What Works for Women and Girls

EVIDENCEPromising Strategies:1. Discussing mother-to-child transmission risk with providers and/or other HIV-positivewomen with seronegative children can increase women’s confidence about preventingmother-to-child transmission of HIV.A 1999–2001 study carried out with 329 HIV-positive women in Thailand found thatsome pregnant HIV-positive women (number not specified) who were originally advisedto abort by providers (number not specified) but were then counseled on PMTCT subsequentlychose to access PMTCT and have a child. One woman said: “A doctor told meabout AZT and its effectiveness, that for every 10 children, only 3 to 5 children wouldcontract HIV [an erroneous statement]. I wanted to try. I really needed my child so theinformation I learned from the doctor made me happier and I decided to keep my pregnancyand wait for the day that I would meet my child” (p. 39). The women were interviewedusing a structured questionnaire. In-depth interviews were conducted among60 HIV-positive women. Four participatory workshops were held on data analysis andreport writing. Women interviewed were selected non-randomly from support groups,clinics, ANC clinics, NGOs and communities using dimensional sampling method.The dimensions used were age (15–25, 26–35, 36–49) and number of years from diagnosis.Women who met the criteria for both dimensions were selected based on convenientor snowball sampling techniques. Six focus group discussions were held with sixto eight men (Yoddumnern-Attig et al., 2004). (Gray IV) (PMTCT, Thailand)Evaluation of the mothers2mothers (m2m) program in South Africa found that the m2mprogram provided a strong continuum of care to the women and infants. Compared tonon-participants, m2m participants had greater psychosocial well-being and greater useof PMTCT services and outcomes. Postpartum program participants were significantlymore likely to have disclosed their status to someone than non-participants, and to havedone so prior to delivery. m2m seeks to reduce PMTCT, empower pregnant and postpartumwomen to improve their health and the health of their babies, fight stigma andencourage and support disclosure. The program offered education and psychosocialsupport to HIV-positive pregnant women and new mothers, assisted women to accessPMTCT services, and followed up to ensure care of mothers and infants after delivery(Baek et al. 2007). (Gray IV) (PMTCT, support groups, South Africa)A study in Cuba found 28 of 55 women interviewed who had given birth in Cuba, saidthat their worries about transmitting HIV to their child subsided after discussing theirpregnancy with doctors, learning about treatment and meeting HIV-positive women whohad had HIV-negative children (Castro et al., 2007). (Gray V) (PMTCT, treatment, Cuba)2. When the woman is HIV-positive, or both male and female partners are HIV-positive andwish to conceive, having an undetectable viral load due to HAART may result in the lowestrisk of perinatal transmission. [See also Chapter 7C. Treatment: Reducing Transmission]WHAT WORKS FOR WOMEN AND GIRLS217