Routine offer of antenatal HIV testing ("opt-out" approach) to prevent mother-to-child transmission of HIV in urban Zimbabwe

Winfreda Chandisarewa, Lynda Stranix-Chibanda, Elizabeth Chirapa, Anna Miller, Micah Simoyi, Agnes Mahomva, Yvonne Maldonado, Avinash K. Shetty

Research output: Contribution to journalArticle

117 Citations (Scopus)

Abstract

Objective: To assess the impact of routine antenatal HIV testing for preventing mother-to-child transmission of HIV (PMTCT) in urban Zimbabwe. Methods: Community counsellors were trained in routine HIV testing policy using a specific training module from June 2005 through November 2005. Key outcomes during the first 6 months of routine testing were compared with the prior 6-month "opt-in" period, and clients were interviewed. Findings: Of the 4551 women presenting for antenatal care during the first 6 months of routine HIV testing, 4547 (99.9%) were tested for HIV compared with 3058 (65%) of 4700 women during the last 6 months of the opt-in testing (P < 0.001), with a corresponding increase in the numbers of HIV-infected women identified antenatally (926 compared with 513, P < 0.001). During routine testing, more HIV-infected women collected results compared to the opt-in testing (908 compared with 487, P < 0.001) resulting in a significant increase in deliveries by HIV-infected women (256 compared with 186, P = 0.001); more mother/infant pairs received antiretroviral prophylaxis ( n = 256) compared to the opt-in testing ( n = 185); and more mother/infant pairs followed up at clinics (105 compared with 49, P = 0.002). Women were satisfied with counselling services and most (89%) stated that offering routine testing is helpful. HIV-infected women reported low levels of spousal abuse and other adverse social consequences. Conclusion: Routine antenatal HIV testing should be implemented at all sites in Zimbabwe to maximize the public health impact of PMTCT.

Original languageEnglish
Pages (from-to)843-850
Number of pages8
JournalBulletin of the World Health Organization
Volume85
Issue number11
DOIs
Publication statusPublished - 01-11-2007
Externally publishedYes

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Zimbabwe
Mothers
HIV
Spouse Abuse
Prenatal Care
Counseling
Public Health

All Science Journal Classification (ASJC) codes

  • Public Health, Environmental and Occupational Health

Cite this

Chandisarewa, W., Stranix-Chibanda, L., Chirapa, E., Miller, A., Simoyi, M., Mahomva, A., ... Shetty, A. K. (2007). Routine offer of antenatal HIV testing ("opt-out" approach) to prevent mother-to-child transmission of HIV in urban Zimbabwe. Bulletin of the World Health Organization, 85(11), 843-850. https://doi.org/10.2471/BLT.06.035188
Chandisarewa, Winfreda ; Stranix-Chibanda, Lynda ; Chirapa, Elizabeth ; Miller, Anna ; Simoyi, Micah ; Mahomva, Agnes ; Maldonado, Yvonne ; Shetty, Avinash K. / Routine offer of antenatal HIV testing ("opt-out" approach) to prevent mother-to-child transmission of HIV in urban Zimbabwe. In: Bulletin of the World Health Organization. 2007 ; Vol. 85, No. 11. pp. 843-850.
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abstract = "Objective: To assess the impact of routine antenatal HIV testing for preventing mother-to-child transmission of HIV (PMTCT) in urban Zimbabwe. Methods: Community counsellors were trained in routine HIV testing policy using a specific training module from June 2005 through November 2005. Key outcomes during the first 6 months of routine testing were compared with the prior 6-month {"}opt-in{"} period, and clients were interviewed. Findings: Of the 4551 women presenting for antenatal care during the first 6 months of routine HIV testing, 4547 (99.9{\%}) were tested for HIV compared with 3058 (65{\%}) of 4700 women during the last 6 months of the opt-in testing (P < 0.001), with a corresponding increase in the numbers of HIV-infected women identified antenatally (926 compared with 513, P < 0.001). During routine testing, more HIV-infected women collected results compared to the opt-in testing (908 compared with 487, P < 0.001) resulting in a significant increase in deliveries by HIV-infected women (256 compared with 186, P = 0.001); more mother/infant pairs received antiretroviral prophylaxis ( n = 256) compared to the opt-in testing ( n = 185); and more mother/infant pairs followed up at clinics (105 compared with 49, P = 0.002). Women were satisfied with counselling services and most (89{\%}) stated that offering routine testing is helpful. HIV-infected women reported low levels of spousal abuse and other adverse social consequences. Conclusion: Routine antenatal HIV testing should be implemented at all sites in Zimbabwe to maximize the public health impact of PMTCT.",
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Chandisarewa, W, Stranix-Chibanda, L, Chirapa, E, Miller, A, Simoyi, M, Mahomva, A, Maldonado, Y & Shetty, AK 2007, 'Routine offer of antenatal HIV testing ("opt-out" approach) to prevent mother-to-child transmission of HIV in urban Zimbabwe', Bulletin of the World Health Organization, vol. 85, no. 11, pp. 843-850. https://doi.org/10.2471/BLT.06.035188

Routine offer of antenatal HIV testing ("opt-out" approach) to prevent mother-to-child transmission of HIV in urban Zimbabwe. / Chandisarewa, Winfreda; Stranix-Chibanda, Lynda; Chirapa, Elizabeth; Miller, Anna; Simoyi, Micah; Mahomva, Agnes; Maldonado, Yvonne; Shetty, Avinash K.

In: Bulletin of the World Health Organization, Vol. 85, No. 11, 01.11.2007, p. 843-850.

Research output: Contribution to journalArticle

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T1 - Routine offer of antenatal HIV testing ("opt-out" approach) to prevent mother-to-child transmission of HIV in urban Zimbabwe

AU - Chandisarewa, Winfreda

AU - Stranix-Chibanda, Lynda

AU - Chirapa, Elizabeth

AU - Miller, Anna

AU - Simoyi, Micah

AU - Mahomva, Agnes

AU - Maldonado, Yvonne

AU - Shetty, Avinash K.

PY - 2007/11/1

Y1 - 2007/11/1

N2 - Objective: To assess the impact of routine antenatal HIV testing for preventing mother-to-child transmission of HIV (PMTCT) in urban Zimbabwe. Methods: Community counsellors were trained in routine HIV testing policy using a specific training module from June 2005 through November 2005. Key outcomes during the first 6 months of routine testing were compared with the prior 6-month "opt-in" period, and clients were interviewed. Findings: Of the 4551 women presenting for antenatal care during the first 6 months of routine HIV testing, 4547 (99.9%) were tested for HIV compared with 3058 (65%) of 4700 women during the last 6 months of the opt-in testing (P < 0.001), with a corresponding increase in the numbers of HIV-infected women identified antenatally (926 compared with 513, P < 0.001). During routine testing, more HIV-infected women collected results compared to the opt-in testing (908 compared with 487, P < 0.001) resulting in a significant increase in deliveries by HIV-infected women (256 compared with 186, P = 0.001); more mother/infant pairs received antiretroviral prophylaxis ( n = 256) compared to the opt-in testing ( n = 185); and more mother/infant pairs followed up at clinics (105 compared with 49, P = 0.002). Women were satisfied with counselling services and most (89%) stated that offering routine testing is helpful. HIV-infected women reported low levels of spousal abuse and other adverse social consequences. Conclusion: Routine antenatal HIV testing should be implemented at all sites in Zimbabwe to maximize the public health impact of PMTCT.

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