HIV testing as part of routine antenatal care in Bangkok, Thailand
Description
Background. A policy of voluntary HIV counseling and testing (VCT) was mandated for antenatal care (ANC) facilities in Thailand in 2000. This study evaluated the VCT program in government ANC facilities in Bangkok. The goal of the study was to determine what factors motivate pregnant women to test and return for their test results, and to evaluate the relationship between testing and HIV risk perception and knowledge of prevention of mother-to-child HIV transmission (PMTC) Methods. This ANC clinic-based study combined 5 focus group discussions with pregnant women, 10 key informant interviews with ANC clinic staff and a cross-sectional survey of pregnant women (n = 675). Fourteen ANC facilities were randomly selected and women were surveyed using a self-administered questionnaire in December 2003 Results. Percentage of participants receiving the HIV test was 98%. Of those tested, 98% planned to return to hear their test results. However, key informants revealed that, while the Thai policy is that the HIV test is voluntary, in practice the test is not voluntary and all women must test Knowledge of PMTC was low. Only 42% of women reporting knowing about medicine for PMTC and 44% reporting that they knew any method of prevention. Higher income was associated with knowing a method of PMTC (p = 0.037). Only 4% often worried about risk of HIV from their partner and 19% sometimes worried. Low perception of risk from partner was associated with education level higher than compulsory (p = 0.014) and being in their first pregnancy (p = 0.014). High perception of risk from partner was associated with being unmarried (p = 0.001), recent migration to Bangkok (p = 0.010), lower income (p = 0.040), not knowing if partner had ever tested for HIV (p = 0.033) and ever discussing the HIV test with partner (p = 0.033) Conclusions. Acceptance of the HIV test and intent to return is nearly universal and both pregnant women and ANC staff strongly support the testing program. However, women are not allowed access to ANC services without having the HIV test. Both knowledge of PMTC and HIV risk perception from partner were low