HIV-positive women's experiences of a PMTCT programme in rural Malawi.
OBJECTIVE
to explore women's experiences of a prevention of mother-to-child transmission (PMTCT) programme in rural Malawi.


METHODS
an exploratory, qualitative study using in-depth interviews with 24 purposively selected women infected with human immunodeficiency virus (HIV). The women were in three groups of eight: (1) those who delivered at the hospital and took nevirapine (NVP) before birth and whose babies received NVP within 72 hours of birth; (2) those who birthed at home and took NVP before birth but their babies never received NVP; and (3) those who birthed at home and did not take NVP and whose babies did not receive NVP. Data were analysed using content analysis.


RESULTS
four themes emerged: (1) 'a wish to confirm and protect' refers to women's decisions to take the HIV test, (2) 'a revelation for action' is an illustration of how the testing may be part of an empowering process, (3) 'a dilemma between silence and openness' points to the dilemma that women are facing in their decision to share or not to share their HIV status with spouse, family, friends and community, and (4) 'a desire challenged by circumstances, chance and tradition' refers to the circumstances and actions which prevent these women from actually delivering at the hospital to protect their babies from HIV infection.


CONCLUSIONS
the PMTCT programme influences women's lives profoundly, and the importance of quality counselling and strengthening male involvement is stressed as the programme is implemented by an increasing number of service providers.
Malamulo Seventh Day Adventist Hospital, Makwasa, Malawi.
Fyson
F
Kasenga
Anna-Karin
AK
Hurtig
Maria
M
Emmelin
D019380:Anti-HIV Agents / Q000627:therapeutic use; D002755:Choice Behavior; D030881:Disclosure; D005260:Female; D006679:HIV Seropositivity / Q000523:psychology / Q000635:transmission*; D007722:Health Knowledge, Attitudes, Practice; D006297:Health Services Accessibility; D006801:Humans; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control*; D008295:Malawi; D008880:Midwifery / Q000379:methods; D019829:Nevirapine / Q000627:therapeutic use; D009723:Nurse-Patient Relations; D011247:Pregnancy; D015397:Program Evaluation; D036301:Qualitative Research; D019035:Rural Health Services; D012944:Social Support; D055815:Young Adult
D019380:Anti-HIV Agents; D019829:Nevirapine