Abstract:
Background: Uptake of Human Immunodeficiency Virus (HIV) re-testing among postnatal mothers who had
previously tested HIV-negative is crucial for the detection of recent seroconverters who are likely to have high
plasma viral loads and an increased risk of mother-to-child HIV transmission. Tanzania set a target of 90% re-testing
of pregnant mothers who had tested negative during the first test. However, there is no statistics on the
implementation, coverage and the factors determining re-testing among pregnant women in Tanzania. This study
determined the proportion of newly-delivered, previously HIV-negative mothers who returned for HIV re-testing,
and assessed the determinants of re-testing in Njombe Region in Tanzania.
Methods: A cross-sectional study was conducted in four health facilities in Njombe and Wanging’ombe districts
during December 2015–June 2016. All newly-delivered mothers (≤7 days from delivery) presenting at health
facilities and who had previously tested HIV-negative during pregnancy were included. A structured questionnaire
was used to collect data on the determinants for re-testing. Records on the previous HIV testing was verified using
antenatal clinic card. A multiple logistic regression model was used to calculate the adjusted odds ratio (AOR) with
their 95% confidence intervals (CI) to quantify the association.
Results: Of 668 mothers (median age = 25 years) enrolled, 203 (30.4%) were re-tested for their HIV status. Among these,
27 (13.3%) tested positive. Significant predictors for HIV re-testing were socio-demographic factors including having at
least a secondary education [AOR = 1.9, 95% CI: 1.25–3.02] and being employed [AOR = 2.1, 95% CI: 1.06–4.34]; personal
and behavioural factors, reporting symptoms of sexually transmitted infections [AOR = 4.9, 95% CI: 2.15–6.14] and use of
condoms during intercourse [AOR = 1.7, 95% CI: 1.13–2.71]. Significant health system factors were having ≥4 ANC visits
[AOR = 1.8, 95% CI: 1.21–2.69] and perceiving good quality of HIV counselling and testing service at the first ANC visit
[AOR = 2.14, 95% CI: 1.53–3.04].
Conclusion: Uptake of the HIV re-testing was lower than the national target. Education level, employment status, having
≥4 ANC visits, reporting sexually-transmitted infections, condom use, and good perception of HIV tests were significant
factors increased uptake for re-testing. Identified factors should be incorporated in the Prevention of the Mother-to-Child
Transmission (PMTCT) programme strategies to prevent HIV infection in new-borns.
Keywords: Retesting,
