Prevalence and Associated Factors of HIV Testing Among Pregnant Women: A Multilevel Analysis Using the Recent Demographic and Health Survey Data from 11 East African Countries

Misganaw Gebrie Worku,¹ Achamyeleh Birhanu Teshale,² Getayeneh Antehunegn Tesema<sup>2

1</sup>Department of Human Anatomy, University of Gondar, College of Medicine and Health Science, School of Medicine, Gondar, Ethiopia; ²Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia

Correspondence: Misganaw Gebrie Worku
Department of Human Anatomy, University of Gondar, College of Medicine and Health Science, School of Medicine, PO. Box: 196, Gondar, Ethiopia
Tel +251925987029
Email misgeb2008@gmail.com

Aim: In developing countries, particularly in sub-Saharan Africa, the burden of mother to child transmission (MTCT) of HIV is higher. Although the Joint United Nations Programme on HIV/AIDS (UNAIDS) and other organizations are working to eliminate MTCT, a large number of pregnant women are not screened for HIV in most African countries.
Methods: The demographic health survey (DHS) used two-stage stratified sampling technique to select the study participants and we appended the most recent DHS done in the 11 East African countries. A weighted sample of 53, 420 women were included. A multilevel logistic regression analysis was used due to the hierarchical structure of the DHS data. To determine whether or not there was a clustering, the Interclass Correlation Coefficient (ICC) and Median Odds Ratio (MOR) were determined. Model comparison was conducted using deviance (− 2LL).
Results: The prevalence of HIV testing among pregnant women was 77.56% [95% CI= 77.20%, 77.91%]. In the Multivariable multi-level analysis, variables such as respondent age, wealth index, marital status, educational level, HIV knowledge, HIV stigma indicator, risky sexual activity, women visiting health care facilities, multiple sexual partnership, early sexual initiation, and awareness about MTCT were the individual-level factors that were associated with HIV testing among pregnant women. While residence and community-level education were the community-level factors that were significantly associated with HIV testing.
Conclusion: The prevalence of HIV testing and counseling among pregnant women was higher compared to the previous report. Respondent age, wealth index, marital status, educational level, HIV knowledge, HIV stigma indicator, risky sexual activity, women visiting health care facilities, multiple sexual partnership, early sexual initiation, residence, community-level education and awareness about MTCT were the significant determinant of HIV testing.

Keywords: HIV/AIDS, East Africa, pregnant women, multilevel analysis