Socio- cultural Factors Influencing Utilization of Prevention of Mother to Child Transmission of HIV Among Women Attending Antenatal Care Clinics in Rachuonyo North Sub- County-Homa-Bay County, Kenya

Abstract

Background: Utilization of services is an important determinant for prevention of transmission of HIV from mother to child. This strategy is reinforced by good practices and attitudes. The aim of the current study was to determine the socio-cultural factors influencing compliance with Prevention of Mother to Child Transmission (PMTCT) of HIV options and therapies initiated in women attending antenatal clinics in North Rachuonyo Sub-county in Kenya.

Methods: A cross sectional study was conducted among 384 HIV infected pregnant women attending 20 antenatal clinics in North Rachuonyo Sub-County in 2016. A simple random sampling technique was used to select the women and the health facilities. Data were collected through structured pre-tested questionnaires and was analyzed using binary and multiple logistic regression to determine the statistically significant association between the dependable variables and the independent variables.

Results: The mean age of the women interviewed was 25.7 years with 44 % of respondents being between 15-24 years and 39% being between 25-34 years. Health care services were mostly sought in government based dispensaries (50%) and health centers (25%), and faith based health facilities (20%). Majority (60%) of the respondents did not seek permission from their partners to undertake HIV testing while only 50% had disclosed the HIV status to their partners. Lack of disclosures of the status was attributed to single parenthood/non- committal relationship (36%) and fear of being abandoned (25%). The main barriers impeding women participation on HIV/AIDS awareness programs included cultural practices such as wife inheritance (25%), lack support from the men partners in attending PMTCT services (24%), fear of losing property inheritance once HIV status is known by the family (22%) and stigma from the community and close relatives. Most respondents indicated the main feeding options for highly HIV exposed infants were exclusive breast feeding for infants less than 6 months (49%) and more than 6 months (62%). The bivariate and multivariate analyses revealed that age, marital status and occupation of the respondents did not have significant association with utilization of PMTCT services; however, women with secondary education and above (AOR = 1.05) 95% CI (1.20, 2.55) and AOR = 1.4, 95% CI (1.09, 1.92) were more likely to attend ANC for PMTCT services.

Conclusion: The study showed that PMTCT services in North Rachuonyo have the potential of improvement in uptake as only 60% of women understood the importance of the service. The dispensaries and health facilities should be strengthened in offering PMTCT services as they were most preferred by the women. The sociocultural barriers noted in increasing awareness of HIV/ AIDS should be addressed by various players such as religious leaders, political leaders and other community resource persons. Women’s empowerment through education, improving antenatal care follow up and male/community involvement can be used to significantly increase utilization, attitude and uptake of the PMTCT services.

Keywords: Mother to Child Transmission of HIV/AIDS, Utilization, and Practice