1. Trends in Antenatal HIV testing rates at Bindura Provincial Hospital, 2010-2014 B Makumbe C Tshuma M Mungati

2. Background In 2014, the UNAIDS estimated HIV prevalence in Zimbabwe to be 15% Antenatal HIV testing is part of PMTCT All primary health care facilities in Zimbabwe offer HIV testing and counseling. Pregnant women who visit the ANC are screened for HIV HTC Process takes consideration of ethics Informed consent for test Confidentiality of results No harm to clients Benefits clients through health education and subsequent treatment

3. Background Antenatal HIV testing helps measure progress towards PMTCT goal The data is recorded onto PMTCT registers In 2013 Bindura Provincial Hospital (BPH) had first visit ANC testing rate of 64.0% However, some registers were incomplete Data set not analysed before

4. Broad Objective To determine the trends of antenatal HIV testing rates at BPH from 2010 to 2014

5. Specific Objectives Trends among Pregnant Women who were tested first time in ANC and received results Trends among Pregnant Women testing HIV positive in ANC Trends among pregnant women booking for first ANC visit with known HIV positive result Trends of Pregnant Women who tested HIV positive in ANC and were initiated on ART Quality of ANC data for HIV tests at Bindura Provincial Hospital

6. Materials and Methods Study design – secondary data analysis Study setting – Bindura Provincial Hospital Sampling – all monthly PMTCT reports from 2010 to 2014

7. Materials and Methods Permission to proceed was sought from – HSO – PMD, Mashonaland Central Province – DMO, Bindura District – Medical Superintendent BPH Ethical considerations – minimal disturbance of staff during working hours – Confidentiality was maintained

8. Results

9. ANC HIV Testing Data Quality at BPH, 2010-2014 VariableCompleteness (%) n=60 Date100.0 Age group100.0 Pregnant Women booking for first ANC Visit91.7 Pregnant Women HIV tested in ANC91.7 Pregnant Women who were tested first time in ANC and received results 91.7 Pregnant Women testing HIV positive in ANC 100.0 pregnant women booking for first ANC visit with known HIV positive result 60.0 Pregnant women booking for first ANC visit already on ART 60.0 Pregnant Women who tested HIV positive in ANC and were initiated on ART 53.4

10. Trends in proportion of pregnant women HIV tested in ANC at BPH, 2010-2014

11. Trends in proportion of pregnant women HIV tested in ANC by age at BPH, 2010-2014

12. Trends in Proportion of pregnant women HIV tested and received results in ANC at BPH, 2010-2014

13. Trends in proportion of pregnant women who tested HIV positive in ANC at BPH, 2010-2014

14. Trends in proportion of pregnant women booking for first ANC visit with Known HIV positive result at BPH, 2010-2014

15. Trends in proportion of pregnant women who tested HIV positive by age at BPH, 2010-2014

16. Trends in proportion of pregnant women booking for first ANC visit already on ART at BPH, 2010-2014

17. Proportion of HIV infected pregnant women initiated on ART in ANC at BPH, 2010-2014

18. Discussion No significant increase or decrease in HIV testing rates Similar to findings by Chandisarewa et.al. Higher proportion of those at least 25 years testing for HIV Decrease in Positivity rate Similar to trends observed by UNFPA 2012

19. Discussion Positivity rate twice as high among those at least 25years as those below Similar to findings from ZDHS 2011 Positivity rate on a steady rise among those aged 16 to 24 years Increase in those who visited the ANC with a known HIV positive result and already on ART Increase in the proportion of women being initiated on ART Similar to finding by Stinson etal, 2013

20. Conclusion HIV testing rates in ANC have been constant between 2010 and 2014 There was a decline in the proportion of women testing HIV positive in ANC Steady increase in prevalence among women aged 16 to 24years Increase in proportion of women with known HIV positive result and already on ART There was an increase in the ART initiation rate in the ANC

21. Recommendations Monthly data verifications at the FCH to improve completeness of data Targeted Health Education among women 16- 24yrs - DHPO A study on factors associated with decrease in HIV positivity rate – PEDCO

22. Acknowledgments PMD, Mashonaland Central DMO, Bindura district Medical Superintendent, BPH MPH Colleagues

23. Thank you