Policy Awareness and Practice Gaps in HIV Testing and Mother-to-Child Transmission Prevention in Maternity Clinics in Leyte Philippines

Background: Maternity clinics serve as critical entry points for preventing mother-to-child transmission (MTCT) of HIV through antenatal screening, counseling, and referral. Despite the enactment of the Philippine HIV and AIDS Policy Act (Republic Act No. 11166), variations in the delivery of HIV testing and MTCT prevention services persist across health facilities, particularly at the local level. Objectives: This study described the awareness, attitudes, and practices of nurses and midwives in maternity clinics regarding HIV testing and MTCT prevention in selected municipalities of Leyte, Philippines. Methods: A descriptive cross-sectional survey was conducted among 90 nurses and midwives from public and private maternity clinics in Ormoc City, Baybay City, Albuera, Inopacan, and Hindang. Data were collected using a validated and pilot-tested questionnaire with acceptable to excellent internal consistency (KR-20 = 0.706–0.894). Analysis was limited to frequencies and percentages. Results: Overall awareness of MTCT prevention (90.56%) and government HIV laws and policies (94.89%) was high. Attitudes toward HIV-positive pregnant women were mixed: while 61.11% reported feeling at ease in providing care, 91.11% perceived occupational risk. Regarding practices, 65.56% of clinics reported implementing routine HIV testing for pregnant women, with lower uptake of repeat testing and partner testing. Public clinics were more likely to offer HIV testing than private clinics. Reported constraints included financial limitations (41.11%) and legal or regulatory concerns (35.56%). Conclusion: Although maternity clinic staff demonstrated high awareness of MTCT prevention and HIV policies, inconsistencies in testing practices and residual attitudinal concerns were observed, particularly across facility types. These findings provide baseline descriptive evidence that may inform local planning, monitoring, and strengthening of MTCT prevention services.