From the total 410 pregnant women recruited 400 participated actively in this study in health facilities of Gondar town making the response rate of 97.6%.
About 285 (71.2%) of the study population (65.5% acceptors & 5.7% non-acceptors of PITC) were from urban areas while the rest 115 (28.8%) (17% of acceptors & 11.8% of non-acceptors of PITC) were from rural part of the study area. Over 90.0 %( 361) of the respondents were married followed by those who were divorced/separated/widowed 20(5.0%) and the majority 194(48.5%) of them had no education, followed by those who attended school secondary and above education 168(42.0%).
The most frequent occupation was housewife (59.0%) seconded by government employed (16.0%) and merchant (10.2%), respectively. The majority 391 (97.8%) of the study participants were Amhara by ethnicity (80.8%acceptors & 17.0% non-acceptors) followed by Tigre and Gurage.
Most of the study participants 361 (90.2%) were followers of orthodox Christianity (74.2% acceptors & 16.0% non-acceptors of PITC) followed by Muslim 35(8.8%). Regarding their age distribution 184(45.8%) of them were in the age range between 2534years with mean (SD) age of 25.37(5.25) and majority (48.0%) of them (42.0% acceptors & 6.0% non-acceptors) have monthly expenditure of 451999 birr per month. Among the study participants 330 (82.5%) of them were acceptors of provider initiated HIV testing and counseling (Table ).
Socio-demographic Characteristics of Acceptors and Non-Acceptors of PITC among pregnant women attending ANC in Health Facilities of Gondar Town, Gondar, 2010
Knowledge and attitude of respondents towards PITC among pregnant women attending ANC in Health facilities of Gondar town
Majority of the respondents in this study (97.3% acceptors, 94.3% non-acceptors and overall 96.8% of mothers) heard about the existence of provider-initiated HIV testing and counseling service during pregnancy and 91.2% acceptors, 90.0% non-acceptors and overall 91.0% of the respondents were in favor of provider-initiated HIV testing and counseling.
Regarding to specific attitudes towards PITC, 46.7% of acceptors and 32.9% of non-acceptors agreed on routine testing makes easier for ANC clients to get tested for HIV and 40.3% of acceptors and 31.4% of non-acceptors agreed on PITC helps ANC clients to take ARV drugs to prevent a baby from HIV.
On the other hand 12.7% acceptors, 41.4% non-acceptors and overall 17.75% of mothers believed that routine testing would cause people to avoid seeing their health care provider for fear of being tested and 4.5% acceptors, 25.7% non-acceptors and overall 8.25% of mothers thought that routine testing would lead to more violence against women (Table ).
Knowledge and Attitude Related to PIHCT among pregnant Women attending ANC in Health facilities of Gondar Town, Gondar, Northwest Ethiopia 2010
Reasons for acceptance and refusal of PITC among pregnant women attending ANC in health facilities of Gondar town
The most frequent reasons given for accepting provider-initiated HIV testing and counseling were concern for their own health and to protect their children (44% and 35% respectively). The major barriers for acceptance of provider-initiated HIV testing and counseling were fear of partners reaction for HIV test (31.4%), was not ready for HIV test (14.3%), need for partners consent (10%), afraid to know if they were HIV-positive and not being sure of the confidentiality of the test (8.6%). (Table )
reasons for acceptance and refusal of PITC among pregnant women attending ANC in Health facilities of Gondar town, Gondar, Northwest Ethiopia, 2010
Association between acceptance of provider-initiated HIV testing and counseling and each explanatory variable
In order to measure the association between acceptance of PITC and a number of explanatory variables, crude OR and adjusted OR with 95% CI were employed.
After controlling for confounders, the association between selected explanatory variables and acceptability of PITC is presented in Table .
Association between acceptance of provider-initiated HIV testing and counseling and each explanatory variable (Crude & adjusted OR)
Compared to older women (3549years), women aged 2534years were 3.9 times
[OR & (95%CI)=3.87(1.23, 12.15)] and women aged 1524years were 5.6 times
[OR & (95% CI)=5.55(1.57, 19.66)] more likely to accept PITC in the ANC clinics of Gondar town, northwest Ethiopia.
Compared to women who live in the rural areas, those women living in the urban areas were about 2.9 times [OR & (95%CI)=2.85 (1.10, 7.41)] more likely to accept PITC.
Women with monthly expenditure of 1000 birr per month were 2.9 times [OR & (95%CI)=2.87 (1.11, 7.44)] more likely to accept PITC than those with monthly expenditure of450 birr per month in ANC clinics of Gondar town health facilities.
Women who received two and above antenatal care during the current pregnancy were 2.6 times [OR & (95%CI)=2.64(1.17, 5.95)] more likely to accept PITC than those who attended antenatal care only once.
Compared to women who do not have comprehensive knowledge of HIV, women with good comprehensive knowledge of HIV were 4.3 times [OR & (95%CI)=4.30 (1.72, 10.73)] more likely to accept PITC in ANC clinics of Gondar, Northwest Ethiopia.
Women with more favourable attitude towards PITC were 6.2 times [OR & (95%CI)=6.17 (2.59, 14.74)] more likely to accept PITC than those women with less favourable attitude towards PITC.
Women who expect positive partners reaction for HIV positive result were 8.2 times [OR & (95%CI)=8.19(3.57, 18.80)] more likely to accept PITC than those who expect negative partners reaction for HIV positive result.
Compared to women with education level of secondary and above, those with no education were about 3.6 times [OR & (95%CI)=3.64(1.04, 12.78)] more likely to accept PITC in the ANC clinics of Gondar town, Northwest Ethiopia.
Finally those women with good knowledge of PMTCT were about 3.3 times [OR & (95%CI)=3.27(1.34, 7.94)] more likely to accept PITC than those who do not have PMTCT knowledge.
On the contrary, occupation, marital status, number of pregnancy, holding stigmatizing attitude towards people having HIV/AIDS, attitude towards counselors, availability & accessibility of health facilities with PITC service, perceived risk of acquiring HIV and perceived benefit of HIV testing were not independently associated with acceptability of PITC but were statistically significant in bivariate analysis.