The prevalence of HIV amongst unregistered parturients showed the importance of offering point-of-care HIV testing and intervention, especially in an environment where antenatal clinic attendance is poor. Rapid testing appeared to be acceptable and feasible in labour to prevent the mother-to-child transmission of HIV.
authors.affiliation: Department of Obstetrics & Gynaecology, University of Ibadan, Ibadan, Nigeria. dr.nikebello@yahoo.com
authors.forename: F A
authors.initials: FA
authors.lastname: Bello
authors.forename: O O
authors.initials: OO
authors.lastname: Ogunbode
authors.forename: O A
authors.initials: OA
authors.lastname: Adesina
authors.forename: O
authors.initials: O
authors.lastname: Olayemi
authors.forename: O M
authors.initials: OM
authors.lastname: Awonuga
authors.forename: I F
authors.initials: IF
authors.lastname: Adewole
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D015153:Blotting, Western; D003376:Counseling; D003430:Cross-Sectional Studies; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D015658:HIV Infections / Q000175:diagnosis* / Q000453:epidemiology / Q000635:transmission; D007722:Health Knowledge, Attitudes, Practice; D006785:Hospitals, University; D006801:Humans; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control; D007743:Labor, Obstetric; D008403:Mass Screening; D009549:Nigeria / Q000453:epidemiology; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000175:diagnosis* / Q000453:epidemiology; D015995:Prevalence; D012959:Socioeconomic Factors; D055815:Young Adult