An assessment of pregnant women's attitudes towards Human Immuno-Deficiency Virus (HIV) counseling and testing in urban Zimbabwe: a study of Rujeko maternity clinic in Dzivarasekwa high density suburb, Harare

Abstract

The purpose of this study was to assess the attitudes pregnant women have towards Human immune-deficiency virus (HIV) counseling and testing. The study`s objectives were to determine the basic characteristics of the respondents, to identify attitudes of pregnant women aged between 15-49 years, identify aspects of the policy on HIV counseling and testing and to draw recommendations on attitudes pregnant women have on HIV counseling and testing for policy makers and planners to review the policy, If need be. The main purpose of this study was to assess the attitudes of pregnant women towards HIV counseling and testing in urban settings. The study location was Rujeko maternity clinic in Dzivarasekwa High Density suburb of the City of Harare. With regard to the study methodology, its design was mainly qualitative and purposive sampling was used to select 8 pregnant women who had visited the clinic in their first pregnancy for ante-natal care. 5 key informants were drawn from the clinic staff and included the Matron, Sister-in-Charge and 3 maternity nurses/ counselors. The respondents were purposively selected at the reception area as they came in to register for ante-natal care. Consent to participate in the study was sought and Focus Group Discussions were conducted. It is from the focus group that those respondents who wished to be interviewed individually were selected for In-depth interviews where an interview was used, observations made and themes were drawn. Socio-demographic characteristics such as age, marital status, religion, location, level of education attained, nature of employment, ethnicity and number of pregnancies one had also determine how pregnant women perceive being tested for HIV. The results of this study showed that pregnant women developed positive attitude towards HIV counseling and testing because of their abundant knowledge about HIV and the benefits associated with being tested while pregnant. Most women who were or intended to become mothers were more concerned about the health of their born and unborn children despite the aversive experiences they go through during ante-natal care. The other results from this study are that pregnant women developed negative attitude towards HIV counseling and testing because of the coercive approach by service providers. The non-involvement of men and their traditional domineering status in most patriarchal societies stimulate the development of negative attitude towards HIV counseling and testing among pregnant women. It was also found out that maternity staff at Rujeko clinic was over-loaded with work since they were double-tasked working both as maternity nurses and as counselors. It is because of fatigue that they end –up failing to offer quality services to the pregnant women. Pregnant women spent the whole day registering for ante-natal care at Rujeko clinic. Pregnant women felt offended and disrespected by poor service delivery. This study recommended that HIV counseling and testing at Rujeko clinic be done by the book. Both enough human and appropriate infrastructure should be provided at Rujeko clinic. In conclusion, this study showed that pregnant women’s positive and negative attitudes towards HIV counseling are shaped by several factors which are not limited to social, cultural and psychological issues. It is strongly believed that the findings and recommendations of this study shall be useful tools for policy makers and policy planners in improving the uptake of HIV counseling and testing among pregnant women for the achievement of a zero HIV transmission from motherto- child and towards the achievement of a free HIV generation in Zimbabwe.