Routine HIV testing helps prevent mother-to-child transmission

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A policy change from voluntary HIV testing to routine HIV testing for pregnant women led to a dramatic and sustained increase in the number of mothers tested for HIV in Mbale, Uganda. The findings are from a seven-year study published on 14 October 2010 in the journal BMC Health Services Research.

The percentage of pregnant women who were tested for HIV increased from 22 percent during the period when HIV testing was recommended on a voluntary basis to more than 87 percent when HIV testing was routine and initiated by health care providers. The study also indicated that the prevalence of HIV-positive prenatal patients at Mbale Regional Referral Hospital over the seven-year study period was 6.1 percent.

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1. Byamugisha R, Tylleskar T, Kagawa MN, et al. Dramatic and sustained increase in HIV-testing rates among antenatal attendees in Eastern Uganda after a policy change from voluntary counselling and testing to routine counselling and testing for HIV: a retrospective analysis of hospital records, 2002-2009. BMC Health Services Research 2010; 10: 290. (open access)

Factors that predict HIV-positive persons’ desires to have children in Uganda

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Since access to antiretroviral therapy has improved quality of life and survival for people living with HIV, many contemplate having children. But a study from Uganda indicates that being on antiretroviral therapy had little to no effect on the desire to have a child in the near future. The study did find that HIV-positive individuals who were of young age, were single or had lost some children were unlikely to desire a child in the near future.

Researchers interviewed 400 HIV-positive patients in southwestern Uganda. Three-fourths were women, 47 percent were aged 25-34 years, over 85 percent were currently married or had ever been married, and 62 percent had primary level of education or less. More than 17 percent had produced a child since the HIV diagnosis was made and 29 percent reported that they would like to have a child in the near future.

Fertility intentions among HIV-positive persons are more common in developing countries (where the overall fertility in the population is still high, contraceptive use is low and unmet need for contraception is high). Previous studies from Zambia and Zimbabwe have also found no effect of HIV diagnosis on subsequent childbearing, implying that pregnancy intentions were unaffected by HIV diagnosis.

“Identification of contextual determinants of decision to have children among HIV positive couples is useful for designing of policies and establishing intervention priorities in reproductive health for this population,” according to the study.

1. Kakaire O, Osinde MO, Kaye DK. Factors that predict fertility desires for people living with HIV infection at a support and treatment centre in Kabale, Uganda. Reproductive Health 2010; 7: 27. (open access)

Cardiovascular disease risk factors in Uganda

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A study has found that more than 22 percent of men and women in Uganda have high blood pressure. While prevalence of other cardiovascular disease risk factors were not as high, the study said that population-based data on the burden of these risk factors can aid in the planning and implementation of an effective response to the double burden of communicable diseases and non-communicable diseases in Uganda and other low-income countries undergoing an epidemiological transition.

The prevalences of diabetes and high blood sugar were 0.4 percent and 2.9 percent, respectively. But most Ugandans with diabetes or hyperglycemia were not aware of it. Less than one percent of men and four percent of women were obese, with 3.6 percent of men and 14.5 percent of women being overweight. The proportions of male and female smokers were only 13.7 percent and 0.9 percent, respectively.

Existing research infrastructure for HIV surveys in Africa can provide a platform for assessing the prevalence of other conditions such as cardiovascular disease risk factors, according to the study.

1. Maher D, Waswa L, Baisley K, et al. Distribution of hyperglycaemia and related cardiovascular disease risk factors in low-income countries: a cross-sectional population-based survey in rural Uganda. International Journal of Epidemiology, published online 5 Oct 2010. (open access)