Barriers to prevention of HIV transmission from mother to child (PMTCT) in a resource poor setting in the Eastern Cape, South Africa

The aim of this study was to investigate knowledge of prevention of mother to child HIV transmission (PMTCT) programmes and to describe potential barriers that might affect their acceptability in a resource poor setting in South Africa. Based on interviews with over 1500 pregnant women, their families and five communities around the PMTCT clinic areas, the authors found that there are several major potential barriers in implementing PMTCT programmes in a resource poor setting.

Overall poor knowledge of PMTCT services was a common problem; whilst most pregnant women, their mothers/in-laws and husbands/partners have relevant HIV knowledge, only one-third were aware of PMTCT. Antenatal clinics provide a good opportunity for HIV counselling and testing of pregnant women, but two thirds of women said that transport costs prevented them from attending. In addition to this an overwhelming majority of women chose not to receive a HIV test because of stigma and fear of being HIV positive, a lack of awareness of where to get tested, and lack of confidentiality of test results. The authors suggest that increased access to HIV testing and counselling would be one of the most effective ways of reducing perinatal transmission. They state that this can be achieved by ensuring that expectant mothers receive antenatal care from trained staff throughout their pregnancy and have a skilled professional childbirth attendant.