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Open Access Highly Accessed Research

The feasibility of preventing mother-to-child transmission of HIV using peer counselors in Zimbabwe

Avinash K Shetty1*, Caroline Marangwanda2, Lynda Stranix-Chibanda34, Winfreda Chandisarewa2, Elizabeth Chirapa2, Agnes Mahomva5, Anna Miller6, Micah Simoyi7 and Yvonne Maldonado8

Author Affiliations

1 Department of Pediatrics, Wake Forest University Health Sciences, Winston-Salem, USA

2 Zimbabwe AIDS Prevention Project-University of Zimbabwe, Harare, Zimbabwe

3 Department of Pediatrics, University of Zimbabwe School of Medicine, Harare, Zimbabwe

4 University of Zimbabwe-University of California San Francisco Collaborative Program in Women's Health, Harare, Zimbabwe

5 Ministry of Health and Child Welfare, Harare, Zimbabwe

6 Elizabeth Glaser Pediatric AIDS Foundation, Harare, Zimbabwe

7 Chitungwiza Health Department, Chitungwiza, Zimbabwe

8 Department of Pediatrics, Stanford University School of Medicine, Palo Alto, USA

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AIDS Research and Therapy 2008, 5:17  doi:10.1186/1742-6405-5-17

Published: 1 August 2008

Abstract

Background

Prevention of mother-to-child transmission of HIV (PMTCT) is a major public health challenge in Zimbabwe.

Methods

Using trained peer counselors, a nevirapine (NVP)-based PMTCT program was implemented as part of routine care in urban antenatal clinics.

Results

Between October 2002 and December 2004, a total of 19,279 women presented for antenatal care. Of these, 18,817 (98%) underwent pre-test counseling; 10,513 (56%) accepted HIV testing, of whom 1986 (19%) were HIV-infected. Overall, 9696 (92%) of women collected results and received individual post-test counseling. Only 288 men opted for HIV testing. Of the 1807 HIV-infected women who received posttest counseling, 1387 (77%) collected NVP tablet and 727 (40%) delivered at the clinics. Of the 1986 HIV-infected women, 691 (35%) received NVPsd at onset of labor, and 615 (31%) infants received NVPsd. Of the 727 HIV-infected women who delivered in the clinics, only 396 women returned to the clinic with their infants for the 6-week follow-up visit; of these mothers, 258 (59%) joined support groups and 234 (53%) opted for contraception. By the end of the study period, 209 (53%) of mother-infant pairs (n = 396) came to the clinic for at least 3 follow-up visits.

Conclusion

Despite considerable challenges and limited resources, it was feasible to implement a PMTCT program using peer counselors in urban clinics in Zimbabwe.