Reasons given by pregnant women for not returning for their results following voluntary counselling and testing (VCT) for the human immunodeficiency virus at Embhuleni Hospital

Abstract

OBJECTIVE: In 2007 36% of the pregnant women tested positive for HIV at Embhuleni Hospital and its satellite clinics. However, only one quarter of those returned to the wellness clinic for their CD4 results so as to begin with Anti-Retrovirus Therapy (ART) if they qualified. The rest would not return to the wellness clinic, and would only present late with opportunistic infections or a subsequent pregnancy. The study aimed at exploring the reasons why women who had been tested for HIV by means of VCT failed to return for their CD4 results, to understand those reasons, to determine what information was given to them before they were tested, to assess the availability of personal support systems (family, friends, etc), and finally to assess the women’s understanding of HIV/AIDS, for which they were tested. METHODS: A descriptive qualitative study was conducted using the free attitude interview technique for data collection. The Ante-natal care (ANC) clinic register of the Embhuleni Hospital was used to trace patients who had consented for voluntary counselling and testing (VCT), but who had since not returned for their results after 30 days of testing. Those patients were visited at their places of residence by the research team (interviewing nurse and the researcher) to request them to participate in the study. The exploratory question was: “May you tell us why you did not come back for your HIV test results?” “Sicela usichazele kutsi yinindzaba ungasetanga kutewuhlola imiphumela yakho yengati? (SiSwati Version). The interviews were audio recorded and field notes taken. The interviewer sought clarification for unclear issues raised, and gave reflective summaries at the conclusion of each idea under discussion. The interviews continued until there was information saturation. In this study, was reached at respondent number nine. The audio-tapes were transcribed verbatim, followed by translation into English. The emerging themes formed the basis for the write-up. RESULTS: The following themes emerged:  Communication between health care workers and patients Poor quality of communication (patients not told to come back)  Knowledge on HIV/AIDS and PMTCT Patients had poor knowledge of HIV/AIDS and PMTCT  Fear of stigma for HIV/AIDS The community associated coming back for the results with being HIV positive  Poor patient support Poor family support system for the patient Limited patient financial resources  Experience at the health facilities Lack of patient privacy Attitude of the health care workers not acceptable to patients CONCLUSION: The factors that resulted in non-return of the pregnant women to the facility for their results were that the women were not made aware that they were to return for their results; poor quality of communication by the hospital staff; unpleasant experiences by patients at the facility; patients feared community stigmatisation; there was lack of patient support, and the patients had poor knowledge of HIV/AIDS and PMTCT