Determinants of Pregnant Women Participation on Triple Elimination of HIV, Syphilis, and Hepatitis B, in Semarang


  • Mei Fatimah Sebelas Maret University


Background: HIV, Syphilis, and Hepatitis B infections are very susceptible to transmission from mother to child during pregnancy, child­birth, and breastfeeding. In 2014, the World Health Organisation (WHO) established a list of validation criteria to facilitate efforts of eli­mination of mother-to-child transmission (EMTCT) of HIV and syphilis. This study aimed to ana­lyze determinants of pregnant women parti­ci­pation in the triple elimination uptake.

Subjects and Method: This was a cross sec­tional study conducted at 25 Public health cen­ters, in Semarang District, Central Java, from December 2019 to February 2020. A sample of 200 pregnant women was selected by random sampling. The dependent variable was triple elimination. The independent variables were intention, access to information, know­led­ge, outcome expectation, modeling, distance, self-efficacy, and husband support. Community health center was variable in level 2. The data were collected by questionnaire and analyzed by a multiple logistic multilevel analysis.

Results: Triple elimination participation in pregnant women increased with good access to information (b= 1.76; 95% CI= 16.72 to 102.18; p<0.001), good knowledge (b= 2.09; 95% CI= 10.91 to 56.14; p<0.001), positive outcome expectation (b= 2.03; 95% CI= 12.93 to 71.91; p<0.001), strong modeling (b= 2.03; 95% CI= 2.83 to 1.64, p< 0.001), strong inten­tion (b= 2.43; 95% CI= 8.49 to 46.22; p <0.001), strong self-efficacy (b= 2.48; 95% CI= 12.64 to 72.37; p<0.001), and strong husband support (b= 1.97; 95% CI= 12.2 to 65.24; p <0.001). Triple elimination participation in pregnant women decreased with further distance to health center (b= -2.20; 95% CI= 0.41 to 1.38; p= 0.032). Public health center had contextual effect on the participation of triple elimination in preg­nant women with ICC= 40.64%.

Conclusion: Triple elimination participation in pregnant women increases with good access to information, good knowledge, positive out­come expectation, strong modeling, strong in­ten­tion, strong self-efficacy, and strong hus­band support. It decreases with further dis­tan­ce to health center. Public health center has con­tex­tual effect on the participation of triple eli­mination in preg­nant women

Keywords: triple elimination, HIV, Syphilis, Hepatitis B, multilevel analysis

Journal of Health Promotion and Behavior (2020), 5(2): 124-134

Author Biography

Mei Fatimah, Sebelas Maret University

Masters Program in Public He­alth, Universitas Sebelas Maret.


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How to Cite

Fatimah, M. (2020). Determinants of Pregnant Women Participation on Triple Elimination of HIV, Syphilis, and Hepatitis B, in Semarang. Journal of Health Promotion and Behavior, 5(2), 123–134. Retrieved from