Abstract:
Objective
To describe the uptake of and factors associated with HIV prevalence among pregnant
women in a large-scale home-based HIV counseling and testing (HBCT) program in west-
ern Kenya.
Methods
In 2007, the Academic Model Providing Access to Healthcare Program (AMPATH) initiated
HBCT to all individuals aged
13 years and high-risk children
<
13 years. Included in this
analysis were females aged 13
–
50 years, from 6 catchment areas (11/08-01/12). We
used descriptive statistics and logistic regression to describe factors associated with HIV
prevalence.
Results
There were 119,678 women eligible for analysis; median age 25 (interquartile range, IQR:
18
–
34) years. Of these, 7,396 (6.2%) were pregnant at the time of HBCT; 4,599 (62%) had
ever previously tested for HIV and 2,995 (40.5%) had not yet attended ANC for their current
pregnancy. Testing uptake among pregnant women was high (97%). HBCT newly identified
241 (3.3%) pregnant HIV-positive women and overall HIV prevalence among all pregnant
women was 6.9%. HIV prevalence among those who had attended ANC in this pregnancy
was 5.4% compared to 9.0% among those who had not. Pregnant women were more likelyto newly test HIV-positive in HBCT if they had not attended ANC in the current pregnancy
(AOR: 6.85, 95% CI: 4.49
–
10.44).
Conclusions
Pregnant women who had never attended ANC were about 6 times more likely to newly test
HIV-positive compared to those who had attended ANC, suggesting that the cascade of ser-
vices for prevention of mother-to-child HIV transmission should optimally begin at the home
and village level if elimination of perinatal HIV transmission is to be achieved.
