Home⇛Annals of Tropical Research⇛vol. 48 no. 1 (2026)

Policy Awareness and Practice Gaps in HIV Testing and MTCT Prevention in Maternity Clinics in Leyte

Florence Mae Anne A. Bajao | Aira Cristelle L. Comadug | Desiree Cristina I. Pardillo | Paul Vincent G. Cayone | Janiela Ritchel Daniel | Janet Alexis A De los Santos

 

Abstract:

Background: Maternity clinics serve as critical entry points for preventing mother-to-child transmission (MTCT) of HIV through antenatal screening, counseling, and referral. Despite the enactment of the Philippine HIV and AIDS Policy Act (Republic Act No. 11166), variations in the delivery of HIV testing and MTCT prevention services persist across health facilities, particularly at the local level. Objectives: This study described the awareness, attitudes, and practices of nurses and midwives in maternity clinics regarding HIV testing and MTCT prevention in selected municipalities of Leyte, Philippines. Methods: A descriptive cross-sectional survey was conducted among 90 nurses and midwives from public and private maternity clinics in Ormoc City, Baybay City, Albuera, Inopacan, and Hindang. Data were collected using a validated and pilot-tested questionnaire with acceptable to excellent internal consistency (KR-20 = 0.706–0.894). Analysis was limited to frequencies, and percentages. Results: Overall awareness of MTCT prevention (90.56%) and government HIV laws and policies (94.89%) was high. Attitudes toward HIV-positive pregnant women were mixed: while 61.11% reported feeling at ease in providing care, 91.11% perceived occupational risk. Regarding practices, 65.56% of clinics reported implementing routine HIV testing for pregnant women, with lower uptake of repeat testing and partner testing. Public clinics were more likely to offer HIV testing than private clinics. Reported constraints included financial limitations (41.11%) and legal or regulatory concerns (35.56%). Conclusion: Although maternity clinic staff demonstrated high awareness of MTCT prevention and HIV policies, inconsistencies in testing practices and residual attitudinal concerns were observed, particularly across facility types. These findings provide baseline descriptive evidence that may inform local planning, monitoring, and strengthening of MTCT prevention services.



References:

  1. 1.     Astawesegn, F. H., Mannan, H., Stulz, V., & Conroy, E. (2024). Understanding the uptake and determinants of prevention of mother-to-child transmission of HIV services in East Africa: Mixed methods systematic review and meta-analysis. PLOS ONE, 19(4), e0300606. https://doi.org/10.1371/journal.pone.0300606
  2. 2.     Bekker, L. G., Beyrer, C., Mgodi, N., Lewin, S. R., Delany-Moretlwe, S., Taiwo, B., Masters, M. C., & Lazarus, J. V. (2023). HIV infection. Nature Reviews Disease Primers, 9(1), 42. https://doi.org/10.1038/s41572-023-00452-3
  3. 3.     Belay, Y. A., Yitayal, M., Atnafu, A., & Taye, F. A. (2022). Barriers and facilitators to the implementation and scale up of differentiated service delivery models for HIV treatment in Africa: A scoping review. BMC Health Services Research, 22(1), 1431. https://doi.org/10.1186/s12913-022-08825-2
  4. 4.     Chilaka, V. N., & Konje, J. C. (2021). HIV in pregnancy: An update. European Journal of Obstetrics, Gynecology, and Reproductive Biology, 256, 484–491. https://doi.org/10.1016/j.ejogrb.2020.11.034
  5. 5.     De Los Santos, J. A. A., Tuppal, C. P., & Milla, N. E. (2023). The correlates of health facility-related stigma and health-seeking behaviors of people living with HIV. Acta Medica Philippina, 57(4), 5–12. https://doi.org/10.47895/amp.vi0.4447
  6. 6.     Department of Health Epidemiology Bureau. (2025, October–December). HIV & AIDS surveillance of the Philippines: October–December 2025. Department of Health Philippines. https://drive.google.com/file/d/1PV1hLBZ4TQ6rg-icw4Up_aSw6vC8s8eU/view
  7. 7.     Ejigu, Y., & Tadesse, B. (2018). HIV testing during pregnancy for prevention of mother-to-child transmission of HIV in Ethiopia. PLOS ONE, 13(8), e0201886. https://doi.org/10.1371/journal.pone.0201886
  8. 8.     Ferguson, L., Gruskin, S., Bolshakova, M., Rozelle, M., Yagyu, S., Kasoka, K., Oraro-Lawrence, T., Motala, A., Stackpool-Moore, L., & Hempel, S. (2023). Systematic review and quantitative and qualitative comparative analysis of interventions to address HIV-related stigma and discrimination. AIDS, 37(13), 1919–1939. https://doi.org/10.1097/QAD.0000000000003628
  9. 9.     Gabieta, J. A. (2024). EV population hits 4.6 million in 2024. Leyte Samar Daily News. https://www.leytesamardailynews.com/ev-population-hits-4-6-million-in-2024/
  10. 10.  Gedefaw, A., Tadesse, B. T., Tadesse, S., Kebede, B., Hussen, S., Hailu, D., Berhan, Y., Makonnen, E., Vella, S., & Aklillu, E. (2024). The progress of mother-to-child transmission of human immunodeficiency virus (HIV) after Dolutegravir (DTG) optimization program: Evidence from a multicenter cohort study in Ethiopia. BMC Public Health, 24(1), 3367. https://doi.org/10.1186/s12889-024-20761-w
  11. 11.  Giorgi, E. E., Abrahams, M. R., Fouda, G., John-Stewart, G., Goga, A., Mullins, J. I., Permar, S. R., Janes, H. E., & Martin, T. M. (2025). Characterization of early viral populations in infants acquiring HIV through perinatal and breastmilk transmission: A review of what is currently known and the gaps that need to be addressed to guide passive HIV immunization of breastfeeding infants. Current HIV Research, 23(6), 363 –379. https://doi.org/10.2174/011570162X357975250902104402
  12. 12.  Hampanda, K. M., Pelowich, K., Freeborn, K., Graybill, L. A., Mutale, W., Jones, K. R., Saidi, F., Kumwenda, A., Kasaro, M., Rosenberg, N. E., & Chi, B. H. (2023). Strategies to increase couples HIV testing and counselling in sub-Saharan Africa: A systematic review. Journal of the International AIDS Society, 26(3), e26075. https://doi.org/10.1002/jia2.26075
  13. 13.  Kuder, G. F., & Richardson, M. W. (1937). The theory of estimation of test reliability. Psychometrika, 2(3), 151–160. https://doi.org/10.1007/BF02288391
  14. 14.  LawPhil. (n.d.). Republic Act No. 11166. https://lawphil.net/statutes/repacts/ra2018/ra_11166_2018.html
  15. 15.  Long, L. C., Girdwood, S., Govender, K., Meyer-Rath, G., & Miot, J. (2023). Cost and outcomes of routine HIV care and treatment: Public and private service delivery models covering low-income earners in South Africa. BMC Health Services Research, 23(1), 240. https://doi.org/10.1186/s12913-023-09147-7
  16. 16.  Mosende, A. G., Lacambra, C. B., & De Los Santos, J. A. A. (2023). Knowledge, attitudes, and behaviors toward HIV/AIDS among health care workers in urban cities in Leyte, Philippines. The Malaysian Journal of Nursing, 14(3), 185–193. https://doi.org/10.31674/mjn.2023.v14i03.022
  17. 17.  Nabitaka, L. K., Delaney, A., Namukanja, P. M., Nalugoda, F., Makumbi, F. E., Dirlikov, E., Nelson, L., Kirungi, W., Sendagala, S., Nakityo, R. B., Kasule, J., Ondo, D., Mudiope, P., Ssewanyana, I., Opio, J., Thu-Ha, D., Adler, M. R., Asiimwe, H., Birabwa, E., Ochora, E. N., Serwadda, D., & Lutalo, T. (2025). An impact evaluation of the national prevention of mother-to-child HIV transmission program and MTCT associated factors in Uganda 2017–2019. Scientific Reports, 15(1), 24402. https://doi.org/10.1038/s41598-025-09511-z
  18. 18.  Ngcobo, S., Scheepers, S., Mbatha, N., Grobler, E., & Rossouw, T. (2022). Roles, barriers, and recommendations for community health workers providing community-based HIV care in sub-Saharan Africa: A review. AIDS Patient Care and STDs, 36(4), 130–144. https://doi.org/10.1089/apc.2022.0020
  19. 19.  Njom Nlend, A. E. (2022). Mother-to-child transmission of HIV through breastfeeding: Improving awareness and education: A short narrative review. International Journal of Women's Health, 14, 697–703. https://doi.org/10.2147/IJWH.S330715
  20. 20.  Nkwabong, E., Meboulou Nguel, R., Kamgaing, N., & Keddi Jippe, A. S. (2018). Knowledge, attitudes, and practices of health personnel of maternities in the prevention of mother-to-child transmission of HIV in a sub-Saharan African region with high transmission rate: Some solutions proposed. BMC Pregnancy and Childbirth, 18, 227. https://doi.org/10.1186/s12884-018-1876-0
  21. 21.  Panel on Treatment of HIV During Pregnancy and Prevention of Perinatal Transmission. (2025). Recommendations for the use of antiretroviral drugs during pregnancy and interventions to reduce perinatal HIV transmission in the United States (Perinatal HIV clinical guidelines). U.S. Department of Health and Human Services. https://clinicalinfo.hiv.gov/sites/default/files/guidelines/documents/perinatal-hiv/guidelines-perinatal.pdf
  22. 22.  UNAIDS. (2023). Global AIDS update 2023. Joint United Nations Programme on HIV/AIDS. https://thepath.unaids.org/wpcontent/the mes/unaids2023/assets/files/2023_report .pdf
  23. 23.  Walters, M. K., Bulterys, M. A., Barry, M., Hicks, S., Richey, A., Sabin, M., Louden, D., Mahy, M., Stover, J., Glaubius, R., Kyu, H. H., Boily, M. C., Mofenson, L., Powis, K., & Imai-Eaton, J. W. (2025). Probability of vertical HIV transmission: a systematic review and meta-regression.The Lancet HIV, 12(9), e638–e648. https://doi.org/10.1016/S2352-3018(25)00132-8
  24. 24.  Yang, L., Cambou, M. C., & Nielsen-Saines, K. (2023). The end is in sight: Current strategies for the elimination of HIV vertical transmission. Current HIV/AIDS Reports, 20(3), 121–130. https://doi.org/10.1007/s11904-023-00655-z
  25. 25.  Zewdie, K., Kiptinness, C., Ngure, K., Kipkurui, N., Wairimu, N., Ambiyo, F., Mugo, N. R., Baeten, J. M., & Mugwanya, K. K. (2022). Targeted implementation of HIV self-testing increases testing uptake among partners of index persons known to have HIV in Kenya. Journal of Acquired Immune Deficiency Syndromes, 90(5), 524–529. https://doi.org/10.1097/QAI.0000000000003003

Tools


Copyright © 2026  KITE Digital Educational Solutions |  Exclusively distributed by CE-Logic