What Works for Women and Girls

An evaluation of UNICEF-funded PMTCT programs in 11 developing countries in2002 involving review of progress reports, interviews with PMTCT program managers,rapid assessments in Rwanda and Zambia and site visits in Honduras and India foundthat PMTCT programs did not discourage use of ANC but helped women to disclosetheir HIV testing experience and serostatus to their partners and family, thus fosteringdiscussions and normalizing HIV testing and HIV care (Rutenberg et al., 2003). (GrayV) (PMTCT, HIV testing, antenatal care, Rwanda, Zambia, Honduras, India)Six hundred women from ten antenatal clinics in southern Uganda found that womenwho received pre-test counseling were more 1.84 times more likely to disclose their HIVstatus (Medley et al., 2008c). (Abstract) (counseling, disclosure, Uganda)3. Involving partners, with women’s consent, can result in increased testing and disclosure.A pre-test/post-test study in India between 2000 and 2003 in six antenatal care clinicsfound that counseling that included male partners of pregnant women had a positiveimpact on male involvement in maternity care and increased dual protection andcondom knowledge and use. Of the six clinics, three were used as intervention sites andthree as controls. A total of 2,836 women and 1,897 husbands attending the clinics forantenatal care participated in the pre-test survey, however, only 327 women and theirhusbands completed the intervention and post-test survey and 302 women and theirhusbands from the control group completed the post-test survey. Women and husbandsat the intervention site were counseled at individual, couple, and same-sex group levelson a variety of reproductive health issues, including the prevention of STIs and correctcondom use. Pregnant women were screened for syphilis and men identified as havingurethral discharge and genital ulcers via syndromic management were treated. Twelvedoctors and 12 nurse midwives were trained to provide counseling to both couples andindividuals at the intervention sites. Women and husbands who attended the controlclinics received the standard care for pregnant women, including nutritional informationand tetanus vaccination, but no additional counseling was provided. Knowledgerelated to dual protection benefits of condom use increased among both males andfemales in the intervention group, however, gender disparities continued to pervade as89% of the males exhibited dual protection knowledge compared to only 48% of thefemales. Use of family planning increased significantly during the six-to-nine monthspostpartum period among intervention participants when compared to controls, 59%versus 45% among women and 65% compared to 48% among men. Of the methodsemployed for family planning purposes, condoms were the most commonly used inboth groups, as 66% of women in both groups and 71% of men in both groups reportedusing condoms. Additionally, intent to use condoms in the future was found to behigher among the intervention group than among controls. Men in general tended tohave more knowledge related to STIs, 66% versus 32% of females, and knowledge andcouple communication related to STIs was not found to have increased after the intervention.Lastly, couples who had attended counseling sessions at the intervention clinicsWHAT WORKS FOR WOMEN AND GIRLS227