Abstract:
Objective—To determine factors associated with an unknown HIV serostatus among pregnant
women admitted in labor to Mulago Hospital, Kampala, Uganda.
Methods—In total, 665 pregnant women admitted to Mulago Hospital were interviewed about
their sociodemographic characteristics, obstetric history, access to prenatal care, fears regarding
HIV testing, and knowledge about modes of mother-to-child-transmission (MTCT). Knowledge of
the HIV serostatus was assessed by self-report and verified by prenatal card review.
Results—The prevalence of unknown HIV serostatus at the time of labor was 27.1%. Factors
associated with an unknown HIV serostatus included high parity (odds ratio [OR] 1.9; 95%
confidence interval [CI], 1.16–3.14), preterm delivery (OR 2.60; 95% CI, 1.06–6.34), prenatal
care at a private clinic (OR 12.87; 95% CI, 5.68–29.14), residence more than 5 km from the
nearest prenatal clinic (OR 2.86; 95% CI, 1.18–17.9), high knowledge about MTCT (OR 0.25;
95% CI, 0.07–0.86), and fears related to disclosing the test result to the partner (OR 3.60; 95% CI,
1.84–7.06).
Conclusion—The high prevalence of unknown HIV serostatus among women in labor
highlights the need to improve accessibility to HIV testing services early during pregnancy to be
able to take advantage of antiretroviral therapy.
