Assessment Of Factors Associated With Womens Informed Choice For Hiv Testing Under Opt-out Approach Among Antenatal Attendees In Ghimbi Town Western Ethiopia.
Introduction: Under routine antenatal HIV testing and counseling or an “opt-out†approach allrnantenatal attendees are tested for HIV apart from those who actively decline the test. There arernconcerns that refusal of the test could be difficult for some women given the substantial socialrnstatus that health providers hold in many societies. However, little is known about pregnantrnwomen‟s ability and associated factors to make informed choice for HIV testing under routinernantenatal HIV testing in Ethiopia and particularly the selected study area. rnObjective: To assess women‟s ability to make informed choice about HIV testing and associatedrnfactors under opt-out approach among pregnant women attending antenatal care at governmentrnhealth institutions in Ghimbi town. rnMethodology: Health institution based cross-sectional study was conducted among 252 pregnantrnwomen attending antenatal care and known to be tested for HIV at government health facilitiesrnin Ghimbi Town from March 15 to May 9, 2013. Pregnant women were interviewed after givingrnblood for HIV testing but before accepting test result using pretested structured interviewerrnadministered questionnaire. Descriptive statistics and multiple logistic regressions were carriedrnout using SPSS version 17. Qualitative method was used to explore women‟s experience on HIVrntesting and counseling with focus on consent for HIV testing to clarify the results of quantitativernanalysis. rnResults: Only 59.9% of the women described acceptance of HIV testing as their own personalrndecision and 53.2% felt that they could not able to decline HIV testing. When adjusted forrnother factors; being asked consent (OR = 12.184, 95% CI: 6.123, 24.243), knowing that antenatalrnHIV testing is offered for the purpose of PMTCT (OR=3.461, 95% CI: 1.523, 7.864), urbanrnresidence (OR=2.442, 95% CI: 1.251, 4.766), and knowing that antenatal HIV testing is optionalrn(OR=2.899, 95% CI: 1.222, 6.876) were associated with the perceived ability do decline HIVrntesting/make informed choice to decline HIV testing. rnConclusion and recommendation: Women are tested in the expense of their right to makerninformed choice for HIV testing that contradicts with the basic principles of HIV testing.rnProviding the minimum components of pretest counseling is important to protect the autonomyrnof women and to ensure fully informed consent for HIV testing and women should be given arnchance to decide about the test.