Abstract
In Nigeria, maternal, newborn, and child health (MNCH) weeks are campaign-like events designed to accelerate progress toward Millennium Development Goals. The authors examined whether integrating HIV testing into MNCH weeks was feasible and could lead to increased case finding and linkage to prevention of mother-to-child transmission (PMTCT) services. Pregnant women attending MNCH week during the first week of December 2014 in 13 local government areas in Benue State were provided with HIV tests and referrals to PMTCT services. Demographic, past antenatal care (ANC), and HIV testing information were collected using a structured questionnaire. We used routine ANC/PMTCT data from national electronic system (DHIS-2) to compare with the results obtained from MNCH week. A total of 50,271 pregnant women with a median age of 25 years (IQR: 21-29) were offered HIV testing. About 50,253 (99.96%) agreed to get HIV testing, with 1,063 (2.1%) testing positive. Six hundred forty-four (60.6%) of those with positive results were linked to PMTCT. In multivariate analysis, marital status, gestation age, and those with no ANC visit during this pregnancy were associated with a positive HIV test. Approximately 30% (50,253 versus 39,080) more pregnant women received HIV testing in MNCH week compared to those who received HIV testing in routine ANC services in 2013. Of the 50,253 who accepted testing, 15,611 (31.1%) did not attend ANC during this pregnancy, of which 9,615 (61.6%) had not had any previous HIV tests. Four hundred forty-two (4.6%) of these 9,615 tested HIV-positive. Integration of HIV testing into MNCH weeks is feasible and improved uptake of HIV testing and linkage to care. However, the rate of HIV positivity was lower than that reported by previous studies. The findings indicate that MNCH weeks provides opportunity to reach those who do not attend ANC services for HIV care.
Highlights
Nigeria accounts for 9% of the global population of people living with HIV, second only to South Africa [1, 2]
Limited access to antenatal care (ANC) services is one of the reasons cited for the low coverage of prevention of mother-to-child transmission (PMTCT) [4]
It was assumed that the community mobilization preceding the MNCH week could increase awareness and demand for MNCH, including PMTCT services, while overcoming the stigma commonly caused by lack of sufficient knowledge about HIV
Summary
Nigeria accounts for 9% of the global population of people living with HIV, second only to South Africa [1, 2]. The country harbors 10% of new HIV infections and 30% of children living with HIV globally [2]. This is likely due to low coverage of prevention of mother-to-child transmission (PMTCT) services measuring less than 28% [2]. This presented a barrier to achieving the goal of reducing mother-to-child transmission of HIV (eMTCT) to less than 5% MTCT by 2015 [1,2,3]. The authors examined whether integrating HIV testing into MNCH weeks was feasible and could lead to increased case finding and linkage to prevention of motherto-child transmission (PMTCT) services
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