Prevention of mother to child transmission (PMTCT) of human immunodeficiency virus (HIV): perceptions and practice of antenatal clients in Nnewi, south-east Nigeria

Context: With increasing feminization of the human immunodeficiency virus (HIV) pandemic especially in Africa, more seropositive women are getting pregnant. There is therefore an increasing need for prevention of mother to child transmission (PMTCT) of HIV and increased need for awareness by our women.Objective: To determine the perceptions and practice of PMTCT of HIV among antenatal clients in Nnewi, south-eastern Nigeria.Study design, setting and subjects: This was a cross sectional descriptive study of six hundred (600) consecutive antenatal clients attending the Nnamdi Azikiwe University Teaching Hospital and five private specialist hospitals in Nnewi, a semi-urban town in Anambra State, south-eastern Nigeria. The study was questionnaire based and was conducted over a six-month period.Results: The mean age of all the 600 clients was 31.4 (SD2.8) years. Most of the clients were married (94%) and in the third trimester of pregnancy (69%). Majority (65%) lived in the semi-urban town of Nnewi and place of domicile did not make any significant difference to knowledge of MTCT (p=0.96). All the clients studied were Christians. Most – 348 (58%) attended secondary school while 5 (0.83%) had no formal education. There was a statistically significant relationship between level of education and knowledge ofMTCT (p<0.00001). Specifically, 544 clients (92.33%) knew about MTCT; 393 (65.50%) clients were aware MTCT could be prevented (PMTCT) but only 37% knew about specific PMTCT measures. HIV counselling and testing (HCT) was done for only 216 (51.55%) of the clients.Conclusion: The study showed that even though a majority of the women were aware of MTCT, they lacked adequate knowledge of the various modalities of PMTCT. Mandatory HIV testing without counselling is still widely practiced in our environment. Concerted efforts are needed to further increase knowledge of MTCT, institute widespread HCT and thus improve PMTCT