HIV Screening Test And Correlates In Early Pregnancy Among Rural Women In High HIV/AIDS Epidemic Areas, Yunnan

Objectives:To understand the HIV detection rate of rural women in their first trimester pregnancy in high HIV/AIDS epidemic areas in Yunnan, and to explore the correlates, so as to provide a basis to promote HIV testing services measures of rural pregnant women in high HIV/AIDS epidemic areas in Yunnan.Methods:A cross sectional study was conducted in four counties chosen from Lincang and Dali prefectures respectively in high HIV/AIDS epidemic areas in Yunnan. A questionnaire survey was undertaken to671sampled randomly rural women during28weeks gestation and6months postpartum women concerning HIV screening test, HIV/AIDS knowledge, attitude, and mental health. In-depth interview was conducted to the women with no HIV detection, health managers and medical staff in local medical institutions regarding the cause of not accepting the HIV testing, problems and possible ways to solve the problem.Results:The total of671rural women received the survey, including242women in their third trimister pregnancy and429postpartum women.(1)The average age of subgects was25±6.0years old. Most of the women received middle school education and above. The han nationality and minority occupied half respectively, family income per capita was3000±3571.43yuan RMB.(2)The awareness rate of HIV/AIDS knowledge was71.9%. The women knew more knowledge regarding three main transmission ways of the AIDS, but less knowledge concerning prevention of mother to child transmission (PMTCT). The awareness rate of consulting of free HIV testing was low. The score of AIDS comprehensive knowledge was13.00±4.00. women who would like to contact HIV+people accounted for58.1%, with the percentage in Lincang being lower than in Dali.(3) The total avarage score of SCL90was1.20±0.30, with a total score of108.00±27.00. There was no significant difference of the avarage score of each factor in SCL-90between pregnant women and postpartum women except for somatization factor score in pregnant women being higher than that in postpartum women. The prevenlance rate of psychological problems was17.0%. The positive rates of somatization, force symptom, hostile ranked the tope three positions in the10factors, with the positive rates of7.9%,7.5%and5.8%, respectively.(4)HIV detection rate of women in their first trimester pregnancy was46.2%, with no signaficant difference of the detection rate between the two prefectures. Multiple Logistic Regression models indicated that being minority, not informing the necessory of HIV test in the first trimister pregnancy and those pregnant women having one or more children were positively associated with no HIV test. Moreover, the women with anxious emotion promoted HIV test.Conclusion:The HIV detection rate of rural women in their first trimester pregnancy in high HIV/AIDS epidemic areas in Yunnan is low. The correlates of no HIV test are being minority, not informing the necessory of HIV test in the first trimister pregnancy and. those pregnant women having one or more children. This study highly suggests that it is urgent to strengthen health care of the first trimister pregnnacy and combine the PMTCT work with regular maternal and child health care work, so as to improve rural women to use PMTCT services.