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Sabin L, Haghparast-Bidgoli H, Miller F, Saville N. A systematic review of barriers and facilitators to antenatal screening for HIV, syphilis or hepatitis B in Asia: Perspectives of pregnant women, their relatives and health care providers. PLoS One 2024; 19:e0300581. [PMID: 38820339 PMCID: PMC11142523 DOI: 10.1371/journal.pone.0300581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 02/29/2024] [Indexed: 06/02/2024] Open
Abstract
BACKGROUND Despite improvements, the prevalence of HIV, syphilis, and hepatitis B remains high in Asia. These sexually transmitted infections (STIs) can be transmitted from infected mothers to their children. Antenatal screening and treatment are effective interventions to prevent mother-to-child transmission (MTCT), but coverage of antenatal screening remains low. Understanding factors influencing antenatal screening is essential to increase its uptake and design effective interventions. This systematic literature review aims to investigate barriers and facilitators to antenatal screening for HIV, syphilis, and hepatitis B in Asia. METHODS We conducted a systematic review by searching Ovid (MEDLINE, Embase, PsycINFO), Scopus, Global Index Medicus and Web of Science for published articles between January 2000 and June 2023, and screening abstracts and full articles. Eligible studies include peer-reviewed journal articles of quantitative, qualitative and mixed-method studies that explored factors influencing the use of antenatal screening for HIV, syphilis or hepatitis B in Asia. We extracted key information including study characteristics, sample, aim, identified barriers and facilitators to screening. We conducted a narrative synthesis to summarise the findings and presented barriers and facilitators following Andersen's conceptual model. RESULTS The literature search revealed 23 articles suitable for inclusion, 19 used quantitative methods, 3 qualitative and one mixed method. We found only three studies on syphilis screening and one on hepatitis B. The analysis demonstrates that antenatal screening for HIV in Asia is influenced by many barriers and facilitators including (1) predisposing characteristics of pregnant women (age, education level, knowledge) (2) enabling factors (wealth, place of residence, husband support, health facilities characteristics, health workers support and training) (3) need factors of pregnant women (risk perception, perceived benefits of screening). CONCLUSION Knowledge of identified barriers to antenatal screening may support implementation of appropriate interventions to prevent MTCT and help countries achieve Sustainable Development Goals' targets for HIV and STIs.
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Affiliation(s)
- Lucie Sabin
- Institute for Global Health, University College London, London, United Kingdom
| | | | - Faith Miller
- Institute for Global Health, University College London, London, United Kingdom
| | - Naomi Saville
- Institute for Global Health, University College London, London, United Kingdom
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Sharma SK, Vishwakarma D. Socioeconomic inequalities in the HIV testing during antenatal care: evidence from Indian demographic health survey, 2015–16. BMC Public Health 2022; 22:979. [PMID: 35570285 PMCID: PMC9107761 DOI: 10.1186/s12889-022-13392-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Accepted: 05/06/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
In India, there is currently a lack of data on socioeconomic inequalities in HIV testing on a national scale; thus, understanding socioeconomic inequalities in response to expanded HIV testing is critical for assessing and ensuring equity of HIV programmes in accordance with the Sustainable Development Goals. The specific objective of the study was to determine the factor associated with HIV testing during antenatal care and assess the socio-economic inequalities in HIV testing during antenatal care (ANC) among Indian women aged 15–49 years with a live birth in the two years preceding the survey.
Methods
The results drawn from the state module of women data file of fourth round of National Family Health Survey (NFHS-4, 2015–16), considering HIV testing during antenatal care among women aged 15–49 who gave live birth in the two years preceding the survey and received the result of HIV test as a matter of fact. Method, such as, descriptive statistics, binary ogistic regression, concentration index were used in the analysis.
Results
The findings of the study show that HIV testing during antenatal care was low (30%) among women in India. Our findings reveal that there were significant inequalities exist in HIV testing during ANC between richer and poorer quintile of women. Education, place of residence, comprehensive knowledge of HIV/AIDS, and regular exposure of mass media were substantially contributing to socioeconomic inequality in HIV testing during ANC among women in India.
Conclusions
The socioeconomic inequities in HIV testing during pregnancy should be monitored and addressed in order to ensure an equitable distribution of the benefits specially among children and accomplishments of HIV programs in India.
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Chu DT, Vo HL, Tran DK, Nguyen Si Anh H, Bao Hoang L, Tran Nhu P, Nguyen Ngoc K, Thu Nguyen T, Pham Van Q, Tien NLB, Thanh VV, Nga VT, Luu Quang T, Minh LB, Pham VH. Socioeconomic Inequalities in the HIV Testing during Antenatal Care in Vietnamese Women. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E3240. [PMID: 31487845 PMCID: PMC6765951 DOI: 10.3390/ijerph16183240] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Revised: 08/30/2019] [Accepted: 09/01/2019] [Indexed: 11/16/2022]
Abstract
Although HIV (human immunodeficiency virus) testing for all women has been promoted by Vietnam's Ministry of Health since 2000, test acceptance rates in this country were reported to be less than 30% in the community. This country has been facing the barriers to approach the national services towards transmission prevention from mother to child including HIV testing during antenatal care (ANC) towards mothers. Here, we aim to assess the socioeconomic inequalities in HIV testing during ANC among Vietnamese women. This study used available data from the Vietnam Multiple Indicator Cluster Survey 2014. Overall, the prevalence of HIV testing during antenatal care was 30% and the concentrate index (CCI) was 0.1926. There was significant inequality between women classified as poor and rich, and when stratified by social characteristics, inequality was found in women aged 15-49 years (CCI: 0.4), living in rural areas (CCI: 0.3), belonging to ethnic minorities (CCI: 0.5) and having primary or less education (CCI: 0.4). In the multivariate logistic regression analysis, ethnicity and socioeconomic status were significant factors associated with HIV testing during ANC. We found the prevalence of HIV testing during ANC was low, and its inequalities were associated with age, living area, ethnicity, education, and economic status.
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Affiliation(s)
- Dinh-Toi Chu
- Faculty of Biology, Hanoi National University of Education, Hanoi 100000, Vietnam.
| | - Hoang-Long Vo
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi 100000, Vietnam.
| | - Dang-Khoa Tran
- Department of Anatomy, University of Medicine Pham Ngoc Thach, Ho Chi Minh City 700000, Vietnam.
| | - Hao Nguyen Si Anh
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi 100000, Vietnam.
| | - Long Bao Hoang
- Institute of Gastroenterology and Hepatology, Hanoi 100000, Vietnam.
| | - Phong Tran Nhu
- Public Health Department, Nursing Faculty, Dai Nam University, Hanoi 100000, Vietnam.
| | - Khanh Nguyen Ngoc
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi 100000, Vietnam.
| | - Trang Thu Nguyen
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi 100000, Vietnam.
| | - Quyet Pham Van
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi 100000, Vietnam.
| | - Nguyen Le Bao Tien
- Institute of Orthopaedics and Trauma Surgery, Viet Duc Hospital, Hanoi 100000, Vietnam.
| | - Vo Van Thanh
- Institute of Orthopaedics and Trauma Surgery, Viet Duc Hospital, Hanoi 100000, Vietnam.
- Department of Surgery, Hanoi Medical University, Hanoi 100000, Vietnam.
| | - Vu Thi Nga
- Institute for Research and Development, Duy Tan University, Danang 550000, Vietnam.
| | - Thuy Luu Quang
- Center for Anesthesia and Surgical Intensive Care, Viet Duc Hospital, Hanoi 100000, Vietnam.
| | - Le Bui Minh
- NTT Hi-tech Institute, Nguyen Tat Thanh University, 300A Nguyen Tat Thanh St., Ward 13, District 4, Ho Chi Minh City 700000, Vietnam.
| | - Van Huy Pham
- AI Lab, Faculty of Information Technology, Ton Duc Thang University, Ho Chi Minh City 700000, Vietnam.
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Kien VD, Jat TR, Phu TV, Cuong LM, Anh VTM, Chu NV, Duong TT, Long VH, Dung TC. Trends in Socioeconomic Inequalities in the Use of Antenatal Care Services by Women Aged 15 to 49 Years in Vietnam. Asia Pac J Public Health 2019; 31:413-421. [PMID: 31232081 DOI: 10.1177/1010539519857305] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Despite considerable variations in the use of antenatal care (ANC) services in Vietnam, limited information is available on socioeconomic inequalities concerning the use of ANC services. This study aimed to assess the trends and changes in socioeconomic inequalities in the use of ANC services by women aged 15 to 49 years in Vietnam from 2006 to 2014. We used data from the Multiple Indicator Cluster Survey conducted in 2006, 2011, and 2014. The percentage of women who received ANC services increased significantly from 26.5% in 2006 to 42.7% in 2011 and reached 56.6% in 2014. We found a decreasing trend in the concentration indices of the use of ANC services from 0.36 in 2006 to 0.19 in 2014. The common factors significantly associated with the higher percentage of the use of ANC services in 2006, 2011, and 2014 were women belonging to the Kinh and Hoa ethnic groups and belonging to wealthier groups. Our study showed a reduction in socioeconomic inequality in the use of ANC services between 2004 and 2014. However, significant inequalities still exist in the use of ANC services based on women’s education, ethnicity, and economic status.
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Affiliation(s)
- Vu Duy Kien
- OnCare Medical Technology Company Limited, Hanoi, Vietnam
| | - Tej Ram Jat
- United Nations Population Fund, Vientiane, Lao PDR
| | - Tran Van Phu
- Vietnam University of Traditional Medicine, Hanoi, Vietnam
| | - Le Manh Cuong
- National Hospital of Traditional Medicine, Hanoi, Vietnam
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Factors Associated with Receiving Late HIV Testing Among Women Delivering at Hung Vuong Hospital, Ho Chi Minh City, Vietnam, 2014. AIDS Behav 2018; 22:629-636. [PMID: 28181013 DOI: 10.1007/s10461-017-1692-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
HIV testing during pregnancy facilitates timely antiretroviral treatment for HIV-positive women. This study identifies reasons for late HIV testing among pregnant women delivering at a hospital in Ho Chi Minh City. We conducted a case-control study in which 160 cases were women who were tested for HIV late (i.e., at labor and delivery) and 160 controls were women who were tested during antenatal care (ANC). In multivariable logistic regression analysis, six variables were associated with late HIV testing: age less than 30 years, nine or fewer years of education, working as a homemaker or worker/farmer, living 20 km or more from the hospital, having received ANC at a private clinic/hospital only, and not believing that HIV testing is important during pregnancy. We recommend that national programs should provide additional effort for HIV testing during pregnancy to young women, less educated women, homemakers, and those receiving ANC at private clinics and hospitals.
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Alemu YM, Ambaw F, Wilder-Smith A. Utilization of HIV testing services among pregnant mothers in low income primary care settings in northern Ethiopia: a cross sectional study. BMC Pregnancy Childbirth 2017. [PMID: 28646888 PMCID: PMC5483315 DOI: 10.1186/s12884-017-1389-2] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Background HIV testing of women in child bearing age is an entry point for preventing mother-to-child transmission of HIV (MTCT). This study aims to identify the proportion of women tested for HIV and to determine factors associated with utilization of HIV testing services among pregnant mothers in primary care settings in northern Ethiopia. Methods A cross sectional study was conducted in 416 pregnant women from four primary care centers between October 2, 2012 and May 31, 2013 in East Gojjam, Ethiopia. Results The proportion of mothers who tested for HIV was 277(67%). Among mothers who were not tested for HIV, lack of HIV risk perception (n = 68, 49%) was a major self-reported barrier for HIV testing. A multivariable logistic regression analysis showed that those pregnant women who had comprehensive knowledge about MTCT had an Adjusted Odd Ratio (AOR) of 3.73 (95% CI: 1.56, 8.94), having comprehensive knowledge on prevention of mother to child transmission (PMTCT) of HIV an AOR of 2.56 (95% CI: 1.26, 5.19), and a favorable attitude towards persons living with HIV an AOR of 2.42 (95%CI, 1.20, 4.86) were more likely to be tested for HIV. Conclusion One third of pregnant women had never been tested for HIV until the time of the study. Efforts should be made to improve mother’s knowledge about MTCT and PMTCT to increase uptake of HIV testing. Enhancing mother’s HIV risk perception to scale up HIV testing in resource limited setting is highly recommended. Electronic supplementary material The online version of this article (doi:10.1186/s12884-017-1389-2) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Yihun Mulugeta Alemu
- Institute of Public Health, Heidelberg University, Heidelberg, Germany. .,School of Public Health, College of Medicine and Health Science, Bahir Dar University, Bahir Dar, Ethiopia.
| | - Fentie Ambaw
- School of Public Health, College of Medicine and Health Science, Bahir Dar University, Bahir Dar, Ethiopia
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Messersmith LJ, Semrau K, Anh TL, Trang NNN, Hoa DM, Eifler K, Sabin L. Women living with HIV in Vietnam: desire for children, use of sexual and reproductive health services, and advice from providers. REPRODUCTIVE HEALTH MATTERS 2013. [PMID: 23177678 DOI: 10.1016/s0968-8080(12)39640-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
In Vietnam, despite the possibility of living healthy sexual lives and bearing children due to the increasing availability of antiretroviral therapy and prevention of mother-to-child transmission services, HIV programming has given little attention to the sexual and reproductive health of people living with HIV. Our study explored factors influencing sexual and reproductive health decision-making, needs, rights and access to services for women living with HIV in Hai Phong and Ho Chi Minh City. Nearly half of the women were sexually active at the time of the study and 15% reported wanting a child or another child. Only 14% of women who did not want a child used contraceptive services in the last six months. More than 40% of women reported being advised, primarily by health care providers and family members, to abstain from sex, and more than 13% who were pregnant at the time of the study said that they had been advised to have an abortion. As with all women, women living with HIV must be informed of their sexual and reproductive rights and must have access to medically sound counseling and services to facilitate informed reproductive health decision-making. Sexual and reproductive health services are urgently needed for this population.
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Affiliation(s)
- Lisa J Messersmith
- Department of International Health, Boston University School of Public Health, Boston, MA, USA.
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Conseil A, Mounier-Jack S, Rudge JW, Coker R. Assessing the effects of HIV/AIDS and TB disease control programmes on health systems in low- and middle-income countries of Southeast Asia: a semi-systematic review of the literature. Public Health 2013; 127:1063-73. [PMID: 24275033 DOI: 10.1016/j.puhe.2013.09.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2012] [Accepted: 09/23/2013] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To systematically review the literature on if and how HIV/AIDS and TB programmes have impacted on general healthcare systems in Association of Southeast Asian Nations (ASEAN) countries. METHODS Medline, Embase, Global Health and CINHAL were searched for English language literature published between 1st January 2003 and 31st March 2011. Papers included had to focus on: HIV and/or TB control programmes; the low- and-middle-income ASEAN countries; and factors related to any health systems functions. The effects were examined along six system functions: Stewardship and Governance; Financing; Planning; Service Delivery; Monitoring and Evaluation; and Demand Generation. A comprehensive thematic analytical tool aligned with the above six health systems functions was developed to support data extraction and analysis. FINDINGS 88 papers met the inclusion criteria. Most programme effects highlighted were related with health service delivery. The other five health system functions were seldom scrutinized, and each covered by less than a quarter of papers. Overall 69% of effects highlighted were positive effects whereas 31% were negative. CONCLUSION There was a paucity of robust evidence. Effects on health systems were rarely a focus of research protocols but more often a minor component in the Results/Discussion sections. Particular attention should be paid by Global Health Initiatives to the negative effects that emerged from this study, such as the development of parallel systems, specific incentives not available to the general health systems, and lack of integration of services with private healthcare providers.
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Affiliation(s)
- A Conseil
- Department of Global Health Development, Faculty of Public Health Policy, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London WC1H 9SH, UK.
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Samrith W, Rahman M, Harun-Or-Rashid M, Sakamoto J. Trends and Barriers to HIV Testing Among Tuberculosis Patients in Prey Kabas Operational District, Takeo Province, Cambodia. Asia Pac J Public Health 2012; 27:NP789-97. [DOI: 10.1177/1010539512445190] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Data for this study were obtained from 2375 tuberculosis (TB) patients registered during 2007-2009 and 43 health providers to examine the trend of TB patient referral for HIV (human immunodeficiency virus) testing and to investigate provider-associated barriers to the referral in Prey Kabas operational district, Takeo province, Cambodia. Referral rate for HIV testing was 4.4% (30/684) in 2007, 15.4% (116/751) in 2008, and 30.1% (283/940) in 2009, with a significant upward trend over the period of time ( P = .009). The main barriers perceived by health providers were poor knowledge about TB/HIV, lack of communication skills, absence of any target plan for TB patient referral for HIV testing, and fear associated with informing positive test results to the TB patients and the associated stigma. Strategies to raise awareness about HIV/AIDS/TB among TB patients and their providers may improve the current state of low referral and its barriers in Cambodia.
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Affiliation(s)
- Wannak Samrith
- Nagoya University Graduate School of Medicine, Nagoya, Japan
- Ministry of Health, Takhmao Town, Cambodia
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Hạnh NTT, Gammeltoft TM, Rasch V. Number and timing of antenatal HIV testing: evidence from a community-based study in Northern Vietnam. BMC Public Health 2011; 11:183. [PMID: 21439043 PMCID: PMC3078880 DOI: 10.1186/1471-2458-11-183] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2010] [Accepted: 03/25/2011] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND HIV testing for pregnant women is an important component for the success of prevention of mother-to-child transmission of HIV (PMTCT). A lack of antenatal HIV testing results in loss of benefits for HIV-infected mothers and their children. However, the provision of unnecessary repeat tests at a very late stage of pregnancy will reduce the beneficial effects of PMTCT and impose unnecessary costs for the individual woman as well as the health system. This study aims to assess the number and timing of antenatal HIV testing in a low-income setting where PMTCT programmes have been scaled up to reach first level health facilities. METHODS A cross-sectional community-based study was conducted among 1108 recently delivered mothers through face-to-face interviews following a structured questionnaire that focused on socio-economic characteristics, experiences of antenatal care and HIV testing. RESULTS The prevalence of women who lacked HIV testing among the study group was 10% while more than half of the women tested had had more than two tests during pregnancy. The following factors were associated with the lack of antenatal HIV test: having two children (aOR 2.1, 95% CI 1.3-3.4), living in a remote rural area (aOR 7.8, 95% CI 3.4-17.8), late antenatal care attendance (aOR 3.6, 95% CI 1.3-10.1) and not being informed about PMTCT at their first antenatal care visits (aOR 7.4, 95% CI 2.6-21.1). Among women who had multiple tests, 80% had the second test after 36 weeks of gestation. Women who had first ANC and first HIV testing at health facilities at primary level were more likely to be tested multiple times (OR 2.9 95% CI 1.9-4.3 and OR = 4.7 95% CI 3.5-6.4), respectively. CONCLUSIONS Not having an HIV test during pregnancy was associated with poor socio-economic characteristics among the women and with not receiving information about PMTCT at the first ANC visit. Multiple testing during pregnancy prevailed; the second tests were often provided at a late stage of gestation.
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Affiliation(s)
- Nguyễn TT Hạnh
- Department of Population, Institute for Preventive Medicine and Public Health, Hanoi Medical University, No.1 Ton That Tung Street, Khuong Thuong, Dong Da, Hanoi, Vietnam
| | - Tine M Gammeltoft
- Department of Anthropology, University of Copenhagen, Øster Farimagsgade 5, DK-1353 Copenhagen K, Denmark
| | - Vibeke Rasch
- Department of International Health, Immunology and Microbiology, Faculty of Health Sciences, University of Copenhagen, Øster Farimagsgade 5, DK-1014 Copenhagen, Denmark
- Department of Obstetrics and Gynaecology, Odense University Hospital, 5000 Odense C, Denmark
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