BARRIERS TO HIV COUNSELING AND TESTING AMONG WOMEN OF CHILD BEARING AGE IN ABUJA, NIGERIA

Abstract

Awareness of HIV status, through HIV counseling and testing (HCT) programmes have been shown to increase safe sexual behavior and use of care and support services among adults. Despite the various strategies implemented by governmental and nongovernmental organizations to encourage voluntary testing, uptake of the services and awareness of HIV status is still low. Ignorance of HIV status by an individual may promote unsafe sexual behavior that drives HIV transmission. This study was conducted to assess the level of awareness and knowledge of HIV, identify barriers of HCT as well as the factors influencing it among women of child bearing age in Abuja, Nigeria. A cross sectional study was conducted and a two stage sampling techniques was used to select women attending health facilities in Abuja. Simple random sampling technique was used to select 10 out of 203 health facilities in Abuja using balloting, thereafter, systematic sampling technique was used to select 1125 respondents among 2125 women attending the chosen facilities. Data on socio-demographic characteristics, awareness and knowledge about HCT, and reasons for non adoption were obtained using a pretested semi-structured interviewer administered questionnaires. Data were analysed using descriptive statistics, Chi-square test and logistic regression with level of significance set at 0.05. The mean age of the respondents was 31.8years (SD=5.7). About 37.1 % had no formal education while 27.0% had tertiary. About two thirds had two or more children while a third had received previous antenatal care. Most (80.2%) had ever heard of HIV/ AIDS. The most commonly identified modes of transmission and prevention of HIV were sex with multiple sexual partners (88.2%) and abstinence (82.7%) respectively. The proportions who knew that HIV can be transmitted from mother to child during pregnancy, delivery and breastfeeding were 8.5%, 25.7% and 54.7% respectively. The proportion of women who had undergone VCT was 31.5% though 92.0% knew a place to get an HIV test. The commonest source of information about HCT was the radio (19.3%). Over half (57.5%) of those who ever tested asked for the test, another 16.0% were offered while 26.5% were required to do the test. Among those who never tested, the main reasons for not testing was not asked or required to take the test (35.8%). Significantly, those that are <25 years (81.7%), with tertiary education (81.2%), that are Christians (70.9%), single (85.9%), from Yoruba tribe (50.0%) and those that have attended antenatal care previously (72.0%) had ever undergone HCT. The significant predictors of uptake of HCT were age (OR=5. l, 95% CI=2. l 􀄽 12.2), higher education (OR =3.9, 95%CI=2.2 - 6.9), tribes (OR =2.5, 95% CI=l.3 - 5.0), religion (OR=8.9, 95%Cl=4.4 - 17.9) and previous antenatal care (OR=13.6, 95% CI=5.5 - 33.3). The proportion ever testing for HIV is still low though majority of the women know where to get the test. More women need to be offered HCT and interventions aimed at targeting women attending health facilities should focus more on women with lower educational status and without previous antenatal care.