Effectiveness of Antenatal Group HIV Voluntary Counseling and Testing Services in Rural India

Abstract

This study assessed HIV attitudes among pregnant women attending antenatal clinics in the Namakkal district of Tamilnadu, India, as well as HIV knowledge before and after group counseling sessions. Two hundred thirteen women (97%) attending five antenatal clinics in July 2004 accepted HIV counseling and testing and completed precounseling and postcounseling questionnaires. Although the majority of women had heard of HIV, precounseling knowledge was low (mean precounseling score; 6.9/18, SD: 4.53), with scores correlating with the women's educational level and the number of sources from which they had received information about HIV. Posttest scores increased by 21%, however, understanding of modalities to prevent HIV infection remained poor. Group counseling sessions achieve small gains in HIV knowledge, but there is a continued need for ongoing and multifaceted HIV education in rural India.

Systematic review of public health research on prevention of mother-to-child transmission of HIV in India with focus on provision and utilization of cascade of PMTCT services

“…The studies on counseling and HIV testing were divided into two sub-categories. Studies that investigated women’s perspective on counseling and HIV testing were categorized as acceptability and utilization (N = 8) [38,39,42,45,46,48-50], and studies carried out from the perspective of health systems were classified as feasibility and provision of counseling and HIV testing (N = 6) [37,40,41,43,44,47]. …”

“…The availability of testing in the labor room would be of great benefit where there is little or no ANC care available. Studies regarding the process and content of counseling suggest that group antenatal counseling sessions have little impact on women’s understanding of modes of HIV prevention and on informed written consent for HIV testing [41,47]. A study from Pune [47] reported that the inclusion of culturally appropriate visual aid to group education and counseling substantially improved pregnant women’s understanding about the key issues related to informed consent for HIV testing (from 38% to 72% in group counseling and 96% in individual counseling).…”

Is HIV Screening in the Labor and Delivery Unit Feasible and Acceptable in Low-Income Settings?

“…As Sinha and colleagues point out in their sample in rural Maharashtra, many pregnant women have good HIV knowledge and risk awareness, yet providers remain a major roadblock to accessing HIV testing [ 5 ]. Two recent reports of providing HIV testing in rural antenatal care clinics demonstrate the acceptability of VCT in this setting [ 7 , 8 ]. While NACO has recently affirmed its policy of expanding VCT in antenatal care, adoption of the testing approach advocated by Pai et al [ 6 ] would appear to offer an optimal safeguard for HIV-infected women and allow the timely provision of PMTCT care during labor and delivery.…”

Counselling services in prevention of mother-to-child transmission (PMTCT) in Delhi, India: An assessment through a modified version of UNICEF-PPTCT tool

“…Sastry et al demonstrated that complex constructs such as informed consent can be conveyed in populations with little education and within busy government hospital settings, and that the standard model may not be sufficient to ensure true informed consent [16]. Group counselling sessions achieve small gains in HIV knowledge, but there is a continued need for ongoing and multifaceted HIV education [17]. Training programmes for counsellors should focus on making the counsellors understand and realize the importance of informed decision-making and how this would translate to improved service reception, active participation and adherence.…”