Acceptance of HIV screening in an antenatal population at a referral teaching hospital in Zimbabwe: a substudy of an operational research in prevention of mother to child HIV vertical transmission.

OBJECTIVE: To determine the acceptance of HIV testing by pregnant women referred to the antenatal clinic at a tertiary training hospital. Women who accepted testing and were positive received nevirapine. Their babies also received nevirapine within 72 hours of birth. Doctors, nurses and pharmacists were equipped with counselling and management skills for prevention of mother to child HIV vertical transmission.

DESIGN: Substudy of a prospective operational research.

SETTING: Harare Central Hospital, antenatal clinic.

SUBJECT: 863 women were given lectures in a group followed by individualised pre and post test HIV counselling; 767 accepted testing for HIV.

MAIN OUTCOME MEASURES: Acceptance rates for HIV testing, number of mothers and babies who received nevirapine as well as the characteristics of HIV positive and negative women were analysed.

RESULTS: 89% of the women accepted HIV testing; 44% were positive. Seventy percent of the women who tested positive and their babies received nevirapine.

CONCLUSION: Acceptance rates increased when lectures were given to a group of pregnant women followed by individualised pre and post test counselling. The support and encouragement that the women gave each other may explain this observation. Nevirapine should be issued to pregnant women at the time that the HIV test results are available irrespective of the age of gestation, with instructions to take the drug at the onset of labour at their place of delivery. This practice will increase the uptake of the drug by pregnant women. Medical students, nursing and pharmacy students should be equipped with skills for initiating and managing a mother to child HIV prevention programme during their training followed by refresher courses after graduating.