Women's knowledge about treatment to prevent mother-to-child human immunodeficiency virus transmission

Systematic review and meta-analysis of knowledge on PMTCT of HIV/AIDS and Association factors among reproductive age women in Ethiopia, 2022

BACKGROUND

Despite increased interventions implemented for the prevention of mother-to-child transmission of HIV, There is still a vertical transmission. Hence, this study tried to assess the pooled prevalence of knowledge on PMTCT and factors associated with residence, ANC follow-up, and knowledge about HIV/AIDS among reproductive age women in Ethiopia.

METHODS

The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline was followed to review either published or unpublished studies in Ethiopia regarding knowledge on PMTCT. A comprehensive search of international databases, including Google Scholar, Cochrane Library, PubMed, HINARI, Embrace, Web of Science, Scopus, ProQuest, CINAHL, and Global Health, were searched. The data were analyzed using STATA/SE version 14. The random-effect model was used to estimate the effect size, and I-squared statistics and Egger's test were used to assess the heterogeneity and publication bias, respectively.

RESULTS

14 out of 14,091 assessed articles met inclusion criteria and were included in the analysis. The estimated pooled level of knowledge on PMTCT among reproductive-age groups was 62.15% [(95% CI: 43.63-80.66)]. Residence [(OR = 4.8, 95%CI: 2.99, 7.85)], ANC follow-up [(OR = 4.2, 95%CI: 2.21, 7.98)], and having sufficient knowledge about the diseases [(OR = 4.9, 95% CI: 3.6, 6.66)] were found to be significant predictors of knowledge on PMTCT among reproductive-age groups.

CONCLUSION

Strategies to improve the knowledge of PMTCT in Ethiopia should focus on rural women, improving knowledge about HIV/AIDS, and ANC follow-up. Efforts are also needed to involve husbands and related organization in the prevention of mother to child transmission of HIV.

Knowledge about mother to child transmission of HIV/AIDS, its prevention and associated factors among reproductive-age women in sub-Saharan Africa: Evidence from 33 countries recent Demographic and Health Surveys

BACKGROUND

In sub-Saharan Africa (SSA) 90 percent of babies acquired HIV/AIDS from infected mothers. Maternal knowledge about mother to child transmission (MTCT) of HIV/AIDS and its prevention is a cornerstone for elimination of MTCT of HIV/AIDS. Despite this, there is limited evidence about knowledge about MTCT of HIV/AIDS and its prevention and associated factors in SSA. Therefore, this study aimed to assess knowledge of MTCT of HIV/AIDS, its prevention (PMTCT) and, associated factors among reproductive-age women in sub-Saharan Africa.

OBJECTIVE

To assess Knowledge about mother to child transmission of HIV/AIDS and its prevention and associated factors among reproductive-age women in Sub-Saharan Africa.

METHODS

The recent SSA countries' Demographic and Health Surveys (DHS), which were conducted from 2008/09 to 2018/19, was our data source. We appended 33 countries' DHS data for our analysis. For our study, a total weighted sample of 350,888 reproductive-age women was used. Due to the hierarchical nature of the DHS data, we conducted a multilevel analysis. Finally, the adjusted odds ratio with its 95% confidence interval was reported, and variables with p-value≤0.05 were considered as significant predictors of knowledge of MTCT of HIV/AIDS and its prevention.

RESULTS

In this study, 56.21% (95% CI: 56.05-56.38) of respondents had correct knowledge about MTCT of HIV/AIDS and its prevention among reproductive-age women in SSA. In the multilevel logistic regression analysis: being in the older age group, better education level, being from a rich household, having mass media exposure, having parity of one and above were associated with higher odds of knowledge about MTCT of HIV/AIDS and its prevention. However, being perceiving distance from the health facility as a big problem was associated with lower odds of knowledge about MTCT of HIV/AIDS and its prevention.

CONCLUSION

Knowledge about MTCT of HIV/AIDS and its prevention among reproductive-age women in SSA was low. Therefore, it is better to consider the high-risk groups during the intervention to increase awareness about this essential public health issue and to tackle its devastating outcome.

HIV testing among pregnant women with prenatal care in the United States: An analysis of the 2011-2017 National Survey of Family Growth

Although there has been significant progress in reducing perinatal human immunodeficiency virus (HIV) transmission, the United States is yet to meet the proposed elimination goal of less than one infection per 100,000 live births. Failure to screen all pregnant women for HIV as recommended by the Centers for Disease Control and Prevention can result in missed opportunities for preventing vertical transmission of HIV with antiretroviral drugs. Using the 2011-2017 National Survey of Family Growth, this study examined HIV testing among pregnant women during prenatal care. We estimated the weighted proportion of self-reported HIV testing among women whose last pregnancy ended within 12 months prior to the interview. Logistic regression models were used to determine the factors associated with HIV testing. Of the 1566 women included in the study, 76.4% (95% confidence intervals [CI] = 72.8-80.0) reported receiving an HIV test during prenatal care. In the multivariable regression model, high school diploma (adjusted odds ratio [aOR] = 1.9, 95% CI = 1.1-3.1), two completed pregnancies (aOR = 1.7, 95% CI = 1.1-2.7), health insurance coverage in the last 12 months (aOR = 1.6, 95% CI = 1.0-2.6), Hispanic race/ethnicity (aOR = 2.8, 95% CI = 1.8-4.4), and non-Hispanic black race/ethnicity (aOR = 2.2, 95% CI = 1.3-3.8) were associated with higher odds of reporting being tested for HIV. However, household income of 300% or more of the federal poverty level (aOR = 0.6, 95% CI = 0.3-0.9) and urban residence (aOR = 0.5, 95% CI = 0.3-0.9) were associated with lower odds of reporting HIV testing. These findings suggest that HIV testing among pregnant women during prenatal care is not universal and may affect achieving the goal of elimination of mother-to-child transmission of HIV in the United States.

HIV Knowledge Among Pregnant Latinas in Rural South Carolina

To inform and strengthen culturally-tailored HIV perinatal prevention, we assessed HIV knowledge among pregnant Latinas receiving prenatal care in rural South Carolina. We administered an 11 item HIV knowledge scale (n = 171). Women who answered 8 of 11 (73 %) items correctly were categorized as having "high" knowledge; <8 items correct was categorized as "low" knowledge. Seventy-six percent of participants had low HIV knowledge; only 37 % knew that there is medicine to prevent mother-to-child HIV transmission. In multivariate analyses, high HIV knowledge was more likely among women who had ≥high school education compared with women with elementary school education only (Adjusted Odds Ratio 10.5, 95 % Confidence Interval 3.3-33.6). These findings highlight the need for targeted educational interventions to better inform Latinas regarding perinatal HIV prevention and transmission risks. Enhancing efforts with patients and providers is aligned with national goals for HIV prevention and elimination of perinatal transmission.

Knowledge of HIV transmission through breast milk among drug-dependent pregnant women

Abstract The current study examined the correlates of knowledge about human immunodeficiency virus (HIV) transmission through breast milk among drug-dependent pregnant women. There is a tremendous need to examine the knowledge about HIV transmission through breastfeeding among this largely understudied, but high-risk subset of pregnant women in order to minimize the extent to which they pass HIV to their children after giving birth. Participants included 97 pregnant women from Baltimore, MD, USA. Prevalence of drug use over the last 6 months included 37.1% reporting smoking marijuana, 36.1% injecting heroin, and 67.0% smoking crack. When asked whether HIV could be transmitted through breast milk, 72 women (74.2%) answered correctly. Our results indicate that the overall knowledge about transmission through breast milk is relatively low. Furthermore, participants who smoked crack during the past 6 months and participants who were white were significantly less likely to have correct knowledge about this topic. Our findings have important implications with regard to preventive interventions for this population. Future research is needed to determine how to best modify these interventions to address the specific needs of drug-dependent pregnant women, and how to specifically target white women and women who smoke crack.

Women's opinions about routine HIV testing during pregnancy: implications for the opt-out approach

The 1995 United States Public Health Service (USPHS) recommendation regarding HIV testing for pregnant women was revised in 2003 calling for routine HIV testing for pregnant women with patient notification. Routine testing (opt-out screening) offers women the opportunity to decline HIV testing but eliminates the requirement of pretest counseling and separate written consent. To assess women's opinions about the opt-out approach to HIV testing during pregnancy, a cross-sectional survey was conducted in May-June 2004 at 14 geographically diverse clinics funded by Ryan White CARE Act (RWCA) Part C and Part D agreements. Of 853 women respondents to the one-page, self-completed survey questionnaire, 90% agreed with routine HIV testing and 91% reported being comfortable with testing, demonstrating that the large majority of women agree with and support HIV testing as a part of routine prenatal care. Women's opinions were associated with HIV testing status, e.g., 76% of women who had never been tested for HIV thought HIV testing should be part of a routine pregnancy check-up as compared with women who were HIV-negative (93%) or HIV-positive (90%) (chi(2) = 31.3943, p < 0.0001). Comfort with HIV testing was associated with higher HIV knowledge. Approximately half of the respondents indicated that HIV tests are different from other tests and that women need more information prior to testing. Results demonstrated clear consensus in support of routine testing. Increased efforts to disseminate resources to providers coupled with providers' effective communication of information to pregnant women can build on the support that women have conveyed for HIV testing during pregnancy.

Physical and sexual abuse and unstable housing among adolescents with HIV

Stable housing is a necessary component of treatment of adolescents with HIV. This study examines the housing status at two points in time of a sample of 224 adolescents with HIV seen at an adolescent medicine clinic in New York City. It addresses whether unstable housing is associated with several forms of abuse, and what factors predict continued instability. 38.6% (n = 86) had a prior history of unstable housing, reduced to 12.9% at the time of program entry. Multivariate logistic regression models predicting current and prior unstable housing revealed two variables related to both outcomes: physical abuse and referral from youth/social services entities. Continued unstable housing was associated with all abuse variables and adolescent history of arrest. When adolescents in abusive situations come to the attention of programs for youth, they have a positive impact on transitioning most adolescents to safer households, potentially improving adolescents' accessing of health care services.

Effectiveness of antenatal group HIV voluntary counseling and testing services in rural India

This study assessed HIV attitudes among pregnant women attending antenatal clinics in the Namakkal district of Tamilnadu, India, as well as HIV knowledge before and after group counseling sessions. Two hundred thirteen women (97%) attending five antenatal clinics in July 2004 accepted HIV counseling and testing and completed precounseling and postcounseling questionnaires. Although the majority of women had heard of HIV, precounseling knowledge was low (mean precounseling score; 6.9/18, SD: 4.53), with scores correlating with the women's educational level and the number of sources from which they had received information about HIV. Posttest scores increased by 21%, however, understanding of modalities to prevent HIV infection remained poor. Group counseling sessions achieve small gains in HIV knowledge, but there is a continued need for ongoing and multifaceted HIV education in rural India.

HIV testing in a national sample of pregnant US women: Who is not getting tested?

It is recommended that all pregnant women in the US receive an HIV test as early as possible during prenatal care to allow HIV-infected women to begin receiving anti-retroviral drugs when they most effectively prevent transmission. We analyzed interview data from a nationally-representative sample of pregnant women to examine the extent of HIV testing among pregnant women and the characteristics associated with testing, including access to healthcare. We used data from the combined 2001 and 2002 Behavioral Risk Factor Surveillance System, a nationally-representative telephone-based behavioral survey of adults, aggregated across all states to yield national estimates. Among 4,855 women pregnant at interview we looked at the percentages recently tested and never tested by major populations subgroups and assessed differences using chi-square tests and multiple logistic regression analysis. Pregnant women were tested at a much higher rate than other women of the same age - 54.1% had been tested in the past year compared with 15.4% of non-pregnant women. Categories of pregnant women that were more likely to never have been tested for HIV include those without a health plan or insurance (adjusted odds ratio (AOR): 1.6) and those without a personal doctor (AOR: 1.7). Women with knowledge of methods to prevent perinatal HIV transmission were less likely to have never been tested (AOR: 0.8). Attaining the recommended goal of universal prenatal testing will require attention to women without personal doctors or health insurance.

Assessing the efficacy of a voluntary HIV counseling and testing intervention for pregnant women and male partners in Urumqi City, China

This study investigated the efficacy of voluntary counseling and testing (VCT) in an educated cohort of pregnant women attending antenatal clinics in Urumqi, China. VCT was given to women and their partners (experimental group) or women alone (control group). Both groups were given pre- and post-intervention questionnaires to assess HIV knowledge and willingness to get HIV testing. Multivariate analysis showed that all women improved significantly in HIV knowledge between baseline and follow-up. Moreover, HIV knowledge was significantly associated with HIV testing willingness. At follow-up, women in the control and experimental groups were 6.8 and 7.9 times more willing to receive HIV testing than at baseline, respectively. VCT seems effective in this cohort of educated pregnant women.

HIV Testing Among U.S. Women During Prenatal Care: Findings from the 2002 National Survey of Family Growth

OBJECTIVES

To measure progress toward the US Public Health Service recommended goal that HIV screening be part of the routine battery of prenatal tests for all pregnant women, using data from a nationally-representative reproductive health survey.

METHODS

Data from the 2002 National Survey of Family Growth (NSFG) measure self-reported prenatal HIV testing for all women who had a completed pregnancy in the 12 months before interview. We estimated the percentage with a prenatal test for categories defined by major socio-economic groups, HIV risk, knowledge of HIV treatment, and access to health care.

RESULTS

Sixty-nine percent of 748 recently pregnant women reported receiving a prenatal HIV test. The percentage tested was significantly higher for women with incomes below 300% of the poverty level (76%) and women who reported some degree of HIV risk (82%), suggesting that prenatal care providers offer and encourage testing based on perceived risk, even though universal HIV screening is recommended. Testing was also higher among women with knowledge of interventions to prevent perinatal HIV transmission (74%), suggesting that more public information on these treatments might be helpful.

CONCLUSIONS

A national estimate indicates that nearly one in 3 recently pregnant women reported they were not tested for HIV during prenatal care. Studies showing that prenatal testing for other infectious diseases can approach 100% suggest that a similar level of testing is attainable for perinatal HIV screening, particularly if it is incorporated into the routine package of prenatal tests and procedures offered to all pregnant women.