To test or not to test? What makes pregnant women decide to take an HIV test?

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Abstract
The aim of this study was to compare the cognitions of pregnant women who decide to take an HIV test with those who decide against testing. As part of a randomized controlled trial of different methods of offering the HIV test, 1,817 antenatal attenders who were offered a test completed a questionnaire following the consultation. The measures were based on constructs from social cognition models. Uptake was noted and ‘testers’ and ‘non-testers’ were compared. There were 642 testers (35%) and 1175 non-testers (65%). The most frequently reported reasons for taking and not taking the HIV test were, respectively: ‘It's a good idea to have it as a routine test’ and ‘I've been in a stable relationship for a long time’. Independent predictors of uptake were: being in favour of testing, the midwife seen, being single, perceived benefits for the baby, perceived benefits for research, perceived risk of HIV and knowledge that breastfeeding can transmit HIV. In areas where an increase in uptake is desired, information given to women should focus on increasing perceived benefits of testing for the baby, perceived risk and knowledge about breastfeeding. Making the test more routine may increase women's positive attitudes towards the test, thereby increasing uptake.