Access to and utilization of antenatal HIV counseling and testing services in countries heavily affected by AIDS: who is offered the test, who accepts the test, and what is the effect of policy on testing uptake?

Kiersten Johnson, Macro International Inc.
Priscilla A. Akwara, United Nations Children's Fund (UNICEF)

Antenatal care-based interventions to prevent mother-to-child transmission of HIV (PMTCT) could eliminate vertical transmission of HIV, prevent new infections among women who test negative for HIV, and improve maternal health and survival among women who test positive. The prerequisite for achieving these desired outcomes is taking an HIV test to know one’s status. Yet women in developing countries are often not offered a test at antenatal care; if they are offered, many refuse testing. The purpose of this paper, therefore, is to use DHS data to explore the levels and differentials in PMTCT service availability and uptake, and discern factors associated with failure to take an HIV test even when one has been offered. We also look for associations between the policy environment and HIV testing uptake. Our findings indicate that knowledge of special drugs to PMTCT and stigma are significantly associated with uptake of HIV testing at antenatal care.