What Works for Women and Girls

What Works—Safe Motherhood and Prevention of Vertical Transmission: Testing andCounseling1. Routinely offered testing that is voluntary and accompanied by counseling is acceptableto most women.2. Informed and appropriate counseling during ANC can lead to increased discussionbetween partners and increased protective behaviors such as condom use.3. Involving partners, with women’s consent, can result in increased testing anddisclosure.Promising Strategies:4. Integrating testing and treatment for syphilis with HIV testing for pregnant womenwill reduce congenital syphilis and may reduce perinatal transmission of HIV.5. Where abortions are safe and legal, offering HIV testing to women early in pregnancymay increase access to safe abortion.6. Counseling women during antenatal care regarding the circumcision of male infantsat birth may reduce HIV acquisition and transmission when those male infantsbecome sexually active young men.EVIDENCE1. Routinely offered testing that is voluntary and accompanied by counseling is acceptable tomost women.A survey on acceptance of HIV testing was conducted in Hong Kong’s maternal andchild health centers during a two-month period. The response rate was 98.2% and 2,669valid questionnaires were analyzed. Seventy per cent (n=1,825) of the respondents indicatedtheir acceptance of the test. A significant association was noted between clients’acceptance and access to HIV information by means of posters, pamphlets, videos andgroup talks. Perceived benefits and health care workers’ recommendation were the mainreported reasons for acceptance, whereas no or low perceived susceptibility was the mainreason for refusal. Acceptance was also positively correlated with level of education andHIV knowledge (Lee et al., 2005). (Gray III) (PMTCT, HIV testing, Hong Kong)A questionnaire administered to 146 women at 10 PMTCT centers in Zimbabwe whowere interviewed during the period they were waiting for their HIV test result foundthat 57% were aware of the routine offer of HIV testing at the health institution theywere using, with more than 94% aware that they were having an HIV test among other224 CHAPTER 9 SAFE MOTHERHOOD AND PREVENTION OF VERTICAL TRANSMISSION