Factors associated with pregnancies among HIV-positive women in a prevention of mother-to-child transmission programme / Factores asociados con embarazos entre mujeres VIH positivas en un programa de prevención de la transmisión de madre a hijo

OBJECTIVE: This study identified factors contributing to pregnancies in HIV-positive women who were on a prevention of HIV from mother-to-child transmission (PMTCT) programme in Letlhakeng Subdistrict, Botswana. METHOD: A cross-sectional descriptive survey was employed using an interviewer administered (face-to-face) questionnaire to obtain information from 35 HIV-positive pregnant women registered for a PMTCT programme. Use was made of a non-probability sampling method to obtain information from all the pregnant women who sought antenatal care (ANC) during the survey period. RESULTS: The age of the participants ranged between 18 and 37 years with a modal age of 30 years and a mean of29.02 years (standard deviation of 5.29). The majority of the participants were single (66%) and had two or more children (74%). About half of the participants (49%) had secondary school education and a high proportion ofthem knew their HIV-positive status for more than one year prior to the interview day (77%) while the same number of them were unemployed. Pregnant participants seemed to know their HIV status prior to pregnancy. Sharing information about the HIV status of their partners and the participant's financial dependence on their partners did not show any significant association with their pregnancy status. However, the partner's desire for parent-hood (p < 0.05, 95% CI), the age difference between them and their partners (p < 0.05, 95%CI) and the use of condoms (p < 0.05, 95% CI) indicated significant associations between decision-making and the pregnancies. CONCLUSION: Pregnancy is common among HIV-positive women who are on a PMTCT at Letlhakeng sub-district as was shown by this study and this may constitute a serious health risk to the child and to the population in general.

OBJETIVO: Este estudio identificó factores que contribuyen a los embarazos en mujeres VIH positivas que tomaban parte en un programa de prevención de la transmisión del VIH de madre a hijo (PMTCT) en el subdistrito Letlhakeng, Botswana. MÉTODO: Se empleo un estudio descriptivo transversal, usando un cuestionario (cara a cara) administrado por el entrevistador para obtener información de 35 mujeres VIH positivas en estado de gestación, registradas para un programa PMTCT. Se usó un método de muestreo no probabilístico para obtener la información de todas las mujeres embarazadas que buscaron atención prenatal (APN) durante el periodo de estudio. RESULTADOS: La edad de las participantes fue entre 18 y 37 anos, con una edad modal de 30 años y una media de 29.02 años (desviación estándar de 5.29). La mayoría de las participantes eran solteras (66%) y tenían dos o más ninos (74%). Alrededor de la mitad de las participantes (49%) habían alcanzado la ensenanza media y una alta proporción de ellas conocían su condición de VIH positiva desde hacía más de un ano antes del día de la entrevista (77%), mientras el mismo número de ellas se hallaban desempleadas. Las participantes embarazadas parecían conocer su estado VIH con anterioridad al embarazo. Compartir la información sobre el estado de VIH de sus parejas y la dependencia financiera de las participantes respecto de sus parejas, no mostró ninguna asociación significativa con su estado de embarazo. Sin embargo, el deseo de paternidad de sus parejas (p < 0.05, 95% CI), la diferencia de edad entre ellas y sus parejas (p < 0.05, 95% CI) y el uso de condones (p < 0.05, 95% CI) indicó asociaciones significativas entre la toma de decisión y los embarazos. CONCLUSIÓN: El embarazo es común entre mujeres VIH positivas que toman parte en un programa de tipo PMTCT en el subdistrito Letlhakeng, tal cual lo ha mostrado este estudio. Esto puede constituir un serio riesgo de salud para el nino y la población en general.

HIV counselling and testing of pregnant women attending antenatal clinics in Botswana, 2001.

This study examined the extent to which women accessing antenatal-care services in Botswana were offered HIV-related information and counselling and an opportunity to take an HIV test as part of the Prevention of Mother-to-Child Transmission of infection, and how these women responded. Data for this study were drawn from the Botswana AIDS Impact Survey 2001, a nationally-representative sample survey. The survey successfully interviewed over 4,494 of 4,728 eligible women on various issues relating to HIV/AIDS at both household and individual levels. Frequencies, cross tabulations, and logistic regression were used for data analysis. Over half (57.9%) of the women were offered HIV/AIDS-related information, counselling, or testing. Age, education, and residence were important predictors of being offered HIV counselling or testing. Younger and more-educated women and those residing in towns were more likely to be offered both HIV counselling and testing than older, less-educated, and rural women. Seventy-nine percent of the women who were offered HIV testing agreed to undergo the test regardless of their background characteristics. The number of pregnant women who underwent HIV testing during antenatal care accounted for only a fifth (21%) of all antenatal-care attendees in 2001. Lack of capacity to deliver voluntary counselling and testing services to all pregnant women attending antenatal care is one of the biggest challenges to increased use of voluntary counselling and testing services.

Prevalence of, and factors associated with, HIV/AIDS-related stigma and discriminatory attitudes in Botswana.

Botswana has the highest prevalence of HIV in the world. The epidemic of HIV/AIDS is often accompanied by stigma and discrimination that create the circumstances for spreading HIV. To facilitate the design of effective programmes to fight the high prevalence of HIV/AIDS-related stigma and discriminatory attitudes, this study examined survey data on the prevalence of, and factors associated with, such attitudes in Botswana. While most respondents showed discriminatory attitudes towards a teacher or a shopkeeper with HIV/AIDS, only 11% of 4,147 respondents reported unwillingness to care for a family member with HIV/AIDS. The more tolerant attitudes towards a family member with HIV/AIDS appeared to be promoted by the fact that family members have been and continue to care for their sick members through a government project called Community Home-based Care aimed at relieving public hospitals of HIV/AIDS patients. Since the burden of caring for sick relatives rests on the shoulders of women, they portrayed more tolerant attitudes towards HIV/AIDS patients. Young people and those who believed a person could get HIV infection by sharing a meal with an HIV/AIDS patient had discriminatory attitudes towards people with HIV/AIDS. The national information, education and communication programme needs to be strengthened to reach more people for HIV/AIDS education. Finally, programmes that aim to promote more tolerant attitudes towards people with HIV/AIDS may be more effective if the human rights of those with HIV/AIDS are promoted and respected.