title: Brief Report: HIV Testing Among Pregnant Women Who Attend Antenatal Care in Malawi.
abstract: Malawi adopted the Option B+ strategy in 2011. Its success in reducing mother-to-child transmission depends on coverage and timing of HIV testing. We assessed HIV status ascertainment and its predictors during pregnancy. HIV status ascertainment was 82.3% (95% confidence interval: 80.2 to 85.9) in the pre-Option B+ period and 85.7% (95% confidence interval: 83.4 to 88.0) in the Option B+ period. Higher HIV ascertainment was independently associated with higher age, attending antenatal care more than once, and registration in 2010. The observed high variability of HIV ascertainment between sites (50.6%-97.7%) and over time suggests that HIV test kit shortages and insufficient numbers of staff posed major barriers to reducing mother-to-child transmission.
authors.affiliation: *Department of HIV and AIDS, Ministry of Health, Lilongwe, Malawi; †Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland; ‡International Training and Education Centre for Health/Department for Global Health, University of Washington, Seattle, WA; §Dignitas International, Zomba, Malawi; ‖Department of Medicine, College of Medicine, University of Malawi, Blantyre, Malawi; ¶International Training and Education Centre for Health Malawi, Lilongwe, Malawi; #Division of Epidemiology and Biostatistics, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa; and **International Training and Education Center for Health Malawi, Lilongwe, Malawi.
authors.forename: Lyson
authors.initials: L
authors.lastname: Tenthani
authors.forename: Andreas D
authors.initials: AD
authors.lastname: Haas
authors.forename: Matthias
authors.initials: M
authors.lastname: Egger
authors.forename: Joep J
authors.initials: JJ
authors.lastname: Van Oosterhout
authors.forename: Andreas
authors.initials: A
authors.lastname: Jahn
authors.forename: Frank
authors.initials: F
authors.lastname: Chimbwandira
authors.forename: Kali
authors.initials: K
authors.lastname: Tal
authors.forename: Landon
authors.initials: L
authors.lastname: Myer
authors.forename: Janne
authors.initials: J
authors.lastname: Estill
authors.forename: Olivia
authors.initials: O
authors.lastname: Keiser
mesh_terms: D000328:Adult; D005260:Female; D015658:HIV Infections / Q000175:diagnosis* / Q000635:transmission; D006801:Humans; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control; D008295:Malawi; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000175:diagnosis*; D011295:Prenatal Care; D055815:Young Adult