KNOWLEDGE, PERCEPTION AND PRACTICES RELATING TO MOTHER-TO-CHILD-TRANSMISSION OF HIV AMONG ANTENATAL CLINIC ATTENDEES IN PRIMARY HEALTH CARE FACILITIES IN ABUJA, NIGERIA

Abstract

The transmission of HIV from mother to child before, during and after birth constitutes a major public health concern. Nigeria has the highest number of new child HIV infections worldwide. Prevention of Mother-To-Child Transmission (PMTCT) strategies remain the most viable strategy for protecting infants and children against HIV infection. However, the predisposing factors among pregnant women which can promote Mother-To-Child Transmission of HIV (MTCTH) such as knowledge, perception and practices, have not been well explored. Knowledge of these factors is needed for designing interventions aimed at preventing MTCTH among expectant mothers. This study was designed to investigate knowledge, perception and practices relating to HIV and MTCTH among antenatal care clients who attended rural-based Primary Health Care Facilities (PHCFs) in the Federal Capital Territory, Abuja. The study was a descriptive cross-sectional survey, involving the use of simple random sampling in selecting 422 pregnant women attending 11 out of the 20 rural PHCFs providing PMTCT services. A semi-structured, interviewer-administered questionnaire was used to collect information on socio-demographic characteristics and HIV-related risky practices. HIV Counselling and Testing (HCT) knowledge. PMTCT knowledge, HCT perception and PMTCT perception were assessed on 6, 23, 7 and 6 point scales respectively. The HCT knowledge scores ≤2,>2-4 and >4, and PMTCT knowledge scores ≤11, >11-16 and >16 were categorised as poor, fair and good respectively. The HCT perception scores ≥4 and PMTCT perception scores ≥3 were classified in each case as favourable respectively. Data were analysed using descriptive statistics, t-test and ANOVA at p=0.05. Age of respondent was 25.8±5.0 years, 63.0% completed at least secondary education and 92.7% were married. Most (93.1%) had heard about HIV with health facility (74.0%) being their commonest source of Information. Respondent who had ever received information on PMTCT and HCT during their previous pregnancies were 61.3% and 69.1%. respectively and most (86.7%) knew that MTCT of HIV can be prevented. The HCT and PMTCT knowledge were 3.1±1.2 and 13.9±4, respectively. Respondents with good HCT and PMTCT Knowledge scores were 10.5% and 29.5%, respectively. Many (67.3%) perceived the adoption of HCT to be a useful HIV prevention practice and 89.3% were willing to adopt HCT for their index pregnancy. Majority (75.4%) had favourable perception of HCT and PMTCT (70.5%). Lifetime prevalence of casual sexual intercourse was 12.2% while 5.2% had ≥2 sexual partners. Majority (83.0%) had ever been tested for HIV. Knowledge of respondents aged >24years (14.2±4.3) was significantly higher than those aged ≤24 years (13.3±4.5). Likewise knowledge of respondents with tertiary education (14.8±4.0) was significantly higher than those with primary (12.9±4.4) and no formal education (12.4±6.0). Despite high awareness of HIV, knowledge of mother-to-child-transmission was low. Educational interventions at Primary Health Care facilities may be successful in improving respondents' knowledge and promoting the adoption of favourable perceptions and practices.