ABSTRACT
Background: Transmission of HIV from pregnant mothers to their children is a key route of HIV transmission in Nigeria. Nigeria contributes up to 30% of the global PMTCT gap and coverage of PMTCT services has however remained low at less than 19% - falling short of both the universal access and National Strategic Plan targets. The current study intends to identify factors underlying the low uptake of PMTCT interventions in Abia state. Method: The study was conducted in ten out of the seventy-four Primary Health Centres offering antenatal as well as Routine HIV Counseling and Testing services in the selected LGAs of Abia state. It was a descriptive cross-sectional study using a multistage sampling technique. Data were collected using questionnaires and analyzed using Statistical Packages for Social Sciences (SPSS) version 20. Chi-square, t-test and binary logistic regression were test statistics used. Level of confidence was at p=0.05. Result: The result was based on 350 pregnant women, 175 each from rural and urban public primary health facilities. Findings showed that majority were aged 25-34 years in both urban and rural groups with their mean ages 32.46±10.12 in urban and 33.24±9.31 in rural. Most respondents had secondary education, working with about 45% being business women in both groups. Higher proportion have attended 2-3 ANC previously and booked at ≤3 months. About 80-90% in urban have heard of PMTCT, that infected mothers can transmit to their children, stages it can be transmitted as well as that giving ARV to mother and child can prevent Mother to child transmission, in rural about 60- 80% had similar knowledge. Their mean knowledge score were 17.85±3.61 and 13.85±4.33 for urban and rural areas and difference was statistically significant. The study showed a significant associations between socio-demographic and mean knowledge as a factor influencing uptake of PMTCT services (educational level in urban, employment status and monthly income for rural). Those that had secondary education were 3.717 times and tertiary education 2.088 times less likely to have good knowledge than those without formal education. This finding is surprising. Those doing business were 8.376 times and those employed 2.557 times more likely to have good knowledge 11 than housewives. Those earning over 20,000 were 7.003 times more likely while those who earned 6,000-10,000 were 2.950 times less likely to have good knowledge than those earning 90%) as well as use of anti HIV drugs for PMTCT. Over 95% in both urban and rural said that it is important to test for HIV when pregnant. There were association between the respondents’ socio-demographic characteristics with mean attitude of PMTCT by groups for age in category in urban and monthly income for rural. There was high proportion of acceptance that use of condom during pregnancy and breast feeding reduces MTCT and acceptance to support strategies for PMTCT from the study. Over 92% in both groups have discussed HIV with their partner and tested for HIV. On possibility of telling husband to use condom, 81.7% urban and 67.4% rural stated that it is possible of which out of them 66.4% urban and 78.8% have done it before The study showed association between the respondents’ socio-demographic characteristics with mean practice of PMTCT for urban. Those doing earning over 20,000 were 1.472 times more likely while those that earned 11,000-20,000 were 1.592 times less likely to have good knowledge than those earning