Health system strategies to increase HIV screening among pregnant women in Mesoamerica
Abstract Background To propose health system strategies to meeting the World Health Organization (WHO) recommendations on HIV screening through antenatal care (ANC) services, we assessed predictors of HIV screening, and simulated the impact of changes in these predictors on the probability of HIV sc...
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doaj-7a862581b7244573a9e77e617b648bf02020-11-25T00:36:27ZengBMCPopulation Health Metrics1478-79542018-03-0116111010.1186/s12963-018-0162-8Health system strategies to increase HIV screening among pregnant women in MesoamericaCharbel El Bcheraoui0Paola Zúñiga-Brenes1Diego Ríos-Zertuche2Erin B. Palmisano3Claire R. McNellan4Sima S. Desai5Marielle C. Gagnier6Annie Haakenstad7Casey Johanns8Alexandra Schaefer9Bernardo Hernandez10Emma Iriarte11Ali H. Mokdad12Institute for Health Metrics and EvaluationSalud Mesoamérica 2015 / Inter-American Development BankSalud Mesoamérica 2015 / Inter-American Development BankInstitute for Health Metrics and EvaluationInstitute for Health Metrics and EvaluationInstitute for Health Metrics and EvaluationInstitute for Health Metrics and EvaluationInstitute for Health Metrics and EvaluationInstitute for Health Metrics and EvaluationInstitute for Health Metrics and EvaluationInstitute for Health Metrics and EvaluationSalud Mesoamérica 2015 / Inter-American Development BankInstitute for Health Metrics and EvaluationAbstract Background To propose health system strategies to meeting the World Health Organization (WHO) recommendations on HIV screening through antenatal care (ANC) services, we assessed predictors of HIV screening, and simulated the impact of changes in these predictors on the probability of HIV screening in Guatemala, Honduras, Mexico (State of Chiapas), Nicaragua, Panama, and El Salvador. Methods We interviewed a representative sample of women of reproductive age from the poorest Mesoamerican areas on ANC services, including HIV screening. We used a multivariate logistic regression model to examine correlates of HIV screening. First differences in expected probabilities of HIV screening were simulated for health system correlates that were associated with HIV screening. Results Overall, 40.7% of women were screened for HIV during their last pregnancy through ANC. This rate was highest in El Salvador and lowest in Guatemala. The probability of HIV screening increased with education, household expenditure, the number of ANC visits, and the type of health care attendant of ANC visits. If all women were to be attended by a nurse, or a physician, and were to receive at least four ANC visits, the probability of HIV screening would increase by 12.5% to reach 45.8%. Conclusions To meet WHO’s recommendations for HIV screening, special attention should be given to the poorest and least educated women to ensure health equity and progress toward an HIV-free generation. In parallel, health systems should be strengthened in terms of testing and human resources to ensure that every pregnant woman gets screened for HIV. A 12.5% increase in HIV screening would require a minimum of four ANC visits and an appropriate professional attendance of these visits.http://link.springer.com/article/10.1186/s12963-018-0162-8Human immunodeficiency virusAntenatal careHIV screeningHealth care disparitiesCentral AmericaMesoamerica |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Charbel El Bcheraoui Paola Zúñiga-Brenes Diego Ríos-Zertuche Erin B. Palmisano Claire R. McNellan Sima S. Desai Marielle C. Gagnier Annie Haakenstad Casey Johanns Alexandra Schaefer Bernardo Hernandez Emma Iriarte Ali H. Mokdad |
spellingShingle |
Charbel El Bcheraoui Paola Zúñiga-Brenes Diego Ríos-Zertuche Erin B. Palmisano Claire R. McNellan Sima S. Desai Marielle C. Gagnier Annie Haakenstad Casey Johanns Alexandra Schaefer Bernardo Hernandez Emma Iriarte Ali H. Mokdad Health system strategies to increase HIV screening among pregnant women in Mesoamerica Population Health Metrics Human immunodeficiency virus Antenatal care HIV screening Health care disparities Central America Mesoamerica |
author_facet |
Charbel El Bcheraoui Paola Zúñiga-Brenes Diego Ríos-Zertuche Erin B. Palmisano Claire R. McNellan Sima S. Desai Marielle C. Gagnier Annie Haakenstad Casey Johanns Alexandra Schaefer Bernardo Hernandez Emma Iriarte Ali H. Mokdad |
author_sort |
Charbel El Bcheraoui |
title |
Health system strategies to increase HIV screening among pregnant women in Mesoamerica |
title_short |
Health system strategies to increase HIV screening among pregnant women in Mesoamerica |
title_full |
Health system strategies to increase HIV screening among pregnant women in Mesoamerica |
title_fullStr |
Health system strategies to increase HIV screening among pregnant women in Mesoamerica |
title_full_unstemmed |
Health system strategies to increase HIV screening among pregnant women in Mesoamerica |
title_sort |
health system strategies to increase hiv screening among pregnant women in mesoamerica |
publisher |
BMC |
series |
Population Health Metrics |
issn |
1478-7954 |
publishDate |
2018-03-01 |
description |
Abstract Background To propose health system strategies to meeting the World Health Organization (WHO) recommendations on HIV screening through antenatal care (ANC) services, we assessed predictors of HIV screening, and simulated the impact of changes in these predictors on the probability of HIV screening in Guatemala, Honduras, Mexico (State of Chiapas), Nicaragua, Panama, and El Salvador. Methods We interviewed a representative sample of women of reproductive age from the poorest Mesoamerican areas on ANC services, including HIV screening. We used a multivariate logistic regression model to examine correlates of HIV screening. First differences in expected probabilities of HIV screening were simulated for health system correlates that were associated with HIV screening. Results Overall, 40.7% of women were screened for HIV during their last pregnancy through ANC. This rate was highest in El Salvador and lowest in Guatemala. The probability of HIV screening increased with education, household expenditure, the number of ANC visits, and the type of health care attendant of ANC visits. If all women were to be attended by a nurse, or a physician, and were to receive at least four ANC visits, the probability of HIV screening would increase by 12.5% to reach 45.8%. Conclusions To meet WHO’s recommendations for HIV screening, special attention should be given to the poorest and least educated women to ensure health equity and progress toward an HIV-free generation. In parallel, health systems should be strengthened in terms of testing and human resources to ensure that every pregnant woman gets screened for HIV. A 12.5% increase in HIV screening would require a minimum of four ANC visits and an appropriate professional attendance of these visits. |
topic |
Human immunodeficiency virus Antenatal care HIV screening Health care disparities Central America Mesoamerica |
url |
http://link.springer.com/article/10.1186/s12963-018-0162-8 |
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