title: Approaches for scaling up human immunodeficiency virus testing and counseling in prevention of mother-to-child human immunodeficiency virus transmission settings in resource-limited countries.
abstract: Prevention of mother-to-child human immunodeficiency virus (HIV) transmission (PMTCT) programs have nearly eliminated mother-to-child transmission of HIV in developed countries, but progress in resource-limited countries has been slow. A key factor limiting the scale-up of PMTCT programs is lack of knowledge of HIV serostatus. Increasing the availability and acceptability of HIV testing and counseling services will encourage more women to learn their status, providing a gateway to PMTCT interventions. Key factors contributing to the scale-up of testing and counseling include a policy of provider-initiated testing and counseling with right to refuse (opt-out); group pretest counseling; rapid HIV testing; innovative staffing strategies; and community and male involvement. Integration of testing and counseling within the community and all maternal and child health settings are critical for scaling-up and for linking women and their families to care and treatment services. This paper will review best practices needed for expansion of testing and counseling in PMTCT settings in resource-limited countries.
authors.affiliation: Centers for Disease Control and Prevention, National Center for HIV, Hepatitis, STD, and TB Prevention, Global AIDS Program, Prevention of Mother-to-Child HIV Transmission Team, Atlanta, GA 30333, USA. obolu@cdc.gov
authors.forename: Omotayo O
authors.initials: OO
authors.lastname: Bolu
authors.forename: Virginia
authors.initials: V
authors.lastname: Allread
authors.forename: Tracy
authors.initials: T
authors.lastname: Creek
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Stringer
authors.forename: Fatu
authors.initials: F
authors.lastname: Forna
authors.forename: Marc
authors.initials: M
authors.lastname: Bulterys
authors.forename: Nathan
authors.initials: N
authors.lastname: Shaffer
mesh_terms: D000349:Africa; D003376:Counseling; D036861:Delivery, Obstetric; D003955:Diagnostic Tests, Routine; D005260:Female; D015658:HIV Infections / Q000175:diagnosis* / Q000635:transmission*; D006295:Health Resources / Q000600:supply & distribution*; D006801:Humans; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control*; D007743:Labor, Obstetric; D008297:Male; D010353:Patient Education as Topic / Q000379:methods; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000175:diagnosis*