THE PREVALENCE OF HUMAN IMMUNODEFICIENCY VIRUS INFECTION AMONG UNBOOKED OBSTETRIC PATIENTS AT THE UNIVERSITY COLLEGE HOSPITAL IBADAN

THE PREVALENCE OF HUMAN IMMUNODEFICIENCY VIRUS INFECTION AMONG UNBOOKED OBSTETRIC PATIENTS AT THE UNIVERSITY COLLEGE HOSPITAL IBADAN

Abstract

Objectives

To determine the prevalence rate of HIV infection among unbooked obstetric patients at the University College Hospital (UCH), Ibadan, to describe the demographic characteristics of acceptors and non-acceptors and to assess these parturients’ knowledge of HIV and attitude to testing in labour.
Methodology

It was a cross-sectional study of “unbooked” parturientspresenting in labour ward at the UCH between December 2005 and February 2006. A questionnaire was filled by the interviewer, while counselling a hundred and four women to assess their knowledge of HIV and acceptability of the test. Blood samples were taken from ninety consenting patients. Rapid HIV testing, using Determine (Abbott Diagnostics, Chicago, Ill.) and Enzyme-linked Immunosorbent Assay were performed, and reactive results sent for confirmation by Western blot. All patients with reactive results were offered appropriate therapy.Results

The prevalence of HIV in this population was 6.67%. The acceptance rate was 86.5%. Women of lower educational status were more likely to accept rapid testing (p=0.028), while age, parity, occupation and knowledge of HIV did not influence either acceptabilityof rapid screening or participants’ serostatus. Most women (66.34%) had an above average knowledge of HIV. Most women did the test because they were genuinely interested in knowing their status and protecting their baby (88.89%). No one admitted to feeling coerced to test for fear of being denied the emergency care for which they presented. Most of the refusals for screening were due to wish to avoid needle pricks (28.57%).

Compared to ELISA screening test, the specificity of the rapid test is 100%, the sensitivity is 85.7%, the positive predictive value is 100% and the negative predictive value is 98.8%. The only discordant result (non-reactive to rapid test and reactive to ELISA) was indeterminate on Western blot.

Attitude to testing (acceptance vs. no-acceptance) was maintained on post-partum re-evaluation.
Conclusion

The prevalence of HIV amongst unbooked parturients’ show theimportance of offering them point-of-care HIV testing and intervention, especially in an environment where antenatal clinic attendance is poor. Rapid testing appears to be acceptable and feasible in labour to prevent the mother-to-child transmission of HIV in a setting such as ours.

 

THE PREVALENCE OF HUMAN IMMUNODEFICIENCY VIRUS INFECTION AMONG UNBOOKED OBSTETRIC PATIENTS AT THE UNIVERSITY COLLEGE HOSPITAL IBADAN

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