Vulnerability of women in an African setting: lessons for mother-to-child HIV transmission prevention programmes

Abstract

After discussing advantages and risks, only a third of the 290 HIV-infected women included in an intervention study to reduce mother-to-child transmission of HIV in Mombasa, Kenya, informed their partners of their results. Despite careful counselling, 10% subsequently experienced violence or disruption of their relationship. To increase the uptake of interventions to reduce perinatal HIV transmission safely, we recommend the involvement of partners in HIV testing. In addition, the counselling of women has to address methods and skills to deal with violence.

Voluntary counseling and testing among post-partum women in Botswana

“…Similar observations were made in several studies [16,[17][18][19][20][21][22][23][24][25][26][27] that looked at the acceptability of voluntary HIV testing by pregnant women in developing countries. This could be explained by the fact that women who were educated feared HIV testing due to their evaluation of risks or implications of a positive HIV result.…”

“…Our acceptance rate of VCT was low compared to reports from several countries where interventions to reduce PMTCT were offered to pregnant women [18]. In our study, infant formula was offered later during the post-partum period.…”

“…Factors associated with reluctance to HIV testing were fear of HIV positive test result, stigmatization, discrimination, domestic violence, separation or divorce, and higher education [8,[16][17][18].…”

Couple-centred testing and counselling for HIV serodiscordant heterosexual couples in sub-Saharan Africa

“…46 At the same time, studies of PMTCT, although not couple-centred, have also concluded that there was a need to "involve" male partners. 48,49 However, in spite of the available data and repeated recommendations, couple-centred approaches to HIV prevention (whether connected with PMTCT or prevention of sexual transmission) have not been implemented on a large scale or, at least, have not been documented in the literature, where others could learn from them. Apart from the experiences reported in Former Zaïre 37 , Rwanda, 38,57 , Zambia 3,14,43,44 , Kenya 45 , and the multi-site study KenyaTanzania-Trinidad 39,40 , it is hard to find in recent years any mention of a couple-centred approach in the scientific literature or in programmatic documents.…”

Results of Social Surveys to Identify Forms of Stigma and Discrimination of People Living With Hiv in Tajikistan

“…Насилие является одним из жестоких последствий стигмы, с которым стал-киваются, главным образом, женщины [32][33][34]. Женщины и девушки сообщают о росте случаев жестокого обращения со стороны их партнеров в ответ на просьбы пользоваться презервативами, обращение в службы добровольного консультирования и тестирования, отказ от половых отношений в браке или от внебрачного секса или получение положительного результата тестирования на ВИЧ [35][36][37][38].…”