The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #68516

Boniface Sebikali, MD, MPH, Marcel Vekemans, MD, and Pape Gaye, MBA. Intrah/PRIME II, University of North Carolina at Chapel Hill, CB 8100, Chapel Hill, NC 27599-8100

To help stem Rwanda’s estimated 11% rate of HIV infection, the PRIME II Project integrates counseling, testing and treatment for prevention of mother-to-child transmission of HIV into prenatal care and obstetric services at two district hospitals and one health center. PRIME’s assistance is part of a national program to build a foundation for improved prenatal, obstetric and postpartum care, better outcomes for seropositive women and their children, and open dialogue about HIV/AIDS. Since March 2002, PRIME has trained more than 75 providers in Voluntary Counseling and Testing (VCT) skills and taught them how to administer nevirapine to HIV-positive mothers and their infants. Encouraging women who have been tested to return for the results presents a hurdle, given the natural reluctance of women who suspect they are HIV-positive to have such dire news confirmed. Even more challenging is the issue of informing the sexual partners of HIV-positive women and then persuading them to receive VCT. Providers follow-up with HIV-positive mothers who have not returned for results through infant vaccination activities. In addition, PRIME carries out community sensitization campaigns on partner involvement and is testing a system in which partners are invited discreetly by letter to accompany women to prenatal care visits and receive information about VCT. Preliminary results show impressive numbers of women returning for test results, ranging from 82.7% to 100% at the three facilities. While overall rates for partner testing remain low, implementation of the “invitation” system has resulted in 29% of partners receiving VCT at Kigoma health center.

Learning Objectives:

• • Articulate strategies, goals, achievements and lessons learned for the national PMTCT program in Rwanda.
  • Discuss challenges to overcoming the stigma of HIV/AIDS and achieving open dialogue and partner involvement.
  • Assess strategies for encouraging women to return for test results and for informing and persuading partners to receive voluntary counseling and testing.

Keywords: HIV Interventions, Counseling

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.