Prevalence of HIV retesting and associated factors among perinatal women who tested negative at the first antenatal screening in the Kilimanjaro region: a facility-based cross-sectional study

In efforts toward eliminating vertical transmission of HIV, the WHO recommends that all pregnant women who test negative during the first test be retested; despite this recommendation, the prevalence of maternal HIV retesting in Tanzania is 30.4%, which is low. To address this challenge, on-the-job training of health care workers, was conducted all over the country. We assessed the updated prevalence of HIV retesting and associated factors among perinatal women who tested negative at the first antenatal screening following the on-the-job training intervention implemented in health facilities. A facility-based cross-sectional study design was conducted from 20th March to 10th May 2024, involving perinatal women from 37 weeks of gestation to 42 days after delivery in Kilimanjaro. Data were collected via a semi structured questionnaire. The data were analysed with STATA version 15.1, and bivariable and multivariable modified Poisson regression models were used to check for associations. The measure of association used was the prevalence ratio with a 95% confidence interval. A P value of <0.05 was considered to indicate statistical significance. A total of 467 perinatal women were recruited, 47.1% (95% CI 42.5-51.7) of whom were retested for HIV, and 3.2% of them tested positive. The factors associated with HIV retesting were being counselled and tested for HIV together with one’s partner during the first antenatal care (ANC) visit (adjusted prevalence ratio (APR) 1.31; 95% CI: 1.07–1.60, P=0.01), attending ANC in a health facility with trained healthcare workers on maternal HIV retesting (APR 3.56; 95% CI: 1.99–6.39, P<0.001), attending only one health facility for ANC (APR 1.21; 95% CI: 1.01–1.45, P=0.04), attending more than four ANC visits (APR 2.95; 95% CI: 1.71–5.09; P<0.001) and having awareness that a woman should be tested twice during pregnancy (APR 1.57; 95% CI: 1.28–1.92, P<0.001). The prevalence of HIV retesting among perinatal women is still low compared with the national target. HIV retesting is associated with individual and ANC service-related factors. To achieve the HIV retesting target, interventions to promote adequate ANC attendance, healthcare worker training and the provision of quality ANC with proper HIV retesting counselling are advocated.