Individual and community-level determinants and spatial distribution of prenatal HIV test uptake in Ethiopia: Spatial and multilevel analysis
IntroductionHuman immunodeficiency virus (HIV) testing and counseling services are routine prenatal care services for the prevention of mother-to-child transmission of HIV. Although the prevalence of HIV infection is high among women, evidence suggests that the uptake of HIV testing during prenatal...
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2023-02-01
|
| Series: | Frontiers in Public Health |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fpubh.2023.962539/full |
| _version_ | 1797901729598013440 |
|---|---|
| author | Nuhamin Tesfa Tsega Daniel Gashaneh Belay Daniel Gashaneh Belay Melaku Hunie Asratie Moges Gashaw Mastewal Endalew Fantu Mamo Aragaw |
| author_facet | Nuhamin Tesfa Tsega Daniel Gashaneh Belay Daniel Gashaneh Belay Melaku Hunie Asratie Moges Gashaw Mastewal Endalew Fantu Mamo Aragaw |
| author_sort | Nuhamin Tesfa Tsega |
| collection | DOAJ |
| description | IntroductionHuman immunodeficiency virus (HIV) testing and counseling services are routine prenatal care services for the prevention of mother-to-child transmission of HIV. Although the prevalence of HIV infection is high among women, evidence suggests that the uptake of HIV testing during prenatal services in Ethiopia is scarce. Therefore, the aim of this study was to investigate individual- and community-level determinants and the spatial distribution of prenatal HIV test uptake in Ethiopia based on the 2016 Ethiopian Demographic and Health Survey.MethodsData were accessed from the 2016 Ethiopian Demographic and Health Survey. A total weighted sample of 4,152 women aged 15–49 years who gave birth in the 2 years preceding the survey were included in the analysis. The Bernoulli model was fitted using SaTScan V.9.6 to identify cold-spot areas and ArcGIS V.10.7 to explore the spatial distribution of prenatal HIV test uptake. Stata version 14 software was used to extract, clean, and analyze the data. A multilevel logistic regression model was used to identify the individual- and community-level determinants of prenatal HIV test uptake. An adjusted odds ratio (AOR) with a corresponding 95% confidence interval (CI) was used to declare significant determinants of prenatal HIV test uptake.ResultsThe prevalence of HIV test uptake was 34.66% (95% CI: 33.23, 36.13%). The spatial analysis revealed that the distribution of prenatal HIV test uptake was significantly varied across the country. In the multilevel analysis, the following individual and community-level determinants were significantly associated with prenatal HIV test uptake: women who attained primary education (AOR = 1.47, 95% CI: 1.15, 1.87) and secondary and higher education (AOR = 2.03, 95% CI: 1.32, 3.11); women from middle (AOR = 1.46; 95% CI: 1.11, 1.91) and rich household wealth status (AOR = 1.81; 95% CI: 1.36, 2.41); those who had health facility visits in the last 12 months (AOR = 2.17; 95% CI: 1.77, 2.66); women who had higher (AOR = 2,07; 95% CI: 1.66, 2.59) and comprehensive HIV-related knowledge (AOR = 2.90; 95% CI: 2.09, 4.04); women who had moderate (AOR = 1.61; 95% CI: 1.27, 2.04), lower (AOR = 1.52; 95% CI: 1.15, 1.99), and no stigma attitudes (AOR = 2.67; 95% CI: 1.43, 4.99); those who had awareness of MTCT (AOR = 1.83; 95% CI: 1.50, 2.24); those from rural areas (AOR = 0.31; 95% CI: 0.16, 0.61); high community level of education for women (AOR =1.61; 95% CI: 1.04, 2.52); and those living in large central (AOR = 0.37; 95% CI: 0.15, 0.91) and small peripheral areas (AOR = 0.22; 95% CI: 0.08, 0.60).ConclusionIn Ethiopia, prenatal HIV test uptake had significant spatial variations across the country. Both individual- and community-level determinants were found to be associated with prenatal HIV test uptake in Ethiopia. Hence, the impact of these determinants should be recognized while developing strategies in “cold spot” areas of prenatal HIV test uptake to enhance prenatal HIV test uptake in Ethiopia. |
| first_indexed | 2024-04-10T09:06:30Z |
| format | Article |
| id | doaj.art-52b4a1d0850b4d319fd17e1527bb60b9 |
| institution | Directory Open Access Journal |
| issn | 2296-2565 |
| language | English |
| last_indexed | 2024-04-10T09:06:30Z |
| publishDate | 2023-02-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Public Health |
| spelling | doaj.art-52b4a1d0850b4d319fd17e1527bb60b92023-02-21T07:03:50ZengFrontiers Media S.A.Frontiers in Public Health2296-25652023-02-011110.3389/fpubh.2023.962539962539Individual and community-level determinants and spatial distribution of prenatal HIV test uptake in Ethiopia: Spatial and multilevel analysisNuhamin Tesfa Tsega0Daniel Gashaneh Belay1Daniel Gashaneh Belay2Melaku Hunie Asratie3Moges Gashaw4Mastewal Endalew5Fantu Mamo Aragaw6Department of Women's and Family Health, School of Midwifery, College of Medicine and Health Sciences, University of Gondar, Gondar, EthiopiaDepartment of Human Anatomy, College of Medicine and Health Sciences, University of Gondar, Gondar, EthiopiaDepartment of Epidemiology and Biostatistics, College of Medicine and Health Sciences, Institute of Public Health, University of Gondar, Gondar, EthiopiaDepartment of Women's and Family Health, School of Midwifery, College of Medicine and Health Sciences, University of Gondar, Gondar, EthiopiaDepartment of Physiotherapy, School of Medicine, College of Medicine and Health Science, University of Gondar, Gondar, EthiopiaDepartment of Environmental and Occupational Health and Safety, College of Medicine and Health Sciences, Institute of Public Health, University of Gondar, Gondar, EthiopiaDepartment of Epidemiology and Biostatistics, College of Medicine and Health Sciences, Institute of Public Health, University of Gondar, Gondar, EthiopiaIntroductionHuman immunodeficiency virus (HIV) testing and counseling services are routine prenatal care services for the prevention of mother-to-child transmission of HIV. Although the prevalence of HIV infection is high among women, evidence suggests that the uptake of HIV testing during prenatal services in Ethiopia is scarce. Therefore, the aim of this study was to investigate individual- and community-level determinants and the spatial distribution of prenatal HIV test uptake in Ethiopia based on the 2016 Ethiopian Demographic and Health Survey.MethodsData were accessed from the 2016 Ethiopian Demographic and Health Survey. A total weighted sample of 4,152 women aged 15–49 years who gave birth in the 2 years preceding the survey were included in the analysis. The Bernoulli model was fitted using SaTScan V.9.6 to identify cold-spot areas and ArcGIS V.10.7 to explore the spatial distribution of prenatal HIV test uptake. Stata version 14 software was used to extract, clean, and analyze the data. A multilevel logistic regression model was used to identify the individual- and community-level determinants of prenatal HIV test uptake. An adjusted odds ratio (AOR) with a corresponding 95% confidence interval (CI) was used to declare significant determinants of prenatal HIV test uptake.ResultsThe prevalence of HIV test uptake was 34.66% (95% CI: 33.23, 36.13%). The spatial analysis revealed that the distribution of prenatal HIV test uptake was significantly varied across the country. In the multilevel analysis, the following individual and community-level determinants were significantly associated with prenatal HIV test uptake: women who attained primary education (AOR = 1.47, 95% CI: 1.15, 1.87) and secondary and higher education (AOR = 2.03, 95% CI: 1.32, 3.11); women from middle (AOR = 1.46; 95% CI: 1.11, 1.91) and rich household wealth status (AOR = 1.81; 95% CI: 1.36, 2.41); those who had health facility visits in the last 12 months (AOR = 2.17; 95% CI: 1.77, 2.66); women who had higher (AOR = 2,07; 95% CI: 1.66, 2.59) and comprehensive HIV-related knowledge (AOR = 2.90; 95% CI: 2.09, 4.04); women who had moderate (AOR = 1.61; 95% CI: 1.27, 2.04), lower (AOR = 1.52; 95% CI: 1.15, 1.99), and no stigma attitudes (AOR = 2.67; 95% CI: 1.43, 4.99); those who had awareness of MTCT (AOR = 1.83; 95% CI: 1.50, 2.24); those from rural areas (AOR = 0.31; 95% CI: 0.16, 0.61); high community level of education for women (AOR =1.61; 95% CI: 1.04, 2.52); and those living in large central (AOR = 0.37; 95% CI: 0.15, 0.91) and small peripheral areas (AOR = 0.22; 95% CI: 0.08, 0.60).ConclusionIn Ethiopia, prenatal HIV test uptake had significant spatial variations across the country. Both individual- and community-level determinants were found to be associated with prenatal HIV test uptake in Ethiopia. Hence, the impact of these determinants should be recognized while developing strategies in “cold spot” areas of prenatal HIV test uptake to enhance prenatal HIV test uptake in Ethiopia.https://www.frontiersin.org/articles/10.3389/fpubh.2023.962539/fullspatial variationmultilevel analysisprenatalHIV test uptakeEthiopia |
| spellingShingle | Nuhamin Tesfa Tsega Daniel Gashaneh Belay Daniel Gashaneh Belay Melaku Hunie Asratie Moges Gashaw Mastewal Endalew Fantu Mamo Aragaw Individual and community-level determinants and spatial distribution of prenatal HIV test uptake in Ethiopia: Spatial and multilevel analysis Frontiers in Public Health spatial variation multilevel analysis prenatal HIV test uptake Ethiopia |
| title | Individual and community-level determinants and spatial distribution of prenatal HIV test uptake in Ethiopia: Spatial and multilevel analysis |
| title_full | Individual and community-level determinants and spatial distribution of prenatal HIV test uptake in Ethiopia: Spatial and multilevel analysis |
| title_fullStr | Individual and community-level determinants and spatial distribution of prenatal HIV test uptake in Ethiopia: Spatial and multilevel analysis |
| title_full_unstemmed | Individual and community-level determinants and spatial distribution of prenatal HIV test uptake in Ethiopia: Spatial and multilevel analysis |
| title_short | Individual and community-level determinants and spatial distribution of prenatal HIV test uptake in Ethiopia: Spatial and multilevel analysis |
| title_sort | individual and community level determinants and spatial distribution of prenatal hiv test uptake in ethiopia spatial and multilevel analysis |
| topic | spatial variation multilevel analysis prenatal HIV test uptake Ethiopia |
| url | https://www.frontiersin.org/articles/10.3389/fpubh.2023.962539/full |
| work_keys_str_mv | AT nuhamintesfatsega individualandcommunityleveldeterminantsandspatialdistributionofprenatalhivtestuptakeinethiopiaspatialandmultilevelanalysis AT danielgashanehbelay individualandcommunityleveldeterminantsandspatialdistributionofprenatalhivtestuptakeinethiopiaspatialandmultilevelanalysis AT danielgashanehbelay individualandcommunityleveldeterminantsandspatialdistributionofprenatalhivtestuptakeinethiopiaspatialandmultilevelanalysis AT melakuhunieasratie individualandcommunityleveldeterminantsandspatialdistributionofprenatalhivtestuptakeinethiopiaspatialandmultilevelanalysis AT mogesgashaw individualandcommunityleveldeterminantsandspatialdistributionofprenatalhivtestuptakeinethiopiaspatialandmultilevelanalysis AT mastewalendalew individualandcommunityleveldeterminantsandspatialdistributionofprenatalhivtestuptakeinethiopiaspatialandmultilevelanalysis AT fantumamoaragaw individualandcommunityleveldeterminantsandspatialdistributionofprenatalhivtestuptakeinethiopiaspatialandmultilevelanalysis |