Abstract

In sub-Saharan Africa little is known about how often women use pregnancy self-tests or characteristics of these women despite evidence that pregnancy self-testing is associated with early antenatal care (ANC) initiation. Understanding the characteristics of women who use pregnancy self-tests can facilitate more targeted efforts to improve pregnancy testing experiences and entry into the ANC pathway. We conducted a cross-sectional survey among pregnant women enrolling in a pre-exposure prophylaxis (PrEP) implementation study to determine the prevalence and factors associated with pregnancy self-testing among women in western Kenya. Overall, in our study population, 17% of women obtained a pregnancy self-test from a pharmacy. Pregnancy test use was higher among employed women, women with secondary and college-level educated partners, and women who spent 30 minutes or less traveling to the maternal and child health (MCH) clinic. The most reported reasons for non-use of pregnancy self-tests included not thinking it was necessary, lack of knowledge, and money to pay for the test. Future research should focus on understanding the knowledge and attitudes of women toward pregnancy self-testing as well as developing community-based models to improve access to pregnancy testing and ANC.

Highlights

  • The World Health Organization (WHO) recommends that pregnant women should initiate the first antenatal care (ANC) visit in the first trimester of pregnancy because early ANC access is central to identifying pregnancy complications and managing pre-existing conditions [1]

  • From December 2018 to July 2019, we collected data as part of a baseline survey among pregnant women enrolling in the pre-exposure prophylaxis (PrEP) Implementation for Mothers in Antenatal Care (PrIMA) study

  • Women were eligible for enrollment if they were: (1) pregnant, (2) HIV negative, (3) not currently using PrEP, (4) 15 years of age, (5) TB negative and (6) planned to receive postnatal and infant care at the enrollment facility

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Summary

Introduction

The World Health Organization (WHO) recommends that pregnant women should initiate the first antenatal care (ANC) visit in the first trimester of pregnancy because early ANC access is central to identifying pregnancy complications and managing pre-existing conditions [1]. In western Kenya, less than 20% of pregnant women are estimated to present for ANC in the first trimester [2].

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