Factors influencing uptake of antenatal-integrated HIV testing in Nigeria: applying the Andersen behavioural model using a multilevel analysis approach

Oladayo A. Adebayo, University of Groningen

The study aims to understand the predisposing, enabling, need and HIV stigma (PENS) factors influencing uptake of antenatal HIV (ANC-HIV) testing among pregnant women in Nigeria as guided by the Andersen behavioural model of health care use. The analysis employs a multilevel modelling approach using the 2013 Nigeria Demographic and Health Survey with a sample size of 5,164 pregnant women who gave birth between 2011 and 2013, attended ANC during the pregnancy and were offered HIV testing. The findings indicate that the ANC-HIV testing uptake is nested within communities and states and that the determinants of ANC-HIV testing include the predisposing (religion and HIV knowledge), enabling (wealth, bargaining power, partner’s education, pre-test HIV counselling and place of ANC attendance) and need (HIV risk perception) factors. The results from the multivariate analysis also reveal that HIV stigmatizing attitude towards PLWH/A is not an independent determinant of ANC-HIV testing uptake in Nigeria.