Objective: To identify the factors that influence the stage of change with regards to HIV testing in women (16–45 years old) in Westmoreland using the trans-theoretical model (TTM) of behaviour change.
Design and Methods: A structured interview-assisted questionnaire was administered to 372 pregnant and non-pregnant respondents in urban and rural areas of Westmoreland after random selection of four public health facilities. The trans-theoretical model which suggests that behaviour change process moves through five stages from pre-contemplation to maintenance was used to evaluate readiness for HIV testing.
Results: Most pregnant women who tested previously were at the preparation stage (78.5%) while nonpregnant women who tested previously were at contemplation (68.5%). The significant predictors of being in the action or maintenance stage among pregnant women was being 20–24 years old, experiencing a first pregnancy and being exposed to counselling. For women who had never tested, preparation was significantly associated with being in an unstable union (non-pregnant). No significant association was found for non-pregnant, previously tested females or for pregnant women who had never tested.
Conclusion: The majority of women lacked self-efficacy as they were unable to maintain the behaviour and did not recognize its importance in the absence of pregnancy. Interventions are needed to target non-pregnant women, especially teenagers, women over 25-years old and women in unions. Integration of testing services into all aspects of primary healthcare, established testing protocols and simultaneous marketing to selected at-risk groups will increase the uptake of HIV testing opportunities and contribute to the control of this epidemic.