Voluntary Counseling and Testing for HIV Among Pregnant Women Presenting in Labor in Kigali, Rwanda

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Abstract
This study investigated factors related to acceptability of voluntary counseling and testing (VCT) for HIV among pregnant women presenting in labor in Kigali, Rwanda, in an era of free and effective antiretroviral drugs for prevention of perinatal transmission of HIV. A pilot-tested questionnaire was administered to study participants to solicit information regarding their intentions to accept or refuse VCT and treatment of HIV infection during labor and delivery if confirmed infected. Two factors correlated significantly with the acceptance rate. The strongest predictive factor for acceptability of HIV testing was the profession of the male partner. Women whose partners had skilled and well-paid jobs were about four times more likely to accept HIV testing than were women whose partners were unemployed (adjusted odds ratio, 3.5; confidence interval, 1.16-10.85). The other factor significantly associated with the acceptance rate was maternal age. The likelihood of acceptance of HIV testing was about three times higher among women 35 years or older than among younger mothers (adjusted odds ratio, 3.1; confidence interval, 1.01-9.4). For every 5-year increment in maternal age, the odds of acceptance of HIV testing increased by a factor of 1.20. Using this important finding, we constructed an acceptance rate probability curve that could serve as a useful tool to evaluate the efficacy of future interventions aimed at improving the acceptability rate of HIV testing among pregnant women at the study site.