AEGiS-15IAC: The effectiveness of an intervention to integrate HIV and STI prevention information into antenatal care services in rural clinics in South Africa.

15th International AIDS Conference

Bangkok, Thailand - July 11-16, 2004

The effectiveness of an intervention to integrate HIV and STI prevention information into antenatal care services in rural clinics in South Africa.

Int Conf AIDS 2004 Jul 11-16; 15:(abstract no. TuPeC4942)

Chege JN, Beksinska M
Population Council, Johannesburg, South Africa

BACKGROUND: The prevalence of HIV (26.5%) and STIs (52%) among antenatal care (ANC) clients in South Africa is high. Frontiers Program of Population Council, in collaboration with the KwaZulu-Natal Department of Health and other partners, implemented a study to assess the feasibility and impact of introducing a comprehensive ANC model consisting of five goal-oriented visits that integrate management of STIs, and provision of information and counselling on STIs, MTCT, and VCT as part of routine ANC package.

METHODS: This was a quasi-experimental pre and post control group design study implemented between April 2002 and May 2003. We randomly sampled two hospitals providing VCT services and three clinics linked to each hospital for referral purposes. We collected data through observation of client-provider interaction and exit interviews with clients. Using bivariate analysis, we compared pre- and post-intervention measures of key variables and magnitude of change between the intervention and comparison clinics.

RESULTS: The intervention was effective in increasing STIs and HIV integration. The intervention clinics had 87% and 91% increase in proportion of clients receiving at least one STI and one HIV related service, compared to a 10% and a 41% increase in the comparison clinics respectively. The proportion of clients who reported ever having received STI and HIV related services increased greatly in the intervention clinics. However, increase in access to information did not translate into a significant increase in the proportion of clients accessing VCT in the intervention clinics. Only 12% compared to 40% of intervention and comparison clinics clients respectively, reported they had ever had the HIV test.

CONCLUSIONS: It is feasible and effective to integrate STI and HIV service provision into ANC services in rural public clinics. However, in the context of high professional nursing staff turnover, a one and off training strategy is inadequate and constant monitoring essential.

Keywords: AEGIS, HIV, Acquired Immunodeficiency Syndrome, HIV Seropositivity, Prenatal Care, HIV Infections, Counseling, Rural Population, Ambulatory Care Facilities, HIV Seroprevalence, HIV-1, Prevalence, Referral and Consultation, South Africa, Humans, prevention & control

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