title: Factors influencing teen mothers' enrollment and participation in prevention of mother-to-child HIV transmission services in Limpopo Province, South Africa.
abstract: In this article, we examine barriers to HIV testing uptake and participation in prevention of mother-to-child HIV transmission (PMTCT) services among adolescent mothers aged 15 to 19 years in rural and urban Limpopo Province, South Africa. We used the narrative research method involving key informants constructing typical case studies of adolescent experiences with HIV testing and entry into PMTCT. Case studies formed the basis of a community-based questionnaire and focus group discussions with adolescent mothers. Client-counselor dynamics during pretest counseling were pivotal in determining uptake and participation, and counselor profile strongly influenced the nature of the interaction. Other factors found to influence adherence to PMTCT recommendations included HIV and early premarital pregnancy stigma, fear of a positive test result, and concerns over confidentiality and poor treatment by health care providers. Adolescents described elaborate strategies to avoid HIV disclosure to labor and delivery staff, despite knowing this would mean no antiretroviral therapy for their newborn infants. Theoretical, methodological, and programmatic implications of study findings are also discussed.
authors.affiliation: Nozizwe Consulting and Human Sciences Research Council, Durban, South Africa.
authors.forename: Christine
authors.initials: C
authors.lastname: Varga
authors.forename: Heather
authors.initials: H
authors.lastname: Brookes
mesh_terms: D015492:AIDS Serodiagnosis; D000293:Adolescent; D000328:Adult; D037001:Directive Counseling; D005260:Female; D017144:Focus Groups; D015658:HIV Infections / Q000517:prevention & control / Q000635:transmission*; D006306:Health Surveys; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control*; D010349:Patient Compliance; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000517:prevention & control / Q000523:psychology*; D011253:Pregnancy in Adolescence / Q000523:psychology*; D011314:Preventive Health Services / Q000706:statistics & numerical data*; D012424:Rural Population; D012725:Sexual Behavior; D013019:South Africa