title: HIV Prevalence and Antenatal Care Attendance among Pregnant Women in a Large Home-Based HIV Counseling and Testing Program in Western Kenya.
abstract: OBJECTIVE
  To describe the uptake of and factors associated with HIV prevalence among pregnant women in a large-scale home-based HIV counseling and testing (HBCT) program in western Kenya.
  
  
  METHODS
  In 2007, the Academic Model Providing Access to Healthcare Program (AMPATH) initiated HBCT to all individuals aged ≥13 years and high-risk children <13 years. Included in this analysis were females aged 13-50 years, from 6 catchment areas (11/08-01/12). We used descriptive statistics and logistic regression to describe factors associated with HIV prevalence.
  
  
  RESULTS
  There were 119,678 women eligible for analysis; median age 25 (interquartile range, IQR: 18-34) years. Of these, 7,396 (6.2%) were pregnant at the time of HBCT; 4,599 (62%) had ever previously tested for HIV and 2,995 (40.5%) had not yet attended ANC for their current pregnancy. Testing uptake among pregnant women was high (97%). HBCT newly identified 241 (3.3%) pregnant HIV-positive women and overall HIV prevalence among all pregnant women was 6.9%. HIV prevalence among those who had attended ANC in this pregnancy was 5.4% compared to 9.0% among those who had not. Pregnant women were more likely to newly test HIV-positive in HBCT if they had not attended ANC in the current pregnancy (AOR: 6.85, 95% CI: 4.49-10.44).
  
  
  CONCLUSIONS
  Pregnant women who had never attended ANC were about 6 times more likely to newly test HIV-positive compared to those who had attended ANC, suggesting that the cascade of services for prevention of mother-to-child HIV transmission should optimally begin at the home and village level if elimination of perinatal HIV transmission is to be achieved.
authors.affiliation: Academic Model Providing Access to Healthcare (AMPATH) Program, Eldoret, Kenya.|Moi University, College of Health Sciences, School of Public Health, Eldoret, Kenya.
authors.forename: Samson
authors.initials: S
authors.lastname: Ndege
authors.affiliation: Indiana University, School of Medicine, Indianapolis, Indiana, United States of America.
authors.forename: Sierra
authors.initials: S
authors.lastname: Washington
authors.affiliation: Academic Model Providing Access to Healthcare (AMPATH) Program, Eldoret, Kenya.|Moi Teaching and Referral Hospital, Eldoret, Kenya.
authors.forename: Alice
authors.initials: A
authors.lastname: Kaaria
authors.affiliation: Academic Model Providing Access to Healthcare (AMPATH) Program, Eldoret, Kenya.|Moi University, College of Health Sciences, School of Public Health, Eldoret, Kenya.|Duke University, School of Medicine and Duke Global Health Institute, Durham, North Carolina, United States of America.
authors.forename: Wendy
authors.initials: W
authors.lastname: Prudhomme-O'Meara
authors.affiliation: Academic Model Providing Access to Healthcare (AMPATH) Program, Eldoret, Kenya.|Moi University, College of Health Sciences, School of Medicine, Eldoret, Kenya.
authors.forename: Edwin
authors.initials: E
authors.lastname: Were
authors.affiliation: Academic Model Providing Access to Healthcare (AMPATH) Program, Eldoret, Kenya.
authors.forename: Monica
authors.initials: M
authors.lastname: Nyambura
authors.affiliation: Academic Model Providing Access to Healthcare (AMPATH) Program, Eldoret, Kenya.
authors.forename: Alfred K
authors.initials: AK
authors.lastname: Keter
authors.affiliation: Academic Model Providing Access to Healthcare (AMPATH) Program, Eldoret, Kenya.|Moi University, College of Health Sciences, School of Medicine, Eldoret, Kenya.
authors.forename: Juddy
authors.initials: J
authors.lastname: Wachira
authors.affiliation: Academic Model Providing Access to Healthcare (AMPATH) Program, Eldoret, Kenya.|Moi University, College of Health Sciences, School of Medicine, Eldoret, Kenya.|University of Toronto, Dalla Lana School of Public Health, Toronto, Canada.|Indiana University, Fairbanks School of Public Health, Indianapolis, Indiana, United States of America.|Regenstrief Institute, Inc. Indianapolis, Indiana, United States of America.
authors.forename: Paula
authors.initials: P
authors.lastname: Braitstein
mesh_terms: D000293:Adolescent; D000328:Adult; D037001:Directive Counseling; D005260:Female; D015658:HIV Infections / Q000175:diagnosis* / Q000453:epidemiology*; D006297:Health Services Accessibility; D006801:Humans; D007630:Kenya / Q000453:epidemiology; D008875:Middle Aged; D011247:Pregnancy; D011295:Prenatal Care; D011296:Prenatal Diagnosis; D015995:Prevalence; D012959:Socioeconomic Factors; D055815:Young Adult