HIV rapid test counseling among
					parturient

Passos, Suzana Cordeiro da Silva; Oliveira, Maria Inês Couto de; Júnior, Saint Clair dos Santos Gomes; Silva, Kátia Silveira da

doi:10.1590/S1415-790X2013000200005

Introduction:

The pre and post-HIV test counseling is recommended by the Ministry of Health, and is a tool for reflection and joint decision-making.

Objectives:

To determine the proportion of women receiving counseling for submission to the HIV rapid test and to assess factors associated to not receiving counseling for this test.

Method:

A cross-sectional study was conducted in five “Baby-Friendly Hospitals” from the High Risk Pregnancy System in Rio de Janeiro City, Southeast Brazil. The study population were 955 rooming-in parturients, undergoing the HIV rapid test, between September 11^thand December 11^th, 2006. Semi-standardized questionnaires were applied to the mothers, and data were also obtained from laboratory and health archives. Binomial regression was performed in order to analyze the variables associated with non-counseling.

Results:

Were submitted to the HIV rapid test 28.5% of the parturients, and only 26.9% of them were counseled. Factors associated with non-counseling were: maternal education below 8 years of school (PR = 1.36; 95% CI: 1.15-1.62), 0 to 3 prenatal visits (RP = 0.73; IC 95%: 0.59-0.90) and hospitals with less than 50% of the parturients submitted to the HIV rapid test (PR = 1.65; 95% CI: 1.40-1.96).

Conclusion:

Socially underprivileged women were not a target of counseling, and only the low number of prenatal visits proved to be a protective factor against non-counseling. Counseling was seldom practiced for HIV rapid testing, indicating that this test has been performed without the consent of women, in an imperative way.

Counseling; HIV rapid test; Parturition; Women’s Rights; Cross-sectional studies.

[1] Corresponding author: Suzana Cordeiro da Silva Passos. Rua Otavio Carneiro, 116 apto. 1302, Icaraí, 24230-191 Rio de Janeiro, RJ. E-mail: suzanaunirio@yahoo.com.br

Hospital	Deliveries performed		Women submitted to the HIV rapid test		Eligible women	Interviewed women	Prevalence of non-counseling
Hospital	n	%	N	%	N	N	%
1	1,152	23.5	585	50.7	456	392	62.8
2	1,893	38.7	349	18.4	301	276	76.8
3	1,081	22.1	328	30.3	246	220	84.1
4	159	3.3	60	37.7	34	32	84.4
5	210	4.3	74	35.2	37	35	80.0
Total	4,895	100.0	1,396	28.5	1,074	955	73.1

Variables	N	%	Prevalence of non-counseling	PR	CI	p-value
Age *
13 to 19 years	254	26.6	73.2	1.007	0.795-1.277	0.953
20 years or more	701	73.4	73.0	1
Ethnicity *
Non-white	693	72.6	72.9	0.971	0.766-1.230	0.805
White	262	27.4	73.7	1
Level of education *
Up to 7 years	415	43.5	78.3	1.426	1.142-1.781	0.001
8 years or more	540	56.5	69.1	1
Maternal income *
Up to 1 minimum wage	691	72.4	71.9	0.850	0.664-1.087	0.189
More than 1 minimum wage	264	27.6	76.1	1
Number of household goods**
0 to 3	358	37.5	76.5	1.241	0.991-1.555	0.057
4 to 5	594	62.2	70.9	1
Mother has a partner *
No	120	12.6	75.2	1.087	0.782-1.511	0.614
Yes	835	87.4	72.8	1
Number of children ***
Primiparous	373	39.3	74.0	1.066	0.859-1.323	0.559
Multiparous	577	60.7	72.3	1

Variables	N	%	Prevalence of non-counseling	PR	CI	p-value
Trimester of beginning of prenatal care **
1st trimester	334	35.0	70.4	1	-
2nd trimester	429	44.9	76.7	1.090	1.000-1.190	0.048
3rd trimester	106	11.1	73.6	1.050	0.920-1.200	0.520
Did not receive prenatal care	82	8.6	64.6	0.920	0.770-1.090	0.310
Number of consultations***
4 or more	758	80.1	74.3	1
0 to 3	188	19.9	67.0	0.902	0.809-1.006	0.045
Had the HIV rapid test during prenatal care*
Yes	743	77.8	74.4	1
No	212	22.2	68.4	0.809	0.641-1.021	0.081
Type of hospital where delivery was performed*
Hospital 1	392	41.0	62.8	1
Hospitals with less than 50% of parturients submitted to the HIV rapid test	563	59.0	80.3	1.889	1.531-2.332	0.000
Type of delivery *
Vaginal	642	67.2	73.2	1
Cesarean section	313	32.8	72.8	0.987	0.790-1.232	0.905

	N	%
Received information about the performance of the HIV rapid test
Yes	716	75.0
No	24	2.5
Did not know	215	22.5
Received an explanation about the reason for the HIV rapid test to be performed
Yes	416	43.5
No	526	55.1
Did not know	13	1.4
Received the test results
Negative	444	46.5
Positive	6	0.6
Did not know	505	52.9
Received counseling
Yes	257	26.9
No	698	73.1
Total	955	100

	Crude PR	Adjusted PR	95%CI	p-value
Level of education lower than complete primary school	1.426	1.364	1.153-1.615	0.000
Complete primary school or higher	1	1
Had 0 to 3 prenatal consultations	0.902	0.727	0.587-0.899	0.003
Had 4 or more prenatal consultations	1	1
Delivery performed in hospitals with less than 50% of parturients submitted to the HIV rapid test	1.889	1.654	1.398-1.958	0.000
Delivery performed in a hospital with more than 50% of parturients submitted to the HIV rapid test	1	1