Assessment of knowledge, attitude, and practice of pregnant women in respect of prevention of Mother-To-Child Transmission (PMTCT) of HIV/AIDS at a selected antenatal clinic in Durban, South Africa.

Abstract

Background: South Africa is one of the sub-Saharan African countries with high rates of HIV/AIDS infection and Kwazulu-Natal province has a particularly high rate of HIV prevalence. Mother-To-Child Transmission (MTCT) of HIV, which can occur during pregnancy, labour, or breastfeeding, is one of the causes of the high rate of HIV and AIDS among children in this region. One of the best strategies to reduce the rate of infection among children is the Prevention of Mother-To-Child Transmission (PMTCT) during pregnancy, labour, and the postnatal period by giving antiretroviral drugs to pregnant women who are HIV-positive. The reasons for an increasing MTCT of HIV might include lack of knowledge of mothers of the risk of MTCT, benefits of preventive interventions, such as prophylactic ARV drugs and infant feeding options. Studies conducted in Sub-Saharan African countries showed that there was a low level of knowledge in mothers about MTCT and PMTCT services. Proper implementation of these services however, requires adequate knowledge and appropriate attitudes and practices of pregnant women toward PMTCT. As there was no published study covering KwaZulu-Natal province to demonstrate the relationship between these factors and PMTCT, it was considered necessary to conduct this study to identify the current level of knowledge of pregnant women and the effective factors impacting on their participation in the PMTCT program. Objective: The objective of this study was to assess the level of knowledge, attitude, and practice of pregnant women toward the PMTCT program and associated factors in a selected antenatal clinic in South Africa. Methods: This was an institution-based, cross-sectional study conducted among pregnant women attending an antenatal care clinic in eThekwini district, South Africa during August 2015. A simple random sampling technique was used to select 345 antenatal care attendees. Data were collected through use of a structured pre-tested questionnaire. Information was then entered into Statistical Package for the Social Sciences (SPSS), Version 22, and were analysed. Finally, data were explored through graphic displays, analysed, interpreted, and summarized. Results: In this research, 345 voluntary pregnant women were studied. The mean age was 26.3 years and the majority (66.3%) had secondary education or above. Of the respondents, 52.7% were single, 38.7% had a regular boyfriend, 8.0% were married and 0.6% were separated. In addition, 29.2% were employed and 70.8% did not have any occupation. This study found that 58.5% had poor, 26.9% had moderate and 14.6% had good basic HIV/AIDS knowledge. On the other hand, 20.4% had poor, 67.6% had moderate and 12.0% had good knowledge on MTCT of HIV and its prevention and they obtained information from health care workers (89.4%) followed by television and radio (22.4%). It was found that age, level of education and occupation had a significant effect on the level of knowledge of respondents. Despite their moderate knowledge concerning PMTCT, 97.6% had a good attitude towards the PMTCT program and 83.1% would support it. Furthermore, it was found that 98.5% did the HIV test and of those who shared the test result, 42.8% were HIV-positive and 52% were HIV-negative. Of respondents, 93.3% discussed having an HIV test with their male partner and 71.0% of partners wanted a couple testing, 15.7% wanted woman to be tested alone and 3.3% did not want the woman to be tested. This study also revealed that 51.9% had antenatal clinic (ANC) visits in their previous pregnancy, but 29.7% did not. It was found that the knowledge level of participants significantly correlated with their ANC visits. In addition, 30.6% did not receive PMTCT counselling upon arrival at the antenatal clinic, but 69.4% received it and 89.8% of them were convinced to continue using PMTCT services. Conclusion: The study showed that the knowledge of pregnant women about PMTCT was moderate, but there were some gaps found in their basic knowledge about HIV/AIDS. Moreover, their knowledge was significantly dependant on their age and education level. On the other hand, the majority had a good attitude and practice towards the PMTCT program. However, it is recommended that the PMTCT counselling should be extended to improve the knowledge of HIV/AIDS and PMTCT strategies in pregnant women through community mobilization.