American Journal of Obstetrics & Gynecology
Volume 197, Issue 3, Supplement , Pages S83-S89, September 2007

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, MSc

      Affiliations

    • 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
    • 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.
  • ,
  • Virginia Allread, MPH

      Affiliations

    • Francois-Xavier Bagnoud Center, University of Medicine and Dentistry of New Jersey, Newark, NJ
  • ,
  • Tracy Creek, MD, MPH

      Affiliations

    • 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
  • ,
  • Elizabeth Stringer, MD, MSc

      Affiliations

    • University of Zambia School of Medicine, Centre for Infectious Disease Research in Zambia, Lusaka, Zambia
  • ,
  • Fatu Forna, MD, MSc

      Affiliations

    • 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
  • ,
  • Marc Bulterys, MD, PhD

      Affiliations

    • Centers for Disease Control and Prevention, Global AIDS Program, Lusaka, Zambia.
  • ,
  • Nathan Shaffer, MD

      Affiliations

    • 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

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.

Key words: counseling, human immunodeficiency virus, mother-to-child human immunodeficiency virus transmission, testing

 

 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

American Journal of Obstetrics & Gynecology
Volume 197, Issue 3, Supplement , Pages S83-S89, September 2007