Acceptance of Voluntary Counselling, Testing and Treatment for HIV Among Pregnant Women in Kumasi, Ghana.

SUMMARY
BACKGROUND: Voluntary counselling and testing (VCT) for human immunodeficiency virus (HIV) and treatment of positive pregnant women can reduce mother to child transmission (MTCT) of HIV.
OBJECTIVE: This study was conducted to assess acceptance of HIV VCT and antiretroviral therapy (ART) by pregnant women in Kumasi, Ghana, before and after VCT and ART were available.
METHODS: Two cross-sectional studies were conducted among women in antenatal clinics. The first, in 2003 among 501 women, before VCT and ART were available in Kumasi. Women who were willing were counselled and tested for HIV. In 2005, after the introduction of VCT and ART by the Ghana Health Service, 675 pregnant women were surveyed regarding HIV/VCT acceptance and uptake.
RESULTS: In 2003, 98% of women accepted counselling and 97% accepted testing; 3.3% tested HIV positive. Multivariate analysis showed that women with secondary education were 88% less likely than those with no/primary education to accept testing (OR=0.12, CI=0.03-0.54,p=0.006). Women who had prior HIV testing were 95% less likely to accept testing (OR=0.05, CI=0.01-0.19, p=0.0001). Women who reported two sexual partners in the past year were 6 times as likely to be HIV positive than those reporting one sexual partner (OR=5.76. CI=1.53 - 21.69, p=>0.05). In 2005, 76% of women reported no prior HIV counselling and 78% no testing.
CONCLUSIONS: In 2003, there was wide uptake of VCT by prenatal women. However, in 2005 the majority of pregnant women were not accessing the available VCT services.