Factors influencing HIV screening decisions for pregnant migrant women in South East Asia

Background: universal screening in pregnancy for HIV is common and migrant women are an identified high risk group. The increasing mobility within countries and migration across borders affects the growing prevalence of HIV, but little is understood about how migrant women view risk of HIV in relation to pregnancy.

Objectives: to explore factors that relate to HIV screening decisions for migrant women.

Design: the HIV antenatal counselling experiences of pregnant migrant women were explored in a Grounded Theory study.

Settings: the four settings were antenatal care units of border hospitals in northern Thailand.

Participants: 38 migrant pregnant women who had been through the HIV screening process at participating antenatal clinics as well as 26 health personnel at the units were purposively recruited and interviewed about their experiences and attitudes to HIV counselling and testing for this group.

Methods: in-depth interviews were conducted from January to March 2008. The grounded theory technique of open coding was employed and constant comparison took place throughout until saturation was achieved.

Findings: four themes were identified as common to the women and the health professionals: ineffective provision of information; internal and external barriers to information; implications of migrant status; and perception of risk.

Conclusions: where language barriers exist interpreters are required and creative approaches to information giving that do not rely on text are necessary. The organisation of clinics does not currently meet the needs of migrant women and causes stress for health staff due to time constraints. Extra resources should be focussed where there are large numbers of migrants.