Prevalence of HIV retesting and associated factors among perinatal women who tested negative in the first antenatal screening in Kilimanjaro region

Abstract

ABSTRACT Background: In Tanzania we have a total of 1.7 million people living with HIV, with the rate of vertical transmission of HIV being 6.9%. In efforts toward elimination of mother to child transmission (e-MTCT) of HIV WHO recommends that all pregnant women who tested negative during first test to be retested, despite this recommendation the prevalence of maternal HIV retesting in Tanzania is 30.4% which is low. Intervention to address this challenge such as on-the-job training of health care workers was conducted all over the country. Therefore, we determined the post-interventional prevalence of HIV retesting and associated factors among perinatal women who tested negative in the first antenatal screening, which has not yet been explored. Objectives: To determine the prevalence of HIV retesting and associated factors among perinatal women who tested negative in the first antenatal screening in Kilimanjaro region, during the year 2024. Materials and methods: A facility based cross-sectional study design was conducted involving perinatal women from 37 weeks of gestation to 42 days after delivery who were attending antenatal care, post-natal and Reproductive and child health clinics in Kilimanjaro. Data was collected using a semi-structured questionnaire and information collected involved sociodemographic characteristics, Obstetric history, facility factors and others like stigma and couple HIV testing during first antenatal care visit. Also, information on retesting on third trimester, labor and delivery and, postnatal was collected and HIV results from antenatal care (ANC) card. Data was analyzed by STATA version 15.1 and bivariable and multivariable modified Poisson regression model was used to check for association, because the anticipated prevalence of maternal HIV retesting was >10%. Results: A total of 467 perinatal women were recruited and 47.1% (95%CI 42.5-51.7) of them were retested for HIV with 3.2% of them testing positive. Factors which were associated with HIV retesting were; being counselled and tested for HIV together with partner during the first ANC visit (Adjusted Prevalence Ratio-APR 1.31; 95%CI:1.07-1.60, P=0.01), attending antenatal care in a health facility with trained healthcare workers (HCWs) on maternal HIV retesting (APR 3.56; 95%CI:1.99-6.39, P<0.001), attending only one health facility for ANC (APR 1.21; 95%CI:1.01-1.45, P=0.04), attending more than four ANC visits (APR 2.95; 95%CI:1.71-5.09, P<0.001) and having awareness that a woman should be tested twice during pregnancy (APR 1.57; 95%CI:1.28-1.92, P<0.001). Place of residence showed no association with HIV retesting. Conclusion: Prevalence of HIV retesting among perinatal women is still low compared to the national target of 95%. HIV retesting was associated with individual and ANC service-related factors. To be able to achieve the HIV retesting target, Ministry of Health and Stakeholders should ensure that interventions to promote adequate ANC attendance, healthcare workers training and provision of quality ANC with proper HIV retesting counseling are advocated.