Abstract
HIV counseling and testing (HCT) is a critical gateway to treatment, care, and support services. For pregnant women, it is to access prevention of mother-to-child-transmission (PMTCT) services. However, not much has been done to appraise this service from the perspective of the recipients in Nigeria. This study documents the appraisal of the HCT services received at the antenatal care (ANC) services in three government hospitals in Ibadan, Nigeria, from the perspectives of pregnant women. Data were collected using focus group discussion guide among purposively selected 40 (21 primigravida and 19 multigravida) pregnant women. Observation and inventory checklists were used to collect data on procedures and basic requirements of HCT. Content analysis was used to analyze the data. Participants were neither counseled nor given opportunity to voluntarily participate in HCT services as it was made compulsory before accessing ANC. Test results were reportedly handed over directly to participants without post-test counseling. Observation of HCT procedure showed that guidelines for counseling were not strictly adhered to. Inventory of facilities, staff, and materials revealed inadequate staffing, lack of a dedicated counseling room, and inadequate antiretroviral drugs and test kits. The HCT services as provided for pregnant women are fraught with procedural inadequacies. Training and supervision of health care workers as well as provision of resources are needed to address the situation.
Highlights
Mother-to-child transmission [MTCT] is the main cause of HIV infection in children (Karamagi, Tumwine, Tylleskar, & Heggenhougen, 2006)
The quality and uptake of the service vary, and it has been documented that even when HIV testing is offered as a part of antenatal care (ANC), many women are still tested for the first time only as they go into labor and do not get the full benefit from the prevention of mother-to-child-transmission (PMTCT) program (Morch, Thu Anh, Ha, & Hanh, 2006; Pai et al, 2008)
The focus group discussion (FGD) guide was used to ensure that similar topics were covered during the discussion as well as allowing participants to express their perceptions and lived experiences of the HIV counseling and testing (HCT) services received during ANC
Summary
Mother-to-child transmission [MTCT] is the main cause of HIV infection in children (Karamagi, Tumwine, Tylleskar, & Heggenhougen, 2006). SAGE Open status can empower individuals and couples to take measures to prevent HIV acquisition or onward transmission For those already infected, a positive test result is necessary to access treatment and, in the case of pregnant women, to access PMTCT services (Higgins et al, 1991; WHO; 2003). Prior to the WHO guidance, numerous countries had adopted the models of PITC in clinical settings, in antenatal clinics in response to evidence of the effectiveness of antiretrovirals (ARV) in reducing MTCT and the urgent need to provide access to PMTCT services to pregnant women with HIV (Centers for Disease Control & Prevention, 2008; Seipone, 2004). This study was designed to bridge this gap by appraising the procedures and basic requirements of HCT services provided for pregnant women at the antenatal clinics of three governmentowned hospitals in Ibadan Southwest Nigeria against the approved standard HCT service at the antenatal clinics
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