Abstract
Background: Globally, an estimated 150,000 children were newly infected with HIV in 2015, over 90% of them in Sub-Saharan Africa. In Zambia, ~500,000 babies are born to HIV positive mothers every year, and without intervention 40,000 of them would acquire the infection. Studies have shown a strong association between education and HIV prevalence, but in Zambia, this association has not been demonstrated. There is little published information on the association between educational attainment and HIV testing uptake among pregnant women, which is fundamental in understanding the mother to child transmission of HIV. This study investigated whether educational attainment was associated with uptake of HIV testing among women of reproductive age in Zambia.Methods: Data were taken from Zambia Demographic and Health Survey in 2014 (ZDHS14). The analysis consisted of all women aged 15–49 years, who responded to the question on HIV testing in the ZDHS. Multivariable logistic regression was used to determine whether educational attainment was associated with uptake of HIV testing among women of reproductive age in Zambia.Results: Educational attainment was strongly associated with HIV testing among 15,388 women of child bearing age [AOR 3.8, 95% CI 1.7–8.2; p = 0.001]. HIV testing differed greatly by socioeconomic social status with an increased uptake among women with higher wealth index [AOR 4.4, 95% CI 1.9–9.9; p = 0.001]. Additionally, HIV testing was observed to be higher among the older women 25–34 years compared to the young women 15–19 years [AOR 2.3, 95% CI 1.3–4.3; p = 0.007].Conclusions: This study revealed educational attainment to be a strong predictor of HIV testing among women of child bearing age in this population. High HIV testing uptake among educated pregnant women indicated that low-educated women may not fully realize the benefits of testing for HIV. Therefore, strengthening HIV testing in rural health facilities and providing initiatives to overcome barriers to testing among women with no formal education may help reduce vertical transmission of HIV.
Highlights
An estimated 150,000 children were newly infected with HIV in 2015, over 90% of them in Sub-Saharan Africa
Prevention of mother to child transmission (PMTCT) programs have been identified as a primary strategy to decrease vertical transmission of HIV [5,6,7,8,9,10]
Making PMTCT services accessible is essential for the eventual elimination of infant HIV transmission in Sub-Saharan Africa
Summary
An estimated 150,000 children were newly infected with HIV in 2015, over 90% of them in Sub-Saharan Africa. There is little published information on the association between educational attainment and HIV testing uptake among pregnant women, which is fundamental in understanding the mother to child transmission of HIV. This study investigated whether educational attainment was associated with uptake of HIV testing among women of reproductive age in Zambia. An estimated 150,000 children were newly infected with HIV in 2015, over 90% of them in Sub-Saharan Africa through mother to child transmission of HIV (MTCT) [1]. In the three years between 2012 and 2014, more than 240,000 new-borns were newly infected with HIV, 90% of them in Sub-Saharan Africa [2, 3]. Making PMTCT services accessible is essential for the eventual elimination of infant HIV transmission in Sub-Saharan Africa. A study from Ethiopia in 2011 showed that, voluntary testing was provided freely, there were progressive losses to follow-up of 55, 68, and 70% of HIV-positive mothers during the antenatal period, delivery, and first postnatal visits, respectively and many deliveries occurred at peripheral sites where PMTCT was not available [11]
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