Status of ANC-Linked HIV Counseling and Testing as an Intervention for PMTCT in Public Health Facilities in Addis Ababa: Quality of HIV Counseling Given to Pregnant Women for PMTCT

ABSTRACT

Background: A high quality of PMTCT is essential for success done well; it will result in significant reduction in child mortality through decreased peri-natal and postnatal HIV transmission; done badly; it could lead to deaths; increased drug resistance; and poor infant feeding. Objective: the aim of this study was to assess the quality of antenatal-based HIV counseling and testing as an intervention for PMTCT at ten public Health Centers in Addis Ababa City. Methodology: a cross sectional study was conducted at purposively selected 10 health centers in Addis Ababa from April to May 2008. Methods included observations of counseling sessions; and interview of key informants at PMTCT sites. Data on counselors' communication skills; duration and content of pre- and post test counseling was collected using a structured questionnaire adapted from UNAIDS tools. SPSS Version 15.0 was used to enter; clean; and analyze the data. Results: A total of 66 (31 pre- and 35 post test) counselling sessions were observed. The mean duration of pre-test counselling was 5.37 minutes (+3.34) and that of post test was 3.0 minutes (+ 2.24). In 78.8of the sessions; the counsellors gave clear and simple information to mothers; in 25.8of the sessions; the mothers were not given the chance to freely consent or dissent for blood test. In the post test sessions; 42.9of the mothers' understanding of the meaning of their test results was not explored. Conclusions: The communication skill of the counselors was generally 'satisfactory'. The majority of pre- and post test sessions included the basic information on HIV and PMTCT/MTCT. However; the discussions were unusually brief; rudimentary and lacked depth and coverage