title: The association between HIV status and antenatal care attendance among pregnant women in rural hospitals in Lesotho.
abstract: OBJECTIVE
  Early and frequent antenatal clinic (ANC) attendance is important for promotion of healthy outcomes for mother and child. This study explored the relationship between HIV status at the first ANC visit and subsequent ANC attendance among pregnant women in Lesotho.
  
  
  METHODS
  A retrospective review of ANC records from a cohort of pregnant women attending their first ANC visit in December 2009 to May 2010 in 3 rural hospitals was conducted. Wilcoxon rank sum tests compared the distribution of gestational age (GA) and ANC visit number by HIV status.
  
  
  RESULTS
  Records from 728 women were reviewed with mean GA at the first ANC visit of 22.3 weeks (SD = 7.2) and 2.7 (SD = 1.4) mean number of ANC visits per woman. Neither number of visits nor GA at first visit differed between HIV-positive and HIV-negative women. In total, 33.9% of women completed 4 ANC visits. Women with documented HIV-positive status before ANC were more likely to present early to ANC than all other women (18.8 vs. 22.6 weeks, adjusted odds ratio = 2.54, 95% confidence interval: 1.41 to 4.57). Geographical region, increasing maternal age, and lower parity were associated with completion of expected ANC visits among all women. Increasing maternal age and CD4 count were associated with completion of expected visits among HIV-positive women.
  
  
  CONCLUSIONS
  In Lesotho, number of subsequent visits did not differ between women testing HIV-positive and HIV-negative in ANC. However, women with documented HIV-positive status attended ANC earlier than women who were tested in ANC. HIV testing and counseling, particularly for HIV-positive women before pregnancy, can promote early ANC attendance.
authors.affiliation: *Elizabeth Glaser Pediatric AIDS Foundation, Washington, DC; †Biostatistics Unit, Center for Evidence Based Health Care, Stellenbosch University, Cape Town, South Africa; ‡Elizabeth Glaser Pediatric AIDS Foundation, Maseru, Lesotho; §Elizabeth Glaser Pediatric AIDS Foundation, Lilongwe, Malawi; ‖South to South Program, Stellenbosch University, Cape Town, South Africa; and ¶Formerly the Ministry of Health, Maseru, Lesotho.
authors.forename: Michelle M
authors.initials: MM
authors.lastname: Gill
authors.forename: Rhoderick
authors.initials: R
authors.lastname: Machekano
authors.forename: Anthony
authors.initials: A
authors.lastname: Isavwa
authors.forename: Allan
authors.initials: A
authors.lastname: Ahimsibwe
authors.forename: Oyebola
authors.initials: O
authors.lastname: Oyebanji
authors.forename: Oluwasanmi L
authors.initials: OL
authors.lastname: Akintade
authors.forename: Appolinaire
authors.initials: A
authors.lastname: Tiam
mesh_terms: D000328:Adult; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000453:epidemiology*; D006780:Hospitals, Rural; D006801:Humans; D007927:Lesotho / Q000453:epidemiology; D010342:Patient Acceptance of Health Care; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000453:epidemiology*; D011295:Prenatal Care / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D013997:Time Factors; D055815:Young Adult