Pregnant women's experiences of routine counselling and testing for HIV in Eastern Uganda: a qualitative study.
ABSTRACT BACKGROUND: Routine HIV counselling and testing as part of antenatal care has been institutionalized in Uganda as an entry point for pregnant women into the prevention of mother-to-child transmission of HIV (PMTCT) programme. Understanding how women experience this mode of HIV testing is important to generate ideas on how to strengthen the PMTCT programme. We explored pregnant HIV positive and negative women's experiences of routine counselling and testing in Mbale District, Eastern Uganda and formulated suggestions for improving service delivery. METHODS: This was a qualitative study conducted at Mbale Regional Referral Hospital in Eastern Uganda between January and May 2010. Data were collected using in-depth interviews with 30 pregnant women (15 HIV positive and 15 HIV negative) attending an antenatal clinic, six key informant interviews with health workers providing antenatal care and observations. Data were analyzed using a content thematic approach. RESULTS: Prior to attending their current ANC visit, most women knew that the hospital provided HIV counselling and testing services as part of antenatal care (ANC). HIV testing was perceived as compulsory for all women attending ANC at the hospital but beneficial, for mothers, especially those who test HIV positive and their unborn babies. Most HIV positive women were satisfied with the immediate counselling they received from health workers, but identified the need to provide follow up counselling and support after the test, as areas for improvement. However, most HIV negative women mentioned that they were given inadequate attention during post-test counselling. This left them with unanswered questions and, for some, doubts about the negative test results. CONCLUSIONS: In this setting, routine HIV counselling and testing services are known and acceptable to mothers. There is need to strengthen post-test and follow up counselling for both HIV positive and negative women in order to maximize opportunities for primary and post exposure HIV prevention. Partnerships and linkages with people living with HIV, especially those in existing support groups such as those at The AIDS Support Organization (TASO), may help to strengthen counselling and support for pregnant women. For effective HIV prevention, women who test HIV negative should be supported to remain negative.
Full-textDOI: · Available from: Thorkild Tylleskär, Jun 16, 2015
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ABSTRACT: Introduction Despite the universal right to access the same range, quality and standard of free or affordable health care and programs as provided to other persons, people with physical disabilities (PWPDs) continue to experience challenges in accessing these services. This article presents the challenges faced by PWPDs in accessing sexual and reproductive health (SRH) services in Kampala, Uganda. Methods This was a qualitative study that was conducted with male and female PWPDs in Kampala in 2007. Data on the challenges experienced by PWPDs in accessing SRH services were collected using in-depth interviews with 40 PWPDs and key informant interviews with 10 PWPDs' representatives, staff of agencies supporting PWPDs and health workers. All data were captured verbatim using an audio-tape recorder, entered into a Microsoft Word computer program and analyzed manually following a content thematic approach. Results The study findings show that PWPDs face a multitude of challenges in accessing SRH services including negative attitudes of service providers, long queues at health facilities, distant health facilities, high costs of services involved, unfriendly physical structures and the perception from able-bodied people that PWPDs should be asexual. Conclusion People with physical disabilities (PWPDs) face health facility-related (service provider and facility-related challenges), economic and societal challenges in accessing SRH services. These findings call for a need to sensitize service providers on SRH needs of PWPDs for better support and for the government to enforce the provision of PWPD-friendly services in all health facilities.Reproductive Health 08/2014; 11. DOI:10.1186/1742-4755-11-59 · 1.62 Impact Factor
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ABSTRACT: Introduction Although most studies report high frequencies of consent to HIV tests, critics argue that clients are subject to pressure, that acceptors later indicate they could not have refused, and that provider-initiated HIV testing raises serious ethical issues. We examine the meaning of consent and why clients think they could not have refused. Methods Clients in Burkina Faso, Kenya, Malawi and Uganda were asked about consenting to HIV tests, whether they thought they could have refused and why. Textual responses were analyzed using qualitative and statistical methods. Results Among 926 respondents, 77% reported they could not have said no, but in fact, 60% actively consented to test, 24% had no objection and only 7% tested without consent. There were few significant associations between categories of consent and their covariates. Conclusions Retrospectively asking clients if they could have refused to test for HIV overestimates coercion. Triangulating qualitative and quantitative data suggests a considerable degree of agency.Journal of the International AIDS Society 03/2014; 17(1):18898. DOI:10.7448/IAS.17.1.18898 · 4.21 Impact Factor
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ABSTRACT: Male partner testing is an important strategy for the success of prevention of mother to child transmission (PMTCT) of HIV programmes. It also plays a crucial role in the adoption of condom use among couples to prevent new infection and re-infections. Yet, very few partners access HIV testing in PMTCT. The study assessed the role of disclosure in partner testing and willingness to use condoms during the post natal period. Focus group discussions were used to collect data from postnatal women receiving PMTCT interventions in Tshwane Metsweding sub-district of Gauteng province, South Africa. Women disclosed their HIV results to male partners and requested that their partners take the HIV test. Male partners were reluctant and preferentially used condoms. Only six of the 25 women knew the HIV status of their male partners. The male partners assumed that their HIV status was similar to that of their HIV positive partners. They also associated condom use with unfaithfulness. Disclosed women insisted on condom use, and opted for abstinence where partners refused to use condoms. Disclosure to male partners did not translate to partner testing and willingness to use condoms, and lack of partner testing was the main barrier to condom use. Women had a comprehensive understanding of the risk of reinfections and insisted on condom use. Male partners should be provided with information about PMTCT by health professionals providing these services. Integrating couple counselling in PMTCT will improve and increase adherence to condom use.African Journal for Physical Health Education, Recreation and Dance 09/2014; 20(September (Supplement 1)):11-21. · 4.03 Impact Factor