Pregnant Women Participation in HIV Test in Blang Mangat

Primary Health Care, Lhokseumawe

Mardiana

, Putri Chairani Eyanoer

Blang Mangat Primary Health Care, Lhokseumawe

Department of Preventive and Community Medicine, Faculty of Medicine, Universitas Sumatera Utara

Keywords: Pregnant Women, Support of HIV Test, Primary Health Care

Abstract: The numbers of pregnant women performing HIV test in Blang Mangat Primary Health Care remain low at

25%. This situation is caused by several factors including lack of knowledge about HIV test, attitude

towards HIV and lack of family support. A cross-sectional design with a total of 101 pregnant women with

consecutive sampling technique was performed. The variable examined namely age, educational

background, knowledge, attitude, husband's and health officer's support. Data were analyzed using the Chi-

Square test and multiple logistic regression to identify the variable that has the greatest impact on the

participation of the pregnant women for HIV test. We found that pregnant women were generally lacking of

knowledge (57.4%) and with a positive attitude (60.4%). Women with support from the husband were

found as many as 61 people (60.4%) and support from the health officer (58.4%). However, most pregnant

women did not want to participate in HIV testing (51.5%). This study found that knowledge and husband's

support are variable with the greatest impact on the participation of pregnant women for HIV testing.

1 INTRODUCTION

WHO studies in several Asia Pacific countries show

that HIV screening of pregnant women conducted in

antenatal care is really cost-effective to prevent

mother-to-child HIV transmission (Kemenkes,

2015). In 2016, new cases of HIV infection in

Indonesia were as many as 48,000 with the

incidence of 0.19%. The total population living with

HIV is 620,000, while the case of pregnant women

in antiretroviral treatment is 14% (UNAIDS, 2017).

More than 90% of the HIV infected child cases

contracted the disease through mother-to-child

infection (Kemenkes 2015).

The implementation of screening among

pregnant women by using the voluntary and

confidential test service (VCT) has risen in all over

Indonesia. However, the knowledge of the existence

of this service is still limited. This corresponds with

a study that showed 16 out of 27 respondents

(59.3%) with low knowledge did not perform VCT

test. Statistically, there is a correlation between the

level of knowledge with the participation of VCT

test in pregnant women (Nurhayati,2016).

People with a higher economy level found to

have better information on VCT service, as well as

on HIV prevention programs (Unicef, 2012). In

Blang Mangat Primary Health Care, only around

25% of pregnant women perform HIV test in the

VCT service. The low utilization of VCT service is

caused by many factors. One of which is the health

officer's support. A study found that those who

perform the VCT receive support from the health

officer (70.8%) (Khoiriyah, 2016). Another study

showed that husband's support is correlated

significantly with VCT test in Public Health Care

(Handayani,2017). This study will look on to several

factors that influenced the willingness of pregnant

women to perform HIV test at the VCT service in

Blang Mangat Primary Health Care.

2 METHODS

This research applied an analytic method with a

cross-sectional design. The population in this study

is all pregnant women in Blang Mangat

Lhokseumawe area, Aceh Province, Indonesia.

Based on sample size computation, a total of 101

pregnant women were then recruited based on their

inclusion criteria

Mardiana, . and Eyanoer, P.

Pregnant Women Participation in HIV Test in Blang Mangat Primary Health Care, Lhokseumawe.

DOI: 10.5220/0009862601670170

In Proceedings of the 2nd International Conference on Tropical Medicine and Infectious Disease (ICTROMI 2019), pages 167-170

ISBN: 978-989-758-469-5

167

Structured interviews were done using a

validated questionnaire to collect primary data from

pregnant women. Meanwhile, secondary data was

obtained from the Health Office of Lhokseumawe,

village office, health, and other related institutions.

The questionnaire is divided into 2 categories,

namely category A and category B. Category A

contains common information such as

respondent’sage, education and occupation.

Category B contains specific data such as

knowledge, attitude, husband's support, and health

officer's support.

Univariate, bivariate, and multivariate analysis

were done. The univariate analysis aims to describe

the frequency distribution of pregnant women based

on their characteristics such as age and education.

Bivariate analysis in the form of a Chi-square test

was done to see the correlation between independent

variables with the dependent variable. The

multivariate analysis aims to determine the most

influential independent variables by using multiple

logistic regression.

3 RESULTS

Factors correlated with the participation of pregnant

women for HIV testing at the Blang Mangat Health

Center of Lhoksumawe are listed in Table 1. It

shows that the majority of respondents are between

20-35 years old (n=53, 52.5%), in which the one

with the middle educational level was found in 43

people (42.6%) and mostly worked as a housewife in

68 people (67.3%).

Based on Table 1, it shows that respondents

below 20 years who did not want to participate in

the HIV test were as many as 8 people (7.9%), while

those who took the HIV test were 9 (8.9%). Among

the 20-35 years group, 27 people (26.7%) did not

want to participate and those who participated in the

HIV test were lower (n=26, 25.7%). There was no

association between maternal age and their

participation in HIV testing (P=0.870).

Of 101 pregnant women with elementary education,

there were only 13 people (12.9%) who did not want

to participate in HIV test and the one willing to

participate in HIV test were as many as 9 people

(8.9%). While pregnant women with higher

education who did not participate in HIV test were

only 16 people (15.8%), and those who took the HIV

test were 20 people (19.8%) There was no

association between education and pregnant women

participation in HIV testing (P=0.524).

In terms of knowledge, women with higher

awareness of HIV were more willing to undertake

the test (n=30, 29.7%) compared to the number of

the mother who had less information on HIV (n=19,

18.8%). There was a strong association between

knowledge and the participation of pregnant women

in HIV testing (P<0.001).

Table 1: The Association of Age, Knowledge, Attitude,

Husband’s Support, and Health Officer’s Support with the

Participation of Pregnant Women in HIV Test at

BlangMangat Health Centre 2018.

Characteristic

HIV Test on VCT service

Participate

Do not

participate

n % n %

0,870

Age

< 20 years 8 7,9 9 8,9

20-35 years 27 26,7 26 25,7

> 35 years 17 16,8 14 13,9

Educational Level

Elementary School 13 12,9 9 8,9

0,524

High School 23 22,8 20 19,8

College 16 15,8 20 19,8

Knowledge

Less 39 38,6 19 18,8

0,000

More 13 12,9 30 29,7

Attitude

Negative 25 24,8 23 12,9

0,025

Positive 27 26,7 36 35,6

Husband’s Support

Less 29 28,7 11 10,9

0,001

Good 23 22,8 38 37,6

Health Officer’s Support

Less 27 26,7 15 14,9

0,030

Good 25 24,8 34 33,7

Pregnant women with a negative attitude but

willing to participate in HIV test were as many as 23

people (12.9%), lower than those with a positive

attitude and participated in HIV test (n=36, 35.6%).

There was an association between knowledge and

the participation of pregnant women in HIV testing

(P=0.025).

Pregnant women with good husband support and

participated in HIV testing were as many as 38

people (37.6%), more than those with less support

from the husband but willing to participate in HIV

testing (n=11, 10.9%). The statistic test result shows

that there was an association between knowledge

and the participation of pregnant women in HIV

testing (P=0.025).

Pregnant women with good health care support

and participated in the HIV test were as many as 34

ICTROMI 2019 - The 2nd International Conference on Tropical Medicine and Infectious Disease

168

people (33.7%), more than those with less

knowledge and participated in the HIV test as many

as 15 people (14.9%). There was an association

between knowledge and the participation of

pregnant women in HIV testing (P=0.030).

Table 2. Analysis in Knowledge, Attitude, Husband’s

Support, and Health Officer’s Support, with The

Participation of Pregnant Women in HIV Test at

BlangMangat Health Centre 2018.

Variable B SE Sig OR

Step: 1

Knowledge 1,55 0,43 0,000 4,730

Constant -2,27 0,65

2 log likelihood:126,0 Overall Percentage: 68,3

Step: 2

Knowledge 1,36 0,45 0,003 3,925

Husband’s

Support

1,26 0,46 0,007 3,532

Constant -4,04

2 log likelihood:118,3 Overall Percentage: 67,3

Multivariate analysis shows that both knowledge

and husband's support is the most influential

variables in the participation of HIV test among

pregnant women, with an odds ratio of 3.925 and

3.532, respectively. This finding suggests that

pregnant women with less knowledge and or less

husband's support will have the risk of not

participating in HIV testing as much as 3.9 and or

3.5 times higher than pregnant women with good

knowledge or good support. This model showed a

contribution as high as 67.3% and it is statistically

significant with P<0.05.

4 DISCUSSION

The results of this study showed that the majority of

pregnant women were aged between 20 and 35 years

old. This is in accordance with a study that found

pregnant women who came to the VCT clinics were

women of the same age (Anggraini, 2017; Ernawati

et al, 2016; Nurmasari et al, 2015). Both studies

found that there was no association between age and

the willingness to participate in HIV test

Most pregnant women in this study were high

school graduates. This result is in accordance with a

study done previously where most pregnant women

who were recruited were high school graduates

(Olanrewaju et al, 2006; Anggarini, 2010).

Statistically, there was also no association between

level of education with the participation of pregnant

women in HIV test. This result is in accordance with

several studies done prior to this one (Halim et al.,

2016)

The analysis of the association between

knowledge and participation, however, is significant.

This result is supported by a similar study

(Nurhayati, 2016). Theory by Notoadmojo

mentioned that knowledge is a very important

domain for creating an action (Sari, 2014). Once a

pregnant woman understands the objectives and

benefits of VCT and where the VCT services can be

accessed, the willingness would then be higher

compared to those who still have no such

information. According to the behavioral theory of

Lawrence W. Green, there are several factors that

cause behavior in a person, such as predisposing

factors including level of education and knowledge.

The higher the education and the knowledge,

therefore, the more she will behave positively

(Notoatmodjo, 2012).

The statistical test result also shows that there

was an association between attitude and the

participation of pregnant women in HIV test. This is

harmonious with a study stating that there is a

correlation between attitude and behavior of HIV

test (Halim et al, 2016). However, another study

found no association between attitude and

willingness (Mujiati et al., 2014). The positive

attitude of the pregnant woman is affected by her

good knowledge of HIV/AIDS and VCT program

itself. Attitude is not yet action and/or activity,

however, it is a predisposition for an action/

practice. Attitude can be positive or negative

(Nuraini, et al, 2011). If the attitude of pregnant

women is positive towards the HIV test, then the

situation will likely to improve and the easier the

treatment process is to be given to prevent

transmission from mother to baby.

The statistical test result of husband support

variable shows that there is an association between

husband’s support with the participation of pregnant

woman in HIV test. This is in accordance with a

study that mentioned that there is a significant

correlation between husband support and VCT

examination (Handayani et al, 2017; Hikmah, 2015).

According to Friedman (2010), family support

consists of attitude, action, and acceptance of family

members. Husband as a role model in the family has

a responsibility to maintain and support and always

ready to provide help and assistance if necessary

from family members including providing support to

the wife in checking their health.

The analysis of health officer support shows that

there is an association between support of health

officer with the participation of pregnant women in

Pregnant Women Participation in HIV Test in Blang Mangat Primary Health Care, Lhokseumawe

169

HIV test. This is in accordance with a previous study

by Halim and Kusumawti (2016). The role of health

workers is very influential because health officers

often interact with pregnant women so that pregnant

women have a sense of trust and accept the presence

of officers for themselves in utilizing the service of

antenatal care (Kemenkes, 2012).

In this study, we found the most dominant factor

related to pregnant women's participation in HIV

Test at Puskesmas Blang Mangat Kota

Lhokseumawe is the knowledge of pregnant women

which has an OR equal to 3.9. This means that a

pregnant mother with good knowledge has the

probability to check their HIV status as much as 3.9

times when compared to pregnant women with less

knowledge. Husband support had an OR equal to

3.5, means that pregnant women with good husband

support have a probability to check HIV status 3.5

times when compared with pregnant women without

husband support. This result is in accordance with a

study by Nurhayati (2016) that showed a pregnant

woman with good knowledge was 5.4 times more

likely to check their HIV status. Meanwhile,

pregnant women with husband support were 6.1

times more likely to check their HIV status.

Knowledge factor is an influential factor in applying

new behavior as well as in HIV testing, the higher a

person's knowledge the easier it is to apply new

behaviors.

5 CONCLUSIONS

We concluded that there was a significant

association between knowledge, attitude, husband's

support, and health officers' support with the

participation of pregnant women in HIV testing

(P<0.05). While there was no significant correlation

between age and education level with the

participation of pregnant mother in HIV test at

Blang Mangat Public Health Centre in

Lhokseumawe (P>0.05). The most dominant factors

associated with the participation of pregnant women

in HIV Test was knowledge with P=0.003 and

husband's support with P=0.007.

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