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Mary Travis Bassett, MD, MPH

The author is with The Rockefeller Foundation (Southern Africa Office), Harare, Zimbabwe.

Correspondence: Requests for reprints should be sent to Mary Travis Bassett, MD, MPH, The Rockefeller Foundation (Southern Africa Office), Kopje Plaza, 1 Jason Moyo Avenue, Harare, Zimbabwe (e-mail: mbassett{at}rockfound.org.zw).

Since 1999, many African governments have launched programs to offer short-course antiretroviral drug regimens to reduce mother-to child transmission of HIV. HIV testing in prenatal care is the gateway to these antiretroviral regimens. Pilot projects in Africa show an uptake of antiretroviral drugs in 8% to 50% of pregnant women presumed to be HIV infected; often, a minority of eligible women in care received these regimens. Use of lay counselors and rapid onsite HIV testing may alleviate health service barriers.

Community education to promote voluntary counseling and testing, which involves men, is the long-term solution. In the short term, possibilities to enhance delivery of an effective intervention include group pretest counseling, universal offer of testing with women having the right to "opt out," universal treatment (mass treatment for those whose HIV status is not determined by voluntary counseling and testing), universal testing with women having the right to "opt out" of learning their test results, and mass treatment for all without testing.

This article has been cited by other articles:

				C. Varga and H. Brookes Factors Influencing Teen Mothers' Enrollment and Participation in Prevention of Mother-to-Child HIV Transmission Services in Limpopo Province, South Africa Qual Health Res, June 1, 2008; 18(6): 786 - 802. [Abstract] [PDF]

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