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Volume 197, Issue 3, Supplement, Pages S83-S89 (September 2007)


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Approaches for scaling up human immunodeficiency virus testing and counseling in prevention of mother-to-child human immunodeficiency virus transmission settings in resource-limited countries

Omotayo O. Bolu, MBBS, MSc1Corresponding Author Informationemail address, Virginia Allread, MPH2, Tracy Creek, MD, MPH1, Elizabeth Stringer, MD, MSc3, Fatu Forna, MD, MSc1, Marc Bulterys, MD, PhD4, Nathan Shaffer, MD1

Received 15 December 2006; received in revised form 14 February 2007; accepted 1 March 2007.

Prevention of mother-to-child human immunodeficiency virus (HIV) transmission (PMTCT) programs have nearly eliminated mother-to-child transmission of HIV in developed countries, but progress in resource-limited countries has been slow. A key factor limiting the scale-up of PMTCT programs is lack of knowledge of HIV serostatus. Increasing the availability and acceptability of HIV testing and counseling services will encourage more women to learn their status, providing a gateway to PMTCT interventions. Key factors contributing to the scale-up of testing and counseling include a policy of provider-initiated testing and counseling with right to refuse (opt-out); group pretest counseling; rapid HIV testing; innovative staffing strategies; and community and male involvement. Integration of testing and counseling within the community and all maternal and child health settings are critical for scaling-up and for linking women and their families to care and treatment services. This paper will review best practices needed for expansion of testing and counseling in PMTCT settings in resource-limited countries.

1 Centers for Disease Control and Prevention, National Center for HIV, Hepatitis, STD, and TB Prevention, Global AIDS Program, Prevention of Mother-to-Child HIV Transmission Team, Atlanta, GA

2 Francois-Xavier Bagnoud Center, University of Medicine and Dentistry of New Jersey, Newark, NJ

3 University of Zambia School of Medicine, Centre for Infectious Disease Research in Zambia, Lusaka, Zambia

4 Centers for Disease Control and Prevention, Global AIDS Program, Lusaka, Zambia.

Corresponding Author InformationReprints: Dr Omotayo O. Bolu, Centers for Disease Control and Prevention, National Center for HIV, Hepatitis, STD, and TB Prevention, Global AIDS Program, Prevention of Mother-to-Child HIV Transmission Team, 1600 Clifton Rd, MS E-04, Atlanta, GA 30333.

 The findings and views expressed herein are those of the authors and do not necessarily represent the views of the U.S. Centers for Disease Control and Prevention.

PII: S0002-9378(07)00296-7

doi:10.1016/j.ajog.2007.03.006


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