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Background and Objectives The major interventions used to reduce the risk of HIV transmission from blood transfusion include the nucleic acid amplification assays (NAT). In Mozambique, screening for HIV infection in blood donors using serological assays is performed routinely. The aim of this study was to evaluate the use of a NAT test to screen blood donors at the blood bank of Hospital Central de Maputo. Material and Methods A cross-sectional study was conducted in a blood bank in the city of Maputo. Overall, 1500 blood donors were enrolled in the study from November 2014 to October 2015. The blood from each participant was drawn and used for both serological and HIV quantification. For HIV viral load quantification, mini-pools of six specimens were tested and, if positive, each sample was retested separately. Results Among the 1500 blood donors, the median age was 31 years old, 78·2% were men, and 74·7% were replacement donors. Our results showed a good sensitivity of (80/80) 100·0% (95·5-100%) and a specificity of (1408/1409) 99·9% (99·6- 100%) for the NAT when compared to the serological assay used at the blood bank. The kappa value of 0·99 (0·98-1·0) and confidence interval of 95·0% were observed indicating a good correlation between the NAT and serological assay. Conclusion Our data show that the HIV nucleic acid quantification assay has a good performance when compared to the serological assays, can detect infected donors/donations and can be used in mini-pools to minimize HIV infection resulting from the blood transfusion in the blood banks of Mozambique. [ABSTRACT FROM AUTHOR]

Background: In low-income countries with poor coverage of healthcare services such as Mozambique, antenatal care serves as a vital tool for providing life-saving and cost-effective services for pregnant mothers. Nonetheless, many countries in Africa, including Mozambique, are struggling to attain an optimum level of antenatal care (at least 4 visits) utilisation among pregnant women. In the present study, we aimed to assess the sociodemographic and economic factors associated with antenatal care use in Mozambique., Methods: Cross-sectional data from the latest round of Mozambique Demographic and Health Survey (2011) on women aged 15-49 years (n = 7080) were analysed. The outcome measures were early and adequate antenatal visit and HIV tests during the last pregnancy. Data were analysed using descriptive and multivariate regression methods. The predictor variables included various demographic (e.g. age, parity), empowerment (e.g. type of employment, household wealth status) and sociocultural factors (e.g. ethnicity, religion)., Results: Of the 7080 women whose data was analyzed, 15.3 and 60.1% had early and adequate ANC visits respectively while 75.4% received HIV test during ANC visits. The odds of early ANC visits were higher [OR = 1.300, 95%CI = 1.062,1.592] among women in the rural areas compared with those in the urban areas. However, participants in rural areas had lower odds [OR = 0.788, 0.687,0.902] of receiving HIV tests during ANC visits. Women in the urban areas with secondary [OR = 1.296, 95%CI = 1.007,1.666] and higher [OR = 1.663, 95%CI = 1.052,2.628] education had higher odds of having early ANC visit. Those in the higher wealth quintiles also had significantly increased odds of using all three types of ANC indicators, particularly for rural women in the highest wealth quintile [OR = 4.776, 95%CI = 1.250,18.24]. Being within the higher wealth quintiles was found to significantly increase the odds of using all three types of ANC indicators, particularly women from rural areas with highest wealth quintile [OR = 4.776, 95%CI = 1.250,18.24]., Conclusion: About two-fifth of the women in Mozambique are not using adequate antenatal care and about and a quarter do not take HIV tests during pregnancy. The sources of low and unequal use of these vital health services might be rooted in women's socioeconomic status and cultural issues that require special policy and research attention.

Objectives: Increasing and sustaining engagement in HIV care for people living with HIV are critical to both individual therapeutic benefit and epidemic control. Men are less likely to test for HIV compared with women in sub-Saharan African countries, and ultimately have delayed entry to HIV care. Stigma is known to impede such engagement, placing an importance on understanding and addressing stigma to improve HIV testing and care outcomes. This study aimed to assess the gendered differences in the relationship between stigma and HIV testing., Design and Setting: A cross-sectional, household probability survey was implemented between November and December 2016 in the Sofala province of Mozambique., Participants: Data were restricted to men and women participants who reported no prior diagnosis of HIV infection (N=2731)., Measures: Measures of sociodemographic characteristics, stigma and past exposure to HIV interventions were included in gender-stratified logistic regression models to estimate the relationship between stigma and recent testing for HIV, as well as to identify other relevant correlates., Results: Significantly fewer men (38.3%) than women (47.6%; p<0.001) had recently tested for HIV. Men who reported previous engagement in community group discussions about HIV had an increased odds of testing in the past 12 months compared to those who had not participated (adjusted OR (aOR)=1.92; 95% CI 1.51 to 2.44). Concerns about stigma were not a commonly reported barrier to HIV testing; however, men who expressed anticipated individual HIV stigma had a 35% lower odds of recent HIV testing (aOR=0.65; 95% CI 0.44 to 0.96). This association was not observed among women., Conclusions: Men have lower uptake of HIV testing in Mozambique when compared to women. Even amidst the beneficial effects of HIV messaging, individual stigma is negatively associated with recent HIV testing among men. Intervention efforts that target the unique challenges and needs of men are essential in promoting men's engagement into the HIV care continuum in sub-Saharan Africa., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)