Prenatal care coverage and correlates of HIV testing in sub-Saharan Africa: Insight from demographic and health surveys of 16 countries.
Prenatal care coverage and correlates of HIV testing in sub-Saharan Africa: Insight from demographic and health surveys of 16 countries.
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DOI：
10.1371/journal.pone.0242001
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发表时间：
2020
期刊：
影响因子：
3.7
通讯作者：
Ajayi AI
中科院分区：
文献类型：
--
作者：
Awopegba OE;Kalu A;Ahinkorah BO;Seidu AA;Ajayi AI
对孕妇进行产前艾滋病毒筛查是消除母婴传播艾滋病毒的关键。虽然撒哈拉以南非洲的一些国家扩大了预防儿童经母体感染艾滋病毒的方案，确保几乎普及产前护理和艾滋病毒检测，并记录了儿童新感染的显著减少，但其他几个国家由于检测不足，结果不佳。我们对人口与健康调查（DHS）进行了多国分析，以评估怀孕期间艾滋病毒检测的覆盖率，并检查与吸收相关的因素。我们使用Stata第16版分析了来自16个SSA国家的64，933名女性的数据，这些数据来自最近的DHS数据集（2015-2018）。调整和未调整的逻辑回归模型被用来检查产前护理艾滋病毒检测的相关性。统计学显著性设定为p<0.05。撒南非洲在扩大产前护理艾滋病毒检测方面的进展不均衡，乍得只有6.1%的孕妇接受了检测，而卢旺达为98.1%。虽然在大多数撒哈拉以南非洲国家，特别是在西非和中非次区域，孕妇在获得艾滋病毒检测方面的不平等现象普遍存在，但包括卢旺达、南非、津巴布韦、马拉维和赞比亚在内的少数国家已设法消除了在获得产前护理艾滋病毒检测方面的财富和城乡不平等现象。我们的研究结果突出了国家和次区域之间的差距，产前护理艾滋病毒检测的吸收在撒哈拉以南非洲。尽管没有一个国家实现了产前护理艾滋病毒检测的普遍覆盖，但东非和南部非洲地区在确保所有孕妇都得到检测方面取得了显著进展。然而，西非和中非区域产前护理检测的覆盖率较低，富人和受过良好教育的人更容易接受检测，而穷人很少接受检测。在这些次区域，解决孕妇获得艾滋病毒检测的机会和覆盖面不平等的问题至关重要。
Prenatal screening of pregnant women for HIV is central to eliminating mother-to-child-transmission (MTCT) of HIV. While some countries in sub-Saharan Africa (SSA) have scaled up their prevention of MTCT programmes, ensuring a near-universal prenatal care HIV testing, and recording a significant reduction in new infection among children, several others have poor outcomes due to inadequate testing. We conducted a multi-country analysis of demographic and health surveys (DHS) to assess the coverage of HIV testing during pregnancy and also examine the factors associated with uptake. We analysed data of 64,933 women from 16 SSA countries with recent DHS datasets (2015–2018) using Stata version 16. Adjusted and unadjusted logistic regression models were used to examine correlates of prenatal care uptake of HIV testing. Statistical significance was set at p<0.05. Progress in scaling up of prenatal care HIV testing was uneven across SSA, with only 6.1% of pregnant women tested in Chad compared to 98.1% in Rwanda. While inequality in access to HIV testing among pregnant women is pervasive in most SSA countries and particularly in West and Central Africa sub-regions, a few countries, including Rwanda, South Africa, Zimbabwe, Malawi and Zambia have managed to eliminate wealth and rural-urban inequalities in access to prenatal care HIV testing. Our findings highlight the between countries and sub-regional disparities in prenatal care uptake of HIV testing in SSA. Even though no country has universal coverage of prenatal care HIV testing, East and Southern African regions have made remarkable progress towards ensuring no pregnant woman is left untested. However, the West and Central Africa regions had low coverage of prenatal care testing, with the rich and well educated having better access to testing, while the poor rarely tested. Addressing the inequitable access and coverage of HIV testing among pregnant women is vital in these sub-regions.
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