Research

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

Avinash K Shetty¹ , Caroline Marangwanda² , Lynda Stranix-Chibanda^3,4 , Winfreda Chandisarewa² , Elizabeth Chirapa² , Agnes Mahomva⁵ , Anna Miller⁶ , Micah Simoyi⁷ and Yvonne Maldonado⁸

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

author email corresponding author email

AIDS Research and Therapy 2008, 5:17doi: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.