HIV This Week

Martin-Herz SP, Shetty AK, Bassett MT, Ley C, Mhazo M, Moyo S, Herz AM, Katzenstein D. Perceived risks and benefits of HIV testing, and predictors of acceptance of HIV counselling and testing among pregnant women in Zimbabwe. Int J STD AIDS 2006;17:835-41.

Martin-Herz and colleagues evaluated perceived risks and benefits and determined predictors of acceptance of voluntary HIV counselling and testing among pregnant women in Zimbabwe. One hundred and seventy pregnant women attending an urban antenatal clinic were surveyed. Implications of a negative or positive HIV test result and of telling a partner or community members that one is HIV positive were queried. Forty women (23.5%) consented to voluntary HIV counselling and testing, and 16 (40%) were HIV positive. Women who saw voluntary HIV counselling and testing as lower risk (OR 2.3, 95% CI 1.1-5.0) and women who had had a stillbirth or child die (OR 0.4, 95% CI 0.16-0.97) were more likely to consent. Prenatal voluntary HIV counselling and testing offers the best opportunity for prevention of mother-to-child transmission of HIV; however, less than 25% of women consented. If such interventions are to be successful, attention must be directed towards developing culturally appropriate strategies to address women's concerns and improve future acceptance of voluntary HIV counselling and testing in Zimbabwe.

Editors’ note: In some senses, these results are not surprising. In unstable, impoverished and deteriorating environments, women may avoid the additional risk to themselves that they perceive knowledge of serostatus and disclosure may incur. Findings such as these call out for key informant interviews and focus groups to explain such a low uptake of HIV testing.