@article{PAR00008729,
  title = {{W}omen's views on consent, counseling and confidentiality in {PMTCT} : a mixed-methods study in four {A}frican countries},
  author = {{H}ardon, {A}. and {V}ernooij, {E}. and {B}ongololo-{M}bera, {G}. and {C}herutich, {P}. and {D}esclaux, {A}lice and {K}yaddondo, {D}. and {K}y-{Z}erbo, {O}. and {N}euman, {M}. and {W}anyenze, {R}. and {O}bermeyer, {C}.},
  editor = {},
  language = {{ENG}},
  abstract = {{B}ackground: {A}mbitious {UN} goals to reduce the mother-to-child transmission of {HIV} have not been met in much of {S}ub-{S}aharan {A}frica. {T}his paper focuses on the quality of information provision and counseling and disclosure patterns in {B}urkina {F}aso, {K}enya, {M}alawi and {U}ganda to identify how services can be improved to enable better {PMTCT} outcomes. {M}ethods: {O}ur mixed-methods study draws on data obtained through: (1) the {MATCH} ({M}ulti-country {A}frican {T}esting and {C}ounseling for {HIV}) study's main survey, conducted in 2008-09 among clients ({N} = 408) and providers at health facilities offering {HIV} {T}esting and {C}ounseling ({HTC}) services; 2) semi-structured interviews with a sub-set of 63 {HIV}-positive women on their experiences of stigma, disclosure, post-test counseling and access to follow-up psycho-social support; (3) in-depth interviews with key informants and {PMTCT} healthcare workers; and (4) document study of national {PMTCT} policies and guidelines. {W}e quantitatively examined differences in the quality of counseling by country and by {HIV} status using {F}isher's exact tests. {R}esults: {T}he majority of pregnant women attending antenatal care (80-90%) report that they were explained the meaning of the tests, explained how {HIV} can be transmitted, given advice on prevention, encouraged to refer their partners for testing, and given time to ask questions. {O}ur qualitative findings reveal that some women found testing regimes to be coercive, while disclosure remains highly problematic. 79% of {HIV}-positive pregnant women reported that they generally keep their status secret; only 37% had disclosed to their husband. {C}onclusion: {T}o achieve better {PMTCT} outcomes, the strategy of testing women in antenatal care (perceived as an exclusively female domain) when they are already pregnant needs to be rethought. {W}hen scaling up {HIV} testing programs, it is particularly important that issues of partner disclosure are taken seriously.},
  keywords = {{PMTCT} ; {A}frica ; {HIV} testing ; {C}ounseling ; {C}onsent ; {D}isclosure ; {AFRIQUE} {SUBSAHARIENNE}},
  booktitle = {},
  journal = {{BMC} {P}ublic {H}ealth},
  volume = {12},
  numero = {},
  pages = {26},
  ISSN = {1471-2458},
  year = {2012},
  DOI = {10.1186/1471-2458-12-26},
  URL = {https://www.documentation.ird.fr/hor/{PAR}00008729},
}