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Acceptance of VCT among partners of pregnant women participating in PMTCT programs in Botswana P. Ndase, AM Owor, Gaborone Mashi Study Team, L Stocking, C Wester, T Peter, I Thior, M Essex. Background Acceptance of voluntary counseling and HIV testing by pregnant women has been reported to be low in several Sub-Saharan African countries due to fear of an HIV positive result, stigma and lack of support from their partners. As a solution, PMTCT programs are trying to have men involved by offering them VCT through their pregnant partners. Objectives To assess the proportion of partners of pregnant women who will accept VCT and among those who accept VCT, to determine the proportion of discordant couples Methods Between April 15 and December 31, 2002, all pregnant women attending four antenatal clinics in Gaborone Botswana were approached for VCT. Clients were also encouraged to have their male partners undergo VCT. Women who were HIV positive were then counseled about available PMTCT programs and were also screened for eligibility for a national antiretroviral treatment program. If they were found to qualify for HAART i.e CD4 count < 200 cells/mm3 or history of an AIDS defining illness, they were encouraged to bring their partner as a treatment adherence partner and those whose partner’s status was not known would be approached for VCT. Results A total of 2068 of 3101 (67%) pregnant women approached for VCT agreed to undergo HIV testing. HIV infection was detected in 757 (37%) of women tested. Among women tested, 60 (2.9%) of their partners subsequently tested for HIV. In 3 cases, the partners had HIV testing after they came as a treatment adherence partner. 31 (52%) of couples tested were negatively sero-concordant, 14 (23%) were positively sero-concordant and15 (25%) of the 60 couples tested were sero-discordant. The woman was the infected partner in seven cases of which four cases qualified for HAART. Conclusions: This study showed a low acceptance of VCT (2.9%) among partners of pregnant women being screened for PMTCT interventions as well as a high proportion of discordant HIV sero-status (25%) among the couples tested. The low acceptance could be due to the refusal of partners to test but also the refusal of women to disclose their status or to recommend that their partners go for VCT. These findings suggest that a low level of partner participation even in the context of available antiretroviral treatment continues to factor into the success of PMTCT programs in Botswana and may undermine efforts towards HIV risk reduction among couples. |