Profile Women Pregnancy with HIV Infection in Clinic Voluntary

Counseling and Testing in Medan

Rahayu Lubis

, Jemadi

and Surya Utama

Faculty of Public Health, Universitas Sumatera Utara, Jalan Universitas No. 21, Medan, Indonesia

Keywords: HIV, AIDS, VCT, Pregnancy, Profile.

Abstract: There were 1.4 million women pregnancy with HIV in 2016 whole world. More than 90% HIV cases in

children get infection by mother to child transmission. In Indonesia, out of 43,264 pregnant women who

underwent HIV testing there were as many as 1,329 people (3.04%) positive HIV. The aim of study is to

describe the profile women pregnancy with HIV infection in clinic voluntary counselling and testing (VCT)

in Medan. This is the retrospective study. The Population is all pregnant women with HIV infection in clinic

VCT in Medan. The sample was pregnant women with HIV infection in 2015 to 2017. Data collection from

medical records. Analysis descriptive data was used and showed in table distribution and frequency. Total 92

respondents were studied. Majority of respondent in aged less than 35 years (75%), Bataknese (72.8%), have

more than 9 years attainment of education (77.2%) and spouse education (73.9%). There are (68.8%) don’t

have employment and their spouse (73.9%) work as non manual worker. They come to clinic in less than 6

month of pregnancy (64.1%), the CD4 less than 350 u/dl (65.2%), in late stadium (71.7%), receiving

antiretroviral therapy more than 6 month (73.9%) and don’t have opportunistic infection (53.3%).

1 INTRODUCTION

Human Immunodeficiency Virus (HIV) is still a

global problem. By 2016 about 36.7 million people

are infected with HIV in the world, 1.8 million of

whom are new HIV cases and about 1 million people

die from HIV (WHO, 2017). In the Asia and Pacific

region by 2016 there are 5.1 million people infected

with HIV. Approximately 270,000 people are new

infections of HIV, 15,000 new cases occur in children

and about 170,000 people die from HIV. The

country's highest HIV prevalence in Asia Pacific is

India, China, Indonesia and Pakistan, covering over

75% of new infections HIV in Asia Pacific. There are

more than 1.4 million (1.1 to 1.7 million) women

pregnancy with HIV infection by 2016. It is estimated

that 76% (66-88%) of women pregnancy with HIV

infection take antiretroviral drugs to prevent HIV

transmission to their babies because more than 90%

HIV cases in children get infection by mother to child

transmission (UNAIDS, 2017).

In Indonesia, HIV cases continue to increase and

have spread in 386 districts / cities. The cumulative

number of HIV patients from 1987-2016 was 232,323

people and the total cumulative AIDS sufferers were

86,725 people (Kemenkes RI, 2017). HIV infection

poses a threat to the development of human quality

and productivity in Indonesia. This is indicated by the

high rate of HIV transmission that occurs. HIV

transmission has begun to shift from predominantly

male-dominated, slowly increasing the number of

HIV-infected individuals in women (KPAN, 2010).

According to Ministry of Health Indonesia that from

86,780 people suffering from HIV, 56% of whom are

women and out of 43,264 pregnant women who

underwent HIV testing there were as many as 1,329

people (3.04%) positive HIV.

HIV-infected women are generally transmitted

from sexual partners, such as HIV-infected wives the

source of infection is HIV-infected husbands as well.

If the wife is pregnant then the risk of transmission

continues from the mother to the baby. The study in

the United States and Europe shows the magnitude of

the risk of perinatal HIV transmission in pregnant

women is 20-40%. The study in Samarinda reported

that the highest risk of HIV transmission in pregnant

women is transmitted from her husband as much as

77.3% (Abidah, 2017). Another study in Medan

showed the cumulative number of pregnant women

with HIV infection in Adam Malik Hospital from

period 2013 to2017 were 132 people (Anggreyani,

2015). Therefore, HIV infection in pregnant women

572

Lubis, R., Jemadi, . and Utama, S.

Proﬁle Women Pregnancy with HIV Infection in Clinic Voluntary Counseling and Testing in Medan.

DOI: 10.5220/0010078605720574

In Proceedings of the International Conference of Science, Technology, Engineering, Environmental and Ramiﬁcation Researches (ICOSTEERR 2018) - Research in Industry 4.0, pages

572-574

ISBN: 978-989-758-449-7

becomes very important because the consideration of

its effect on pregnancy and the baby. The aim of this

study is to know the profile of the incidence of women

pregnancy with HIV infection in VCT Clinic Medan

City.

2 METHODS

This is a retrospective study in clinic voluntary

counselling and testing in Medan. The Population is

all pregnant women with HIV infected patients in

clinic VCT in Medan. The sample was pregnant

women with HIV infected patient in clinic VCT

Medan during the period of 2015-2017. Data

collection from medical records at clinic VCT in

Medan. Analysis with descriptive data was used and

showed in table distribution and frequency.

3 RESULT AND DISCUSION

3.1 Sociodemographic Characteristic

Totally 92 pregnant women with HIV infection

included in this study. Majority in aged less than 35

years old (75%), Bataknese (72.8%), with Christian

religion (51.1%). More than 9 years attainment of

respondent’s education (77.2%) and spouse education

(73.9%). There are (68.8%) of respondent don’t have

employment and their spouse (73.9%) as non manual

worker, such as government employees, private

employees, for more details can be seen in Table 1.

Similarity with this study in Africa reported that

elevated incidence of pregnant women with HIV

infection in younger women (less than 35 years old)

(Chetty, 2017). In this study the youngest age of

pregnant women with HIV is 21 years, and the oldest

age is 42 years. The largest proportion of pregnant

women with HIV occurs in the age less than 35 years.

The age group of 20-35 years is the age of active

reproduction and the best age for childbirth because

pregnancy in age above 35 years is high risk. Similar

with this study in Sanglah hospital in Bali found that

the largest proportion of pregnant women with HIV

occurred at the age of less than 35 years (Suherlim,

2015).

3.2 Clinical Condition

Regarding the clinical condition of respondent,

majority come to clinic with less than 6 month of a

pregnancy (64.1%) with the CD4 less than 350 u/dl

(65.2%), in late stadium of HIV (71.7%) and

receiving antiretroviral therapy more than 6 month

(73.9%). Haemoglobin level and body mass index

(BMI) not much difference between normal and

abnormal level. The respondent who don’t have

opportunistic infection (53.3%) and who have

opportunistic infection (46.7%). It can seen in Table

2. Similarity with this study in Brighton reported that

about 60% pregnant women with HIV infection

received ART (Salters, 2017). Pregnant women

received ART for prevention of mother to child

transmission as per protocol which varied during the

period of study (Dadhwal, 2017). In Africa, more than

half pregnant women with HIV infection come to

clinic with less immunity and there were association

between pregnancy and clinical (Wall, 2017). The

similar study showed that the respondent come to

clinic on average at 22 weeks gestation (range 6-34)

and most of patient with BMI more increased

(Floridia, 2017). Antiretroviral therapy can maintain

the condition of pregnant women with HIV.

Similarity with this study showed that ART can

extend the life expectancy of HIV patients (Lubis,

2014)

Table 1: Sociodemographic characteristic of respondent

Varibles f (%)

Aged (years old)

< 35

≥ 35

69 (75%)

23 (25%)

Ethnic

Bataknese

Javanese

Others

67 (72.8%)

16 (17.4%)

9 ( 9.8%)

Religion

Christian

Moeslem

Bhuddist

47 (51.1%)

44 (47.8%)

1 ( 1.1%)

Education of Pregnant

women

≥ 9 years attainment

< 9 years attainment

Education of Spouse

≥ 9 years attainment

< 9 years attainment

71 (77.2%)

21 (22.8%)

68 (73.9%)

24 (26.1%)

Occupotional of Pregnant

women

Not Employment

Employment

Occupotional of Spouse

Non manual worker

Manual worker

63 (68.5%)

29 (31.5%)

68 (73.9%)

24 (26.1%)

Proﬁle Women Pregnancy with HIV Infection in Clinic Voluntary Counseling and Testing in Medan

573

Table 2: Clinical condition of respondent

Varibles f (%)

Pregnancy

< 6 month

≥ 6 month

59 (64.1%)

33 (35.9%)

CD4 (u/dl)

≥ 350

< 350

32 (34.8%)

60 (65.2%)

BMI (kg/m

)

≥ 23

< 23

49 (53.3%)

43 (46.7%)

Hb (g%)

≥ 11

< 11

47 (51.1%)

45 (48.9%)

Stadium of HIV

Early

Late

26 (28.3%)

66 (71.7%)

Infeksi opportunistic

Yes

49 (53.3%)

43 (46.7%)

Antiretroviral therapy

≥ 6 month

< 6 month

68 (73.9%)

24 (26.1%)

4 CONCLUSIONS

The Majority of pregnant women in aged less than 35

years, Bataknese , Christian religion, have more than

9 years attainment of education for respondents and

their spouse, unemployment of respondent and their

spouse work as non manual worker. They come to

clinic in less than 6 month of pregnancy, the CD4 less

than 350 u/dl, in late stadium of HIV, receiving

antiretroviral therapy more than 6 month

Haemoglobin level and body mass index not much

difference between normal and abnormal level. The

respondent who don’t have opportunistic infection

more than who have opportunistic infection.

ACKNOWLEDGEMENTS

This study supported by TALENTA fund Universitas

Sumatera Utara (Basic Research Scheme) in 2018

based on contract number 185/UN5.2.3.1/PPM/KP-

TALENTA USU/2018.

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