What Works for Women and Girls

outine tests. Fifty percent of the women who accepted HIV testing directly after groupeducation were not aware of the possibility of opting for individual pre-test counseling.Seven of the nine women who declined HIV testing did not feel that the offer of routineHIV testing would deter them from seeking ANC services. However, “it cannot bedemonstrated from this study whether or not some women are not attending ANCservices due to the implementation of routine offer of HIV testing, since this study wasconducted among women who were already presenting at the health facilities” (Mugoreet al., 2008:663). (Gray V) (PMTCT, HIV testing, antenatal care, Zimbabwe)“Routine but not compulsory” testing was instituted in Botswana after a presidentialdeclaration in 2004. After routine testing started, the percentage of all HIV-infectedwomen delivering in the regional hospital who knew their HIV status increased from47% to 78% and the percentage receiving PMTCT interventions increased from 29% to56%. ANC attendance and the percentage of HIV-positive women who disclosed theirHIV status to others remained stable. Interviews indicated that ANC clients supportedthe policy (Creek et al., 2007). (Gray V) A study to evaluate the first 2.5 years found thatroutine HIV testing (RHT) has been widely accepted by the population. There has beena rapid scale-up of RHT. A total of 60,846 persons were tested through RHT in 2004versus 157,894 in 2005 and 88,218 in the first half of 2006. Testing rates in the populationthrough RHT were 40 per 1000 persons, 93 per 1000 persons, and 104 per 1000persons, respectively. In 2005, 89% of those offered testing accepted, with 69% of thosetested being female and 31% male. The proportion of men who tested HIV-positive was34% versus 30% for women. The main reasons for testing in 2005 were patient’s wish(50%), pregnancy (25%), medical examination (7%), clinical suspicion (6%), and sexuallytransmitted infection (2%). Attendance at voluntary counseling and testing centershas increased parallel to the scale-up of RHT. RHT has been widely accepted by thepopulation, and no adverse effects or instances have been reported. It has providedincreased access to preventive services and earlier assessment for antiretroviral treatment(Steen et al., 2007). (Gray V) (PMTCT, antenatal care, HIV testing, Botswana)In May 2004, PMTCT services were established in the antenatal clinic (ANC) of a200-bed hospital in rural Uganda; in December 2004, ANC PMTCT services becameopt-out, and routine opt-out intrapartum counseling and testing was established in thematernity ward. This study compared acceptability, feasibility, and uptake of maternityand ANC PMTCT services between December 2004 and September 2005 and foundthat counseling and testing acceptance was 97% (3591/3741) among women and 97%(104/107) among accompanying men in the ANC and 86% (522/605) among womenand 98% (176/180) among their male partners in the maternity. Thirty-four womenwere found to be HIV-positive through intrapartum testing, representing a 12% (34/278)increase in HIV infection detection. Of these, 14 received their result and nevirapinebefore delivery. The percentage of women discharged from the maternity ward withdocumented HIV status increased from 39% (480/1235) to 88% (1395/1594) over theperiod (Homsy et al., 2006). (Gray V) (PMTCT, HIV testing, antenatal care, Uganda)WHAT WORKS FOR WOMEN AND GIRLS225