Acceptability of intrapartum HIV counselling and testing in Cameroon

Eugene J Kongnyuy,Nelson Fomulu,Philip N Nana,Rebecca N Tonye,Robert Ji Leke,Enow R Mbu,Pierre M Tebeu,Francois X Mbopi-Keou

doi:10.1186/1471-2393-9-9

Eugene J Kongnyuy, Nelson Fomulu + Show 6 more

Open Access

https://doi.org/10.1186/1471-2393-9-9

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Abstract

BackgroundTo assess the acceptability of intrapartum HIV testing and determine the prevalence of HIV among labouring women with unknown HIV status in Cameroon.MethodThe study was conducted in four hospitals (two referral and two districts hospitals) in Cameroon. Labouring women with unknown HIV status were counselled and those who accepted were tested for HIV.ResultsA total of 2413 women were counselled and 2130 (88.3%) accepted to be tested for HIV. Of the 2130 women tested, 214 (10.1%) were HIV positive. Acceptability of HIV testing during labour was negatively associated with maternal age, parity and number of antenatal visits, but positively associated with level of education. HIV sero-status was positively associated with maternal age, parity, number of antenatal visits and level education.ConclusionAcceptability of intrapartum HIV testing is high and the prevalence of HIV is also high among women with unknown HIV sero-status in Cameroon. We recommend an opt-out approach (where women are informed that HIV testing will be routine during labour if HIV status is unknown but each person may decline to be tested) for Cameroon and countries with similar social profiles.

Highlights

IntroductionThe traditional method for preventing mother-to-child transmission (MTCT) of Human Immunodeficiency Virus (HIV) is voluntary testing during antenatal care and provision of antiretroviral prophylaxis to the HIV-infected women and their newborns [3,4]
To assess the acceptability of intrapartum Human Immunodeficiency Virus (HIV) testing and determine the prevalence of HIV among labouring women with unknown HIV status in Cameroon
We reported a negative association between acceptability of HIV testing during labour on one hand, and maternal age and number of antenatal visits on the other hand

Summary

Introduction

The traditional method for preventing mother-to-child transmission (MTCT) of HIV is voluntary testing during antenatal care and provision of antiretroviral prophylaxis to the HIV-infected women and their newborns [3,4]. In settings where many women give birth with unknown HIV status either because of low antenatal attendance or otherwise, HIV testing during labour provides the last window of opportunity before delivery for interventions to reduce MTCT of HIV [7,8]. A recent study in the USA reported that out of 190 labouring women who underwent rapid HIV testing, 7 were found positive. The authors suggested that availability of rapid HIV testing on labour and delivery units should not replace rigorous prenatal screening, which is currently the standard method screening for HIV during pregnancy. A two-step rapid HIV testing, parallel testing, has been reported to be superior to single test strategy and is comparable to standard testing [4]

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