Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
Department of Public Health, College of Medicine and Health Sciences, Debre Markos University, Debre Markos, Ethiopia.
PLoS One. 2024 Sep 19;19(9):e0310890. doi: 10.1371/journal.pone.0310890. eCollection 2024.
While HIV testing and counselling play a crucial role in preventing mother-to-child transmission, numerous pregnant women did not receive these services. Understanding the spatial variation of HIV testing and counselling and its associated factors during antenatal care in Ethiopia remains limited. Thus, this study was aimed at assessing the spatial patterns and factors associated with HIV testing and counselling during antenatal care visits in Ethiopia.
A cross-sectional study design was employed with a two-stage stratified cluster sampling technique. A total of 2,789 women who gave birth in the two years prior to the survey and had at least one antenatal care visit were included in the study. Stata version 16 and ArcGIS version 10.8 software were used for analysis. A multilevel robust Poisson regression model was fitted to identify significantly associated factors since the prevalence of HIV testing and counselling was higher than 10%. A statistically significant association was declared based on multivariable multilevel robust Poisson regression analysis using an adjusted prevalence ratio with its 95% confidence interval at a p-value < 0.05. Spatial regression analysis was conducted, and the local coefficients of statistically significant spatial covariates were visualised.
In Ethiopia, the overall prevalence of HIV testing and counselling during antenatal care visits was 29.5% (95% CI: 27.8%, 31.2%). Significant spatial clustering was observed (Global Moran's I = 0.138, p-value <0.001). In the spatial regression analysis, high and comprehensive knowledge related to HIV, and comprehensive knowledge on the prevention of mother-to-child transmission were significant explanatory variables for the spatial variation of HIV testing and counselling. In the multivariable multilevel robust Poisson regression analysis, education, household wealth, media exposure, number of antenatal care visits, comprehensive knowledge on mother-to-child transmission, comprehensive knowledge on prevention of mother-to-child transmission, and region were significantly associated factors.
The prevalence of HIV testing and counselling during antenatal care visits was low. Empowering women through education, promoting mass media exposure, increasing numbers of antenatal care visits, and enhancing women's knowledge related to HIV and mother-to-child transmission by targeting cold spot areas could improve HIV testing and counselling service uptake among pregnant women in Ethiopia.
虽然艾滋病毒检测和咨询在预防母婴传播方面发挥着至关重要的作用，但仍有许多孕妇未接受这些服务。在埃塞俄比亚，了解艾滋病毒检测和咨询在产前保健期间的空间变化及其相关因素仍然有限。因此，本研究旨在评估在埃塞俄比亚产前保健期间艾滋病毒检测和咨询的空间模式和相关因素。
采用两阶段分层聚类抽样技术进行横断面研究设计。共纳入 2789 名在调查前两年内分娩且至少接受过一次产前保健的妇女。使用 Stata 版本 16 和 ArcGIS 版本 10.8 软件进行分析。由于艾滋病毒检测和咨询的流行率高于 10%，因此采用多水平稳健泊松回归模型来确定显著相关因素。基于多变量多层次稳健泊松回归分析，使用调整后的患病率比及其 95%置信区间，在 p 值 < 0.05 的情况下，对具有统计学意义的关联进行了声明。进行了空间回归分析，并可视化了具有统计学意义的空间协变量的局部系数。
在埃塞俄比亚，产前保健期间艾滋病毒检测和咨询的总体流行率为 29.5%（95%CI：27.8%，31.2%）。观察到显著的空间聚类（全局 Moran's I = 0.138，p 值 <0.001）。在空间回归分析中，与艾滋病毒相关的高且全面的知识以及与母婴传播预防相关的全面知识是艾滋病毒检测和咨询空间变化的重要解释变量。在多变量多层次稳健泊松回归分析中，教育、家庭财富、媒体接触、产前保健次数、母婴传播综合知识、母婴传播预防综合知识和地区是显著相关因素。
产前保健期间艾滋病毒检测和咨询的普及率较低。通过教育赋予妇女权力，促进大众媒体的接触，增加产前保健次数，并针对冷点地区提高妇女与艾滋病毒和母婴传播相关的知识，可以提高埃塞俄比亚孕妇接受艾滋病毒检测和咨询服务的机会。
