KNOWLEDGE AND PREVENTIVE PRACTICES OF MOTHER TO CHILD TRANSMISSION (PMTCT) SERVICES AMONG PREGNANT WOMEN IN CALABAR MUNICIPALITY
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1.1 Background of the study
In 2011, a Global Plan was launched to reduce the number of new HIV infections via mother-to-child transmission by 90% by 2015. Strategies to improve the knowledge of MTCT and PMTCT in Nigeria, has been focused on rural women, emerging regions, the poor, illiterate and unemployed women. Efforts are also needed to involve religious leaders and related organization in the prevention of mother to child transmission of HIV. Prevention of mother-to-child transmission (PMTCT) programmes provides antiretroviral treatment (ART) to HIV-positive pregnant women to stop their infants from acquiring the virus (Aidsportal, 2015).
A number of studies have identified the link between knowledge of HIV, MTCT and PMTCT and uptake of PMTCT services. For example, research from Togo reported a 92% HIV testing uptake among participants where: 77% of pregnant women agreed that unprotected sex increased the risk of HIV transmission to their child and 61% recognised that the risk of HIV transmission to their child was higher for mixed breastfeeding than for exclusive breastfeeding (Tatagan, 2011). A study of more than 10,000 women in Tanzania found that only 46% of respondents had an adequate knowledge on MTCT and PMTCT. Factors associated with having adequate knowledge were experiencing at least one pregnancy, higher education levels, higher household wealth, living in an urban area, being exposed to HIV education, having taken an HIV test or knowing where to get tested for HIV. Women living with HIV were more likely to have adequate knowledge of MTCT than women who were HIV negative (56% compared to 46%) (Adebajo, 2016)
Conversely, other studies have associated high levels of HIV, MTCT and PMTCT knowledge with lower acceptability of PMTCT. One study from south west Nigeria recorded that, while 99.8% of pregnant women were aware of HIV and had very high knowledge of MTCT (92%) and PMTCT (91%), 71% had negative views towards PMTCT. This was due to factors such as stigma and discrimination (Olugbenga-Bello, 2013). A study was carried out to determine the perception about ‘opt out’ HIV testing among 500 pregnant women attending the antenatal clinic at Adeoyo Maternity Hospital, Ibada in Nigeria. Almost all (97%) respondents had done an HIV test and received the results due to the ‘opt out’ approach. Slightly less than half (48%) mentioned the hospital as the first source of information about HIV. However, knowledge of HIV and PMTCT was high among the vast majority of women (95%), which the study partly attributes to the information and counselling session that all respondents had attended before testing (Balogun, and Owoaje, 2016)
Some women in the study reported testing because they feared they would be suspected of being HIV positive should they decline. Others thought they might be denied antenatal care (ANC) if they refused testing. This brings to question the voluntariness of the ‘opt out’ strategy as about a fifth of the study participants felt that they were forced to have an HIV test (Balogun, and Owoaje, 2016). Not knowing one’s HIV status acts as a barrier to PMTCT services. The point at which women are tested for HIV can also impact on their journey through PMTCT, should they test positive. For example, a study of pregnant women living with HIV from Cameroon, Cote d’Ivoire, South Africa, and Zambia found women who were diagnosed with HIV before their pregnancy were more likely to adhere to PMTCT treatment than women who tested positive during pregnancy (Dionne-Odam, 2016).
Prevention of mother-to-child transmission (PMTCT) programmes provide antiretroviral treatment (ART) to HIV-positive pregnant women to stop their infants from acquiring the virus. Without treatment, the likelihood of HIV passing from mother-to-child is 15% to 45%. However, ART and other effective PMTCT interventions can reduce this risk to below 5%. PMTCT services should also continue after an infant has been born – although this remains a major challenge to programmes – with early infant diagnosis at four to six weeks after birth and ART initiation within the first 12 weeks for HIV-exposed infants. PMTCT services, where implemented, are effective. Around 1.6 million new HIV infections among children have been prevented as a result of these programmes since 1995 (WHO, 2016).
1.2 Statement of the problem
The greatest challenge to human kind in the 21st century is the epidemic of Acquired immune Deficiency Syndrome (AIDS).Human Immune Deficiency Virus (HIV) is the causative organism of AIDS. Without treatment, the likelihood of HIV passing from mother-to-child is 15% to 45%. However, ART and other effective PMTCT interventions can reduce this risk to below 5%. Despite the introduction of improved preventive services of MTCT of HIV over the years, HIV infections via MTCT (vertically/ perinatal transmission) is still on the increase in Nigeria. For this reason, this pertinent question formed the birth rock of this study: what is the level of knowledge, and preventive practices among pregnant women?
1.3 General Objective of the Study
The general objective of this study was to determine the level of knowledge, and preventive practices of mother to child transmission (pmtct) services among pregnant women in Calabar Municipality of Cross River State
The specific objectives of this study were to:
- determine the level of knowledge of mother to child transmission (pmtct) services among pregnant women in Calabar Municipality of Cross River State
- assess preventive practices of pregnant women to mother to child transmission
- compare the level of knowledge, and preventive practices among pregnant women in Calabar Municipality of Cross River State