Optimizing HIV Counseling: Effects of Personalized, Reinforced Key Messages Among Antenatal Clinic Attendees

Abstract

Introduction: Antenatal HIV counseling is an opportunity to educate HIV negative women to remain protected from infection. However, it needs to be optimized to achieve the desired effect. Objective: To evaluate the effect of reinforcement of key messages during the antenatal HIV counseling. Methods: In a PPTCT clinic 202 pregnant women who had already received pretest HIV counseling were assessed for retention in knowledge in four key domains of HIV knowledge using an 8 point scoring system (Non-Intervention group Score B). In another 200 newly recruited pregnant women, intervention was interactive group counseling, assessment (Intervention group Score A), personal reinforcement session and reassessment during post counseling (Intervention group Score B). Impact of intervention was determined by comparing the scores between and within groups using factorial and repeated measures ANOVA respectively. Results: Non-Intervention group Score B was 4.4 (SD± 1.7), compared to 6.5 (SD± 1.6) in Intervention group, where more than 80% answered all questions correctly in each domain. Women in Intervention group had a mean Score of more than 6/8 even when they returned beyond 3 weeks for post test counseling. Despite the intervention, educated women retained the knowledge better than uneducated counterparts. Conclusions: Intervention of key messages reinforcement improved comprehension and retention in knowledge, and sensitized participants for prompt collection of reports. Women with less education would require customized key messages delivery to help them comprehend the information. The 8 point scoring system used in this study can serve as in-house quality check for antenatal counseling in PPTCT clinics.