Perception of risk of vertically acquired HIV infection and acceptability of provider-initiated testing and counseling among adolescents in Zimbabwe.
OBJECTIVE
We investigated attitudes toward provider-initiated HIV testing and counseling (PITC) in the suburbs of Harare, Zimbabwe, where late presentation after mother-to-child HIV transmission (MTCT) is a major cause of adolescent mortality.


METHODS
Adolescents (10-18 years) attending 2 primary clinics were offered PITC. Participants completed a questionnaire investigating acceptability of PITC, and in-depth interviews with 41 adolescents and 30 guardians explored understanding of long-term survival after MTCT.


RESULTS
Of 506 participants, 16 were known to be HIV-positive; of the remaining 490, only 5 (1%) declined HIV testing. Infected adolescents and their guardians often anticipated a positive result and reported being advised by relatives (but not health workers) to be tested because of chronic illness, especially if parents or siblings had died or were HIV-infected. However, HIV-negative participants were not aware that long-term survival following MTCT could occur. All adolescents felt that HIV diagnosed at their age would be assumed to have been sexually acquired regardless of the true mode of transmission.


CONCLUSIONS
Including late diagnosis of MTCT in pretest counseling and health educational messages may facilitate PITC for older children and adolescents, especially for those who have not had their sexual debut.
London School of Hygiene and Tropical Medicine, UK. rabferr@gmail.com
Rashida A
RA
Ferrand
Caroline
C
Trigg
Tsitsi
T
Bandason
Chiratidzo E
CE
Ndhlovu
Stanley
S
Mungofa
Kusum
K
Nathoo
Diana M
DM
Gibb
Frances M
FM
Cowan
Elizabeth L
EL
Corbett
D015492:AIDS Serodiagnosis; D000293:Adolescent; D001294:Attitude to Health; D002648:Child; D003376:Counseling; D005260:Female; D015658:HIV Infections / Q000175:diagnosis* / Q000523:psychology / Q000635:transmission; D006679:HIV Seropositivity / Q000523:psychology; D006801:Humans; D018445:Infectious Disease Transmission, Vertical; D007872:Legal Guardians / Q000523:psychology; D008297:Male; D010342:Patient Acceptance of Health Care / Q000523:psychology*; D012306:Risk; D015030:Zimbabwe