Research On Pregnant Women Utilizing PMTCT Services In Rural Regions Of Low-intensity Transmission

Since the first AIDS patient reported in1985in China, the number of peopleliving with HIV/AIDS keeps going up, among which the HIV-positive womenaccount for28.6%.In recent years, the proportion of women infected by HIV has anincreasing trendency. Although the cases of the HIV-positive Children via mother tochild transmission has benn low so far, the risk of mother to child transmissionincreases gradually as a result of the more number of the women infected with themain mode of sex transmission.Currently,the resources for HIV/AIDS preventionand treatment are more inclined to high-prevalence regions.With the development ofthe national epidemic on HIV-AIDS, PMTCT in low prevalence regions is facinggreat challenges.【Objective】Aiming at investigating on AIDS KAP, health education needs and the statusquo of PMTCT service utilization and analyzing its influencing factors amongpregnant women in some rural regions of low-intensity transmission, with theintegrated use of a variety of AIDS health education interventions, to promote ruralwomen to change attitudes and behaviors for their self-protection awareness and toestablish the integrated PMTCT intervention model on rural women reproductiveage and get objective evaluation from the health administrative departments onPMTCT effects and the basis of relevant policies formulated.【Methods】In the survey stage of rural pregnant women AIDS KAP, health education needsand the status quo of PMTCT service utilization in some rural regions of low-intensitytransmission, using self-designed questionnaire.401rural pregnant women wereinvestigated outpaitnet and in the hospital in C county,G city, L county and Q county of Jilin province.In the AIDS health education intervention stage,400women ofchildbearing age were investigated in the baseline and final survey.The methods ofimplementation of health education intervention include centralized trainingn, videos,PMTCT health material dissemination, group activities, role-playing, peer education,etc. The same questionnaire was used before and after the intervention and descriptivestatistical analysis, analysis and logistic regression were applied. AIDS-relatedknwledge and attitude and willingness to HIV counseling and testing were comparedbefore and after the intervention and the factors affecting their willingness to HIVcounseling and testing were analyzed.【Results】In the survey stage of rural pregnant women AIDS KAP,health education needsand the status quo of PMTCT service utilization,404questionnaires weredistributed.401questionnaires were valid andvalid rate of return was99.3%.1.AIDS and MTCT knowledge awareness rate were46.9%and22.4%respectively among rural pregnant women,60.3%of which wouldn’t contact withHIV-infected people and AIDS patients, holding discriminatory attitudes. Theproportion of pregnant women frequently use and each use condoms only8.2%and2.7%.2.Rural pregnant women have AIDS health education needs, accounting for49.4%. The proportion of TV, brochures and health lectures accounted for48.5%,47.0%and39.9%respectively in the ways of health education. AIDS healtheducation content selection focused on the understanding of AIDS relevantknowledge.71.3%rural pregnant women would take part in PMTCT educationactivities. The most important reason that pregnant women didn’t participate ineducation activities is no time.This study shows that among401rural pregnantwomen, only7.2%(29cases) rural pregnant women participated in AIDS healtheducation activities.3.20.7%pregnant women know about the place to get free condoms,7.7%pregnant women were instructed to use condoms properly.AIDS counseling rate was 8%,32of401rural pregnant women. Among32pregnant women,59.4%pregnantwomen accepted AIDS counseling before HIV antibody test,12.5%after HIVantibody test,28.1%both before and after HIV antibody test. HIV antibody test was57.9%.93.5%pregnant women tested one times,4.3%tested two times, and2.2%tested over3times.12.1%tested before pregnancy,14.7%in early andmid-pregnancy,6.5%in the third trimester of pregnancy,74.6%before giving a birthto a child,0.9%after giving a birth to a child,9.9%voluntary test,25.9%afterdoctors recommend,64.2%when hospitalized.26.7%were told the interpretation ofthe test results by doctors,73.3%were not.In the AIDS health education intervention stage of400rural women ofchildbearing age,400questionnaires were distributed.400questionnaires were validand valid rate of return was100%.The rate of AIDS knowledge awareness among women of childbearing age is33.0%, and the rate of MTCT knowledge awareness is21.0%.After AIDS healtheducation intervention the rate of AIDS knowledge awareness is93.3%, and the rateof MTCT knowledge awareness is90.5%. Rural women of childbearing age AIDSrelated knowledge, attitude and desire were statistically significant before and afterthe intervention.【Conclusions】1.AIDS-related knowledge awareness among rural pregnant women is low inrural regions of low-intensity transmission.Most pregnant women wouldn’t contactwith HIV-infected people and AIDS patients, and hold discriminatory attitudes.Theircondom use is so low and their discriminatory attitudes and behaviors haverelationship with low level of AIDS knowledge awareness.2. PMTCT services utilization is poor. The percentage of pregnant women inearly and middle pregnancy with HIV antibody test is quite low..3.The influencing factors of rural pregnant women AIDS knowledge awarenessare education, spouse/boyfriend nation, and spouse/boyfriend education. Theinfluencing factors of rural pregnant women MTCT knowledge awareness are spouse/boyfriend nation, the family average annual income last year, attendingschool training for pregnant women. The influencing factors of rural pregnantwomen AIDS counseling are the nation, emotion of a couple, attending schooltraining for pregnant women, pregnancy check more than5times, MTCT knowledgeawareness, participation of AIDS health education activities. The influencing factorsof rural pregnant women HIV antibody test are nation, delivery times, and attendingschool training for pregnant women, pregnancy check more than5times.The factorsof intervention and AIDS knowledge awareness have impact on AIDS counselingdesire of rural pregnant women of childbearing age. HIV antibody tests of ruralwomen of childbearing age before and during pregnancy are influenced byintervention and AIDS knowledge awareness and MTCT knowledge awareness.4.The method of participatory centralized training, group activities, peereducation improve rural women of childbearing age of AIDS-related knowledge,and changed their attitudes and willingness to HIV counseling and testing. ThePMTCT services utilization in rural regions of low-intensity transmission wasexplored with the implementation of individual intervention and group interventionon rural women of childbearing age.