Acceptance of HIV testing among pregnant women in Dar-es-Salaam, Tanzania

Background: Increased prevention of maternal-to-child transmission of HIV-1 has now become possible due to the availability of effective antiretroviral drugs in developing countries. It is necessary for pregnant women to know their HIV status in order to administer timely treatment to reduce transmission of the virus. This study assesses correlates of acceptance of testing for HIV infection in the antenatal setting in Dar-es-Salaam, Tanzania. Methods: Between August 13, 2001 and November 27, 2002, 14,235 pregnant women were offered screening for HIV as part of routine prenatal care. Demographic information pertaining to the women and their partners, if applicable, was collected. Univariate and multiple logistic regression analyses were carried out. Results: The majority of women were married monogamously (60.0%), had less than or equal to7 years of education (75%), and were unemployed (70.4%). Of the 14,235 women offered screening for HIV, 10,991 (77.2%) accepted. Site of recruitment was significantly associated with screening acceptance (P for trend <0.0001). Additionally, age, education, marital status, and partner's occupation were significant predictors of testing acceptance. Conclusion: The site at which recruitment occurs is a significant factor in determining a woman's odds of accepting HIV testing. The site covariate includes such factors as individual counselor effects, length of waiting time, and length of time the site has been operational.