Translational Health Research Institute (THRI), Campbelltown Campus, Western Sydney University, Penrith, NSW 2751, Australia.
School of Public Health, College of Medicine and Health Sciences, Hawassa University, Hawassa P.O. Box 1560, Ethiopia.
Int J Environ Res Public Health. 2021 May 16;18(10):5289. doi: 10.3390/ijerph18105289.
Identifying the socioeconomic and structural issues that act as enablers and/or barriers to HIV testing services is critical in combatting HIV/AIDS amongst mothers and children in Africa. In this study, we used a weighted sample of 46,645 women aged 15-49 who gave birth in the two years preceding the survey from the recent DHS dataset of ten East African countries. Multivariable logistic regression was used to investigate the factors associated with prenatal HIV test uptake in East Africa. The overall prenatal HIV test uptake for the prevention of mother-to-child transmission (PMTCT) of HIV was 80.8% (95% CI: 74.5-78.9%) in East Africa, with highest in Rwanda (97.9%, 95% CI: 97.2-98.3%) and lowest in Comoros (17.0%, 95% CI: 13.9-20.7%). Common factors associated with prenatal HIV test service uptake were higher maternal education level (AOR = 1.29; 95% CI: 1.10-1.50 for primary education and AOR = 1.96; 95% CI: 1.53-2.51 for secondary or higher education), higher partner education level (AOR = 1.24; 95% CI: 1.06-1.45 for primary education and AOR = 1.56; 95% CI: 1.26-1.94 for secondary or higher school), women from higher household wealth index (AOR = 1.29; 95% CI: 1.11-1.50 for middle wealth index; AOR = 1.57; 95% CL: 1.17-2.11 for rich wealth index), improved maternal exposure to the media, and increased awareness about MTCT of HIV. However, residents living in rural communities (AOR = 0.66; 95% CI: 0.51-0.85) and travelling long distances to the health facility (AOR = 0.8; 95% CI: 0.69-0.91) were associated with non-use of prenatal HIV test service in East African countries. In each East African country, factors associated with prenatal HIV test uptake for PMTCT varied. In conclusion, the pooled prenatal HIV test uptake for PMTCT of HIV was low in East Africa compared to the global target. Scaling up interventions to improve enablers whilst addressing barriers to the use of prenatal HIV test services are essential to end the HIV/AIDS epidemic in East African countries.
确定促进和/或阻碍非洲母婴艾滋病毒检测服务的社会经济和结构性问题，对于防治艾滋病毒/艾滋病至关重要。本研究使用最近来自十个东非国家的 DHS 数据集的加权样本，纳入了在调查前两年内分娩的 46645 名 15-49 岁的妇女。采用多变量逻辑回归分析东非地区与产前 HIV 检测使用率相关的因素。东非地区为预防母婴传播（PMTCT）而进行的产前 HIV 检测总覆盖率为 80.8%（95%CI：74.5-78.9%），卢旺达最高（97.9%，95%CI：97.2-98.3%），科摩罗最低（17.0%，95%CI：13.9-20.7%）。与产前 HIV 检测服务使用率相关的常见因素包括：较高的母亲教育水平（AOR=1.29；95%CI：1.10-1.50 为小学教育，AOR=1.96；95%CI：1.53-2.51 为中学或以上教育）、较高的伴侣教育水平（AOR=1.24；95%CI：1.06-1.45 为小学教育，AOR=1.56；95%CI：1.26-1.94 为中学或以上教育）、来自较高家庭财富指数的妇女（AOR=1.29；95%CI：1.11-1.50 为中等财富指数；AOR=1.57；95%CL：1.17-2.11 为富裕财富指数）、更多地接触媒体以及提高对母婴传播 HIV 的认识。然而，居住在农村社区的居民（AOR=0.66；95%CI：0.51-0.85）和长途跋涉到保健机构的居民（AOR=0.8；95%CI：0.69-0.91）与东非国家不使用产前 HIV 检测服务有关。在每个东非国家，与产前 HIV 检测用于 PMTCT 的因素各不相同。总之，与全球目标相比，东非地区为 PMTCT 进行的产前 HIV 检测总体覆盖率较低。扩大干预措施以加强促进因素，同时解决产前 HIV 检测服务使用方面的障碍，对于结束东非国家的艾滋病毒/艾滋病流行至关重要。
