Factors Affecting Fertility Decisions of Married Men and Women Living with HIV in South Wollo Zone; Northeast Ethiopia

Background: In a setting with high HIV prevalence and high fertility rates; addressing fertility issues of People Living with HIV/AIDS (PLWHA) is crucial. However; understanding of the factors associated with fertility decisions of PLWHA in Ethiopia is remarkably low. Objective: The study was conducted to assess factors associated with fertility decisions of PLWHA in South Wollo Zone; Northeast Ethiopia. Methods: The study was conducted from February 1 to March 30; 2008 using cross-sectional design. Quantitative data were collected from a sample of 458 men and 458 women using structured questionnaire. Qualitative data were also collected from six health care providers. Logistic regression was used to analyze the quantitative data. Results: The study showed that 18.3of currently married PLWHA have decided to have a child. The factors found to be independently associated with current decision to have a child were higher family income [OR (95CI) = 2.29 (1.23; 4.26)]; partner's decision to have a child [OR (95CI) = 36.4 (17.0; 77.5)]; having knowledge on PMTCT [OR (95CI) = 2.26 (1.44; 3.54)] and having partner with negative HIV test result [OR (95CI) = 0.408 (0.219; 0.759)]. During in-depth interview the health care providers indicated the fertility related counseling service to be low. Conclusion: In spite of the fact that significant proportion of married PLWHA had decided to have a child; the fertility related counseling service is low. Improving fertility related counseling services to enable clients make informed fertility decision is mandatory. The factors identified to be associated with fertility decision could be of major importance and as such should be investigated further. [Ethiop. J. Health Dev.2010;24(3):214-220]

Determinants of Acceptance of Voluntary HIV Testing among Antenatal Clinic Attendees at Dil Chora Hospital; Dire Dawa; East Ethiopia

Back ground: Voluntary Counseling and Testing (VCT) is one of the best interventions to reduce mother to child transmission of HIV. Despite the proven benefits of VCT; many women are not willing to have HIV testing. Objective: The objective of this study was to identify factors that determine the acceptance of voluntary HIV testing among pregnant women attending antenatal care at Dil Chora Hospital in Dire Dawa. Method: The study employed unmatched case control study which was conducted from August 20 to September 10; 2006. The study population consisted of 234 antenatal care followers. Cases were antenatal care followers who were counseled and tested for HIV in the current pregnancy. Controls were antenatal care followers who were counseled but not tested for HIV in the current pregnancy. Data were collected by trained enumerators using structured questionnaire. Univariate and multivariate analysis was carried out using SPSS version 12.0.1 software. Results: The majority (79.5) of respondents (97.4of cases and 60.5of controls) had good knowledge on HIV; mother to child transmission and VCT. Marital status; knowledge about HIV; mother to child transmission and VCT; attitude towards VCT; antenatal care follow up and perceived benefits of VCT were independent predictors of acceptance of voluntary HIV testing. Conclusion: Knowledge on MTCT and VCT; positive attitude towards VCT; antenatal care follow-up were predictors of acceptance of VCT. During the VCT session; health professionals should focus on knowledge; attitude; and benefits of VCT

Discordance between Providers Estimated and Caregivers Self Reported Adherence to HAART and Immunological Response among HIV Infected Children in Ethiopia

Purpose: Poor concordance between patient and physician reports of adherence might lead to inappropriate decisions regarding therapy. This study was undertaken to determine the rate of discordance between caregivers of children and physicians on adherence to Highly Active Antiretroviral Therapy (HAART). Methods: In a cross sectional study involving 390 respondents that was conducted in five hospitals in Addis Ababa; agreement between caregiver-reported adherence and providers' estimate of adherence was compared using Kappa (k) statistic. The association between the CD4 counts and measure of adherence was evaluated using a receiver operating characteristic (ROC) curve. Results: Caregivers reported dose adherence was 87in the last 7 days and physician estimated 84of the children as adherent based on their judgment. Fair agreement was observed between caregivers-reported dose adherence and providers' estimate adherence (Kappa = 0.27; p=0.0001). In a ROC curve; the association between a current CD4 count slope and physician estimated was poor. Conclusions: There is fair agreement and high rate of discordance (18) between physicians estimated and caregivers reported adherence. These recall for an intervention to augment better mutual understanding between physicians and caregivers on the issue of adherence to HAART under clinical care programme