Attitudes and practices of obstetric care providers in Kabul, Afghanistan regarding antenatal testing for sexually transmitted infection

Objective: To determine attitudes toward and utilization of testing for HIV, syphilis, and hepatitis B among obstetric care providers in Kabul, Afghanistan. Design: Cross-sectional survey. Setting: Three public maternity hospitals in Kabul, Afghanistan. Participants: One hundred and fourteen (114) doctors and midwives. MainOutcome Measure: Prevalence and correlates of ever having tested patients for HIV, syphilis, and hepatitis B and agreement with statements concerning attitudes toward testing and care. Results: Less than half of the patient care providers surveyed had previously tested a patient for HIV, syphilis, or hepatitis B. Presumed rarity of these infections in Afghanistan was the most frequently stated reason for not testing, although many midwives stated that they did not have the authority to order tests. Most providers supported testing to promote neonatal health, but some midwives expressed concern regarding patient and family perceptions. Conclusions: Due to logistical and cultural barriers, obstetric care providers underutilize testing for antenatal patients in Afghanistan. Improved training, empowerment of female providers, and availability of rapid testing are needed.