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[procaare] Durban 2000: VCT - Attitudes among Pregnant Women in Uganda
- From: ProCAARE <firstname.lastname@example.org>
- Date: Sun, 15 Oct 2000 14:06:31 -0400 (EDT)
Durban 2000: VCT Abstract (3)
'Attitudes to voluntary counselling and testing for HIV among pregnant women and maternity staff in
rural south west Uganda'
M. Gysels, R. Pool, S. Nyanzi
Uganda Virus Research Institute, PO Box 49, Entebbe, Uganda
Vertical transmission rates in Africa are 21-43%, and most infants acquire HIV during the
peripartum period. A recent trial of nevirapine in Uganda showed a reduced risk of HIV
transmission of almost 50% during the first 14-16 weeks of life. Although provision of nevirapine
to all pregnant women may be potentially cost effective, ideally HIV positive pregnant women
should be targeted in poor resource countries. This requires voluntary counselling and testing
(VCT). The attitudes of women and maternity staff to VCT are important to the success of such
24 focus group discussions (FGDs) were carried out with 208 women attending maternity clinics, 5
FGDs were held with 25 maternity staff, and in-depth interviews were held with 8 traditional birth
attendants and 26 women recognised by the community as being knowledgeable about issues relating to
pregnancy in 3 sites in rural SW Uganda.
Almost all women were willing in principle to take an HIV test in the event of pregnancy, and to
reveal their HIV status to maternity staff. They were anxious, however, about confidentiality, and
there was a widespread fear that maternity staff might refuse to assist them when the time came to
deliver if their status were known. This applied more to TBAs than to biomedical health staff.
There were also rumours about medical staff intentionally killing HIV positive patients in order to
stem the spread of the epidemic. Maternity staff were adamant that they would treat knowledge of a
patient's HIV status confidentially. Although they claimed that they would treat HIV positive women
the same as anyone else during delivery, they expressed much anxiety about the possibility of
getting infected, especially due to lack of proper clothing and gloves.
Although VCT during pregnancy is acceptable in principle, much will need to be done to ensure
confidentiality and allay women's fears of stigmatisation and discrimination during delivery.
Maternity staff will also need to be trained and resources made available for adequate protection.
Presenting author: M. Gysels, Uganda Virus Research Institute, PO Box 49, Entebbe, Uganda, Tel.:
+256 41 320 042, Fax: +256 41 321 137, E-mail: email@example.com
[We invite the authors of this abstract to share their views regarding testing in resource-poor
[*VCT = Voluntary Counselling and Testing]
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