title: Predictors of unknown HIV serostatus at the time of labor and delivery in Kampala, Uganda.
abstract: OBJECTIVE
  To determine factors associated with an unknown HIV serostatus among pregnant women admitted in labor to Mulago Hospital, Kampala, Uganda.
  
  
  METHODS
  In total, 665 pregnant women admitted to Mulago Hospital were interviewed about their sociodemographic characteristics, obstetric history, access to prenatal care, fears regarding HIV testing, and knowledge about modes of mother-to-child-transmission (MTCT). Knowledge of the HIV serostatus was assessed by self-report and verified by prenatal card review.
  
  
  RESULTS
  The prevalence of unknown HIV serostatus at the time of labor was 27.1%. Factors associated with an unknown HIV serostatus included high parity (odds ratio [OR] 1.9; 95% confidence interval [CI], 1.16-3.14), preterm delivery (OR 2.60; 95% CI, 1.06-6.34), prenatal care at a private clinic (OR 12.87; 95% CI, 5.68-29.14), residence more than 5 km from the nearest prenatal clinic (OR 2.86; 95% CI, 1.18-17.9), high knowledge about MTCT (OR 0.25; 95% CI, 0.07-0.86), and fears related to disclosing the test result to the partner (OR 3.60; 95% CI, 1.84-7.06).
  
  
  CONCLUSIONS
  The high prevalence of unknown HIV serostatus among women in labor highlights the need to improve accessibility to HIV testing services early during pregnancy to be able to take advantage of antiretroviral therapy.
authors.affiliation: Department of Obstetrics and Gynaecology, Makerere University College of Health Sciences, Kampala, Uganda; Clinical Epidemiology Unit, Makerere University College of Health Sciences, Kampala, Uganda. Electronic address: ononge2006@yahoo.com.
authors.forename: Sam
authors.initials: S
authors.lastname: Ononge
authors.affiliation: Clinical Epidemiology Unit, Makerere University College of Health Sciences, Kampala, Uganda; Department of Paediatrics and Child Health, Makerere University College of Health Sciences, Kampala, Uganda.
authors.forename: Charles
authors.initials: C
authors.lastname: Karamagi
authors.affiliation: Department of Obstetrics and Gynaecology, Makerere University College of Health Sciences, Kampala, Uganda.
authors.forename: Clemensia
authors.initials: C
authors.lastname: Nakabiito
authors.affiliation: Department of Obstetrics and Gynaecology, Walter Sisulu University, Mthatha, South Africa.
authors.forename: Julius
authors.initials: J
authors.lastname: Wandabwa
authors.affiliation: Department of Obstetrics and Gynaecology, Makerere University College of Health Sciences, Kampala, Uganda.
authors.forename: Florence
authors.initials: F
authors.lastname: Mirembe
authors.affiliation: Department of Psychiatry, Mbarara University of Science and Technology, Mbarara, Uganda.
authors.forename: Godfrey Z
authors.initials: GZ
authors.lastname: Rukundo
authors.affiliation: Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA.
authors.forename: Larissa
authors.initials: L
authors.lastname: Jennings
mesh_terms: D015492:AIDS Serodiagnosis / Q000379:methods*; D000293:Adolescent; D000328:Adult; D001294:Attitude to Health; D003430:Cross-Sectional Studies; D036861:Delivery, Obstetric; D005260:Female; D006679:HIV Seropositivity / Q000175:diagnosis* / Q000523:psychology; D006297:Health Services Accessibility; D006801:Humans; D007743:Labor, Obstetric; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000175:diagnosis* / Q000821:virology; D011295:Prenatal Care / Q000379:methods; D015995:Prevalence; D014454:Uganda; D055815:Young Adult
keywords: Delivery; Labor; Prevention of mother-to-child transmission; Unknown HIV serostatus