title: Barriers to access prevention of mother-to-child transmission for HIV positive women in a well-resourced setting in Vietnam.
abstract: BACKGROUND
  According to Vietnamese policy, HIV-infected women should have access at least to HIV testing and Nevirapine prophylaxis, or where available, to adequate counselling, HIV infection staging, ARV prophylaxis, and infant formula. Many studies in high HIV prevalence settings have reported low coverage of PMTCT services, but there have been few reports from low HIV prevalence settings, such as Asian countries. We investigated the access of HIV-infected pregnant women to PMTCT services in the well-resourced setting of the capital city, Hanoi.
  
  
  METHODS
  Fifty-two HIV positive women enrolled in a self-help group in Hanoi were consulted, through in-depth interviews and bi-weekly meetings, about their experiences in accessing PMTCT services.
  
  
  RESULTS
  Only 44% and 20% of the women had received minimal and comprehensive PMTCT services, respectively. Nine women did not receive any services. Twenty-two women received no counselling. The women reported being limited by lack of knowledge and information due to poor counselling, gaps in PMTCT services, and fear of stigma and discrimination. HIV testing was done too late for optimal interventions and poor quality of care by health staff was frequently mentioned.
  
  
  CONCLUSIONS
  In a setting where PMTCT is available, HIV-infected women and children did not receive adequate care because of barriers to accessing those services. The results suggest key improvements would be improving quality of counselling and making PMTCT guidelines available to health services. Women should receive early HIV testing with adequate counselling, safe care and prophylaxis in a positive atmosphere towards HIV-infected women.
authors.affiliation: Faculty of Public Health, Hanoi Medical University, Hanoi, Vietnam. anhstat@yahoo.com
authors.forename: Thu Anh
authors.initials: TA
authors.lastname: Nguyen
authors.forename: Pauline
authors.initials: P
authors.lastname: Oosterhoff
authors.forename: Yen Pham
authors.initials: YP
authors.lastname: Ngoc
authors.forename: Pamela
authors.initials: P
authors.lastname: Wright
authors.forename: Anita
authors.initials: A
authors.lastname: Hardon