What Works for Women and Girls

2. Additional efforts are needed to improve information and counseling about HIV duringANC to ensure that pregnant woman and their sexual partners have adequate information.Studies found significant numbers of pregnant women received HIV tests with no counselingand reported that HIV testing was a mandatory part of their antenatal care. Studiesalso found that HIV-positive women feared transmitting HIV to their babies throughcasual contact. Studies found some providers assured women that treatment guaranteedthat there would be no vertical transmission. In addition, studies found that some coupleserroneously believed that sex during pregnancy causes miscarriages.Gap noted, for example, in India (Sinha et al., 2008; Van Hollen, 2007; Rogers et al.,2006); Uganda (Medley et al., 2008a); Vietnam (Nguyen et al., 2008f; Brickley et al.,2008); Kazakhstan (Sandgren et al., 2008); South Africa (Groves et al., 2008); Kenya(Delva et al., 2006); Thailand (Teeraratkul et al., 2005); India, Thailand, Philippines andIndonesia (Paxton et al., 2004a); and Nigeria (Onah et al., 2002).3. Additional efforts are needed to ensure confidentiality in testing. Studies found that womenwere tested without their consent and that providers did not protect women’s confidentiality.Gap noted, for example, in Vietnam (Oosterhoff et al., 2008) and Turkey (Ersoy andAkpinar, 2008).4. Increased support is needed for HIV serostatus disclosure, particularly at key times such asdelivery, infant weaning, and at the resumption of sexual activity. Studies found that disclosureto partners was low and women reported needing additional support to disclose.Gap noted, for example, in Côte d’Ivoire (Tonwe-Gold et al., 2009; Brou et al., 2007).5. Further interventions are needed to provide couples counseling and testing to reduce seroconversionduring pregnancy. Studies found that inadequate numbers of couples are counseledon safer sex during pregnancy and that despite national guidelines, repeat testingduring pregnancy is not routinely done.Gap noted, for example, in South Africa (Peltzer et al., 2009, Moodley et al., 2009);India (Vijayakumari et al., 2008); Swaziland (Keiffer et al., 2008); Zimbabwe (Tavengwaet al., 2007) and in southern Africa (Rutenberg et al., 2001).6. Multiple strategies are needed to promote male involvement in ways that meet pregnantwomen’s needs. Studies found that some women found their partners’ involvement controllingand/or violent and other women wanted more autonomy in health decision-making.Studies also found men lacked information on vertical transmission and felt excluded fromPMTCT programs.Gap noted, for example, in South Africa (Maman et al., 2008b); Tanzania (Theuring etal., 2008); and Uganda (Medley et al., 2008c; Medley et al., 2008d).WHAT WORKS FOR WOMEN AND GIRLS231