Few women accessing PMTCT services

Few pregnant mothers in Botswana are accessing free HIV/AIDS related services, including free antiretrovirals being provided by the state, says a recent study.

The survey of 504 women at ante-natal clinics and in post-natal wards countrywide, revealed that although 95 percent were accessing the health care provided at these facilities, the utilisation of free Prevention of Mother-To-Child Transmission of HIV (PMTCT) services and voluntary testing was still low - though it had increased from 38 percent in 2002 to 58 percent in 2003.

About 39 percent of young pregant women in Botswana are HIV positive, according to UNAIDS.

"The most common reason for not wanting to be tested is that they doubt their own ability to cope if the test results should indicate they are HIV positive," said Dr Peter Kilmarx, director of the Botswana and USA (BOTUSA) project which conducted the survey. The BOTUSA project, is a collaborative venture between the United States' Centres for Disease Control and the Botswana government.

The study - designed to assess knowledge, attitudes and choices regarding PMTCT among pregnant and post-natal women - found that women who were well informed about PMTCT and AIDS were more likely to allow themselves to be tested for HIV and take antiretrovirals.

Since 2001, the Botswana government has provided voluntary HIV testing during pregnancy, a short course of AZT for mothers and infants, a food formula for the infants for a 12-month period, and also introduced the provision of a single dose of Nevirapine during labour in 2003.

An estimated 42 percent of those surveyed felt they did not have the ability to deal with the stress of being HIV positive, while a further 15 percent believed they would become ill or die if they knew they were HIV positive.

About 29 percent of respondents reportedly found HIV counseling difficult to deal with, and as many as 32 percent wished they had not accessed HIV counseling.

"I think in the old system, the counseling was not focused on routine testing and placed the burden on women to decide on testing. Under the new system, the default is that women will get tested unless they refuse," Kilmarx explained.

The survey revealed that 67 percent of women received advice from a "lay counselor".

"Women are willing to be in the programme, but will often start too late. Women need to start medication on time, which is about four weeks before delivery," Kilmarx told Plusnews.

The survey also showed that 61 percent of pregnancies were unplanned, which made these women more likely to refuse an HIV test.

Kilmarx said, "Strengthening family planning is also very important - HIV positive women should not have unwanted children."