Paper: Determinants of HIV provider-initiated testing and counseling screening service used by pregnant women in primary health centers in Surabaya

Determinants of HIV provider-initiated testing and counseling screening service used by pregnant women  in primary health centers in Surabaya

Samsriyaningsih Handayani, Susilowati Andajani, Lilik Djuari

Reference:

Handayani, S., Andajani, S., & Djuari, L. (2018). Determinants of HIV provider-initiated testing and counseling screening service used by pregnant women in primary health centers in Surabaya. Medical Journal of Indonesia, 26(4), 293-301.

DOI: http://dx.doi.org/10.13181/mji.v26i4.1398
My Summary
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Private midwives YES

Abstract

Background: Offering free HIV screening service for pregnant women in primary health center in Surabaya has become obligatory since 2014, but only 70% used the service. Prior studies on HIV screening mostly focused on Voluntary Counseling and Testing.

Methods: This was a cross-sectional study. Interviews were conducted with 150 pregnant women attending antenatal care in 1 of 9 public health centers (PHCs) in Surabaya and offered HIV screening within the same PHC. The eligibility criterium was pregnant women attending antenatal care in PHCs. The exclusion criteria were having been counseled for HIV prior to the interviews and/or experiencing an obstetric emergency. Using PRECEDE Framework with the concept of a comprehensive framework, this study focuses on identifying determinants of HIV PITC service use in PHCs in Surabaya. Binary logistic regressions and multiple binary logistic regressions were used in analyses.

Results: The service use was associated with self-confidence of getting blood drawn for the test (p<0.001, adjusted OR=12.368, 95% CI=3.237–47.250) and past use of midwife private service for current pregnancy (p=0.029, adjusted OR=3.902, 95% CI=1.150–13.246). Self-confidence of getting blood drawn for HIV test mediated the effect of past use of midwife’s private service on HIV screening use.

Conclusion: Past use of midwife’s private service affected self-confidence of getting blood drawn for HIV test on HIV screening use, and self-confidence affected the use of HIV PITC. This study results suggest that more midwives’ private practices are needed to increase the use of HIV PITC screening in PHC.

Latar belakang: Deteksi HIV secara gratis wajib ditawarkan oleh petugas kesehatan kepada seluruh ibu hamil yang berkunjung ke puskesmas di Surabaya, namun tidak semua ibu hamil memanfaatkannya.

Penelitian ini bertujuan untuk mengidentifikasi determinan penggunaan layanan penjaringan HIV melalui provider-initiated testing and counseling (PITC) bagi ibu hamil di puskesmas urban di Surabaya. Berbagai penelitian yang telah ada mengenai determinan tersebut kurang komprehensif dan lebih mengutamakan voluntary counseling and testing (VCT).

Metode: Penelitian ini bersifat potong lintang. Wawancara dilakukan terhadap 150 ibu hamil yang sedang berkunjung ke satu dari 9 Puskesmas di Surabaya dan telah ditawari tes HIV PITC. Kriteria inklusi adalah wanita hamil yang berkunjung ke bagian kesehatan ibu dan anak di Puskesmas. Kriteria eksklusi adalah sudah pernah mendapat konseling HIV sebelum wawancara dan/ atau mengalami gawat darurat obstetrik. PRECEDE-PROCEED framework, dipergunakan untuk menggali determinan. dan analisa dilakukan dengan regresi logistik biner dan berganda.

Hasil: Penggunaan HIV PITC oleh ibu hamil berhubungan dengan rasa percaya diri untuk diambil darah (p<0,001, adjusted OR=12,368, 95% CI=3,237–47,250) dan penggunaan layanan bidan swasta untuk kehamilan ini sebelum dilakukan tes HIV (p=0,029, adjusted OR=3,902, 95% CI=1,150–13,246). Rasa percaya diri untuk diambil darah untuk tes HIV merupakan mediator efek layanan bidan praktek swasta di masa lalu untuk kehamilan ini terhadap penggunaan layanan penjaringan HIV di Puskesmas.

Kesimpulan:
Kesimpulan: Pengalaman penggunaaan layanan bidan swasta meningkatkan rasa percaya diri untuk diambil darah dalam penyaringan HIV PITC, dan rasa percaya diri tersebut meningkatkan penggunaan layanan penyaringan HIV PITC. Diperlukan peningkatan keterlibatan bidan praktek swasta dalam program HIV PITC di Puskesmas.

CONCLUSION

In conclusion, HIV PITC screening use was affected by a predisposing factor, i.e self-confidence of getting blood drawn for HIV test. The self-confidence was affected by past use of midwife’s service affected on HIV screening use. The use of HIV screening service at PHCs may be indirectly improved by increasing husbands’ involvement in reminding their wives to get their health checked.