Barriers to HIV testing among mothers at a maternity ward in Phnom Penh, Cambodia

Introduction

As a response to the shift in epidemic transmission, prevention of mother to child transmission (PMTCT) services have been expanded in Cambodia. However, the improvement of the acceptance for HIV testing and counselling is still challenging even after the ministry of health in Cambodia adopted provider-initiated HIV testing and counselling (PITC) policy. The objective of this study was to investigate the accessibility of HIV testing and its barriers among mothers at maternity ward in Phnom Penh where the PITC approach had been widely offered.

Methods

This study was a quantitative and cross-sectional assessment of mothers after delivery at National Maternal and Child Health Centre (NMCHC) in Phnom Penh. Randomly selected 599 mothers from October through December 2007 were asked to participate in a half hour's face-to-face interview by trained interviewers.

Results

Of the 599 mothers, 455 (76%) had an experience of HIV testing. Most of the mothers got information about HIV testing from health care provider (360: 79.1%) and mass media (86: 18.9%). After adjusting by the multivariate logistic regression, need of partner's permission for HIV testing (OR = 0.27, 95% CI = 0.14–0.51, p < 0.01), low knowledge on HIV prevention and treatment (OR = 0.38, CI = 0.22–0.66, p < 0.01), ANC place out of Phnom Penh (OR = 0.35, 95% CI = 0.21–0.58, p < 0.01) were found to be barriers to HIV testing.

Discussion

Three factors were found to be barriers to HIV testing: partner's permission, low knowledge on HIV prevention and treatment, and place of ANC. It is necessary to provide education and quality counselling not only for mothers but also for their partners even in PITC strategy. In addition, access of pregnant women to HIV testing and counselling services in rural areas should be improved through strategic approaches such as efficient utilization of human resources.