Factors associated with conducting repeat HIV testing among pregnant women during the third trimester in Blantyre by Martha Kaula

Kaula, Martha

Factors associated with conducting repeat HIV testing among pregnant women during the third trimester in Blantyre by Martha Kaula

Date

28-10-21

Authors

Kaula, Martha

Publisher

Kamuzu University of Health Sciencies

Abstract

Type of Study: A convergent parallel mixed-methods study design will be used to collect, analyse and interpret quantitative and qualitative data. Problem statement Mother to child transmission of HIV during pregnancy remains high in Malawi currently at 13% (15). A repeat HIV testing has been adopted in antenatal guidelines as one of the strategies in eliminating paeditric HIV infection in Malawi since 2019 (2). However, there is scanty information on repeat HIV testing among pregnant women and associated factors to its implementation, hence the need for this study. Objectives of the study The overall objective of the study is to investigate the factors associated with conducting a repeat HIV test among pregnant women in the third trimester specifically to; 1. determine the proportion of pregnant women who received a repeat HTC in the third trimester in 2020. 2. assess clients’ characteristics that influence uptake of repeat HIV test among pregnant women in the third trimester. 3. assess clinic organisational factors that influence uptake of repeat HIV test among pregnant women in the third trimester. 4. explore intervention characteristics that influence uptake of repeat HIV test among pregnant women in the third trimester. 5. identify strategies at service delivery level and health workforce that can increase uptake of repeat HIV test in the third trimester. Methodology The study which will use case review for quantitative and exploratory cross-sectional design for qualitative data. Study setting The study will be conducted in Blantyre district at Ndirande and Lirangwe primary health facilities. Study population Antenatal clients assisted from July 2019 to June 2020 will constitute population for the quantitative approach. All the pregnant women, postnatal women, PMTCT providers and HCT will comprise the population for the qualitative data. Study period The study will be conducted over a period of ten (10) months from June 2021 to March 2022. Sample size A total of 1024 records of antenatal women will be reviewed to collect quantitative data while 62 participants will be selected purposively and recruited for the qualitative data. Data collection The researchers will conduct all the survey and the interviews. A checklist will be used for clients’ case note reviews. Semi structured question guides will be used for in-depth interviews, key informant interviews and focus group discussion to obtain qualitative data Data management and analysis Stata 14 will be used to analyse quantitative data and the results will be presented as descriptive statistics. Qualitative data will be managed with NVivo 10.0 and analysed using thematic analysis and results presented as themes. Expected findings and dissemination of results. It is expected that the study will identify the prevalence of repeat HIV testing among pregnant women and its associated factors. The results of this study will be shared with the department of HIV and AIDS (DHA) in the Ministry of Health, other stakeholders include Blantyre District Health Office, College of Medicine Research and Ethics Committee (COMREC) and M-HIRST coordinating team. Furthermore, the findings will be disseminated through meetings, reports, international and local conferences and through publication in peer reviewed journals. Ethical Considerations Permission to conduct the study will be sought from College of Medicine Research and Ethics Committee (COMREC) while institutional permission will be sought from Blantyre District Health Office. Written informed consent for participation and digital recording of the discussions will be obtained from each participant. Each participant will be informed that participation is voluntary and can with draw their participation at any point without reprimands. Possible constraints The participants will be from Ndirande and Lirangwe health facilities and their catchment areas, therefore the results cannot be generalized. However, the findings will contribute towards improving uptake of repeat HIV testing among pregnant women in Blantyre.