Trends in Antenatal HIV testing rates at Bindura Provincial

Hospital, 2010-2014

B MakumbeC Tshuma

M Mungati

Background• In 2014, the UNAIDS estimated HIV prevalence in

Zimbabwe to be 15%• Antenatal HIV testing is part of PMTCT• All primary health care facilities in Zimbabwe offer HIV

testing and counseling. • Pregnant women who visit the ANC are screened for

HIV• HTC Process takes consideration of ethics

• Informed consent for test• Confidentiality of results• No harm to clients• Benefits clients through health education and subsequent

treatment

Background

• Antenatal HIV testing helps measure progress towards PMTCT goal

• The data is recorded onto PMTCT registers• In 2013 Bindura Provincial Hospital (BPH) had

first visit ANC testing rate of 64.0% • However, some registers were incomplete• Data set not analysed before

Broad Objective

• To determine the trends of antenatal HIV testing rates at BPH from 2010 to 2014

Specific Objectives• Trends among Pregnant Women who were

tested first time in ANC and received results • Trends among Pregnant Women testing HIV

positive in ANC • Trends among pregnant women booking for first

ANC visit with known HIV positive result• Trends of Pregnant Women who tested HIV

positive in ANC and were initiated on ART• Quality of ANC data for HIV tests at Bindura

Provincial Hospital

Materials and Methods

• Study design– secondary data analysis

• Study setting– Bindura Provincial Hospital

• Sampling– all monthly PMTCT reports from 2010 to 2014

Materials and Methods

• Permission to proceed was sought from– HSO– PMD, Mashonaland Central Province– DMO, Bindura District– Medical Superintendent BPH

• Ethical considerations– minimal disturbance of staff during working hours– Confidentiality was maintained

Results

ANC HIV Testing Data Quality at BPH, 2010-2014

Variable Completeness (%) n=60

Date 100.0

Age group 100.0

Pregnant Women  booking  for    first  ANC Visit 91.7

Pregnant  Women HIV tested in  ANC 91.7

Pregnant Women who were tested first time in ANC and received results

91.7

Pregnant Women testing HIV positive in ANC  100.0

pregnant women booking for first ANC visit with known HIV positive result

60.0

Pregnant women booking for first ANC visit already on  ART

60.0

Pregnant Women who tested HIV positive in ANC and were initiated on ART

53.4

Trends in proportion of pregnant women HIV tested in ANC at BPH, 2010-2014

Trends in proportion of pregnant women HIV tested in ANC by age at BPH, 2010-2014

Trends in Proportion of pregnant women HIV tested and received results in ANC at

BPH, 2010-2014

Trends in proportion of pregnant women who tested HIV positive in ANC at BPH,

2010-2014

Trends in proportion of pregnant women booking for first ANC visit with Known HIV

positive result at BPH, 2010-2014

Trends in proportion of pregnant women who tested HIV positive by age at BPH, 2010-2014

Trends in proportion of pregnant women booking for first ANC visit already on ART at

BPH, 2010-2014

Proportion of HIV infected pregnant women initiated on ART in ANC at BPH,

2010-2014

Discussion

• No significant increase or decrease in HIV testing rates• Similar to findings by Chandisarewa et.al.

• Higher proportion of those at least 25 years testing for HIV

• Decrease in Positivity rate• Similar to trends observed by UNFPA 2012

Discussion• Positivity rate twice as high among those at least

25years as those below• Similar to findings from ZDHS 2011

• Positivity rate on a steady rise among those aged 16 to 24 years

• Increase in those who visited the ANC with a known HIV positive result and already on ART

• Increase in the proportion of women being initiated on ART• Similar to finding by Stinson etal , 2013

Conclusion• HIV testing rates in ANC have been constant

between 2010 and 2014• There was a decline in the proportion of

women testing HIV positive in ANC• Steady increase in prevalence among women

aged 16 to 24years• Increase in proportion of women with known

HIV positive result and already on ART• There was an increase in the ART initiation

rate in the ANC

Recommendations

• Monthly data verifications at the FCH to improve completeness of data

• Targeted Health Education among women 16-24yrs - DHPO

• A study on factors associated with decrease in HIV positivity rate – PEDCO

Acknowledgments

• PMD, Mashonaland Central• DMO, Bindura district• Medical Superintendent, BPH• MPH Colleagues

Thank you